Disease In Different Regions Research Articles

CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF RESPIRATORY SYNCYTIAL VIRUS INFECTION IN CHILDREN THE FIRST YEAR OF LIFE

The purpose was to study the clinical and epidemiological features of respiratory syncytial virus infection in hospitalized children the first year of life with lower respiratory tract diseases in different regions of the Russian Federation (Russia) during the 2015–2016 epidemic season.Materials and methods: in the original study data of a multicentre observational study conducted on the basis of children’s hospitals in St. Petersburg, Arkhangelsk, Kazan, and Saratov are presented. Etiology of acute respiratory viral infections were confirmed by examination of smears from the posterior pharyngeal wall by polymerase chain reaction. The study sample included 991 child’s first year of life with lesions of the lower respiratory tract.Results. In the etiological structure of the surveyed children in the season of 2015-2016, RSVI ranged from 14% to 46,2%, an average of 33%. RSVI dominated in the Centers of St. Petersburg (38,3%), Arkhangelsk (36.2%) and Kazan (42.5 per cent).RSVI significantly more often (p<0.01) leads to the development of bronchiolitis (29.4% against 16.3% and 10.0%, with rhinovirus infection and parainfluenza, respectively. Patients with RSUI often develop pneumonia (23,5%) vs 20.6% and 20,0% with rhinovirus infection, and parainfluenza. Patients with RSVI often suffer severe forms of the disease require oxygen support (13,8%) and treatment in the departmentof intensive care (15,9%).Seasonal peaks of hospitalization due to RSVI in all Centres were recorded in December-April 2015 and 2016. Regional differences in monthly intensity of hospitalization of children with RSVI were established.Thus, the high prevalence of RSVI among children in the first year of life, especially with heavy and complicated forms of lower respiratory tract disorders requiring intensive care benefits, represents a socially important issue, which requires monitoring for effective prevention in children at risk.

Identification of Two New Races of Podosphaera xanthii Causing Powdery Mildew in Melon in South Korea.

Powdery mildew caused by the obligate biotrophic fungus Podosphaera xanthii poses a serious threat to melon (Cucumis melo L.) production worldwide. Frequent occurrences of the disease in different regions of South Korea hints at the potential existence of several races which need to be identified. The races of five isolates collected from different powdery mildew affected regions were identified based on the pathogenicity tests of these isolates on eight known differential melon cultigens namely, SCNU1154, PMR 45, WMR 29, PMR 5, MR-1, PI124112, Edisto 47 and PI414723. None of the isolates have shown same disease responses to those of the known races tested in this study and in previous reports on these identical differential melon cultigens. This indicates that the tested uncharacterized isolates are new races. Among the isolates, the isolates from Hadong, Buyeo, Yeongam and Gokseong have shown same pathogenicity indicating the possibility of these isolates being one new race, for which we propose the name ‘race KN1’. The isolate of Janghueng have also shown unique disease response in the tested differential melon cultigens and hence, we identified it as another new race with a proposed name ‘race KN2’. Report of these new races will be helpful in taking effective control measures in prevalent regions and for future breeding programs aimed at developing varieties that are resistant to these race(s).

THIRTY-YEAR CHANGES IN AVERAGE BLOOD LIPIDS LEVELS IN POPULATIONS OF THE RUSSIAN FEDERATION AND THE USA

Aim. To conduct a comparative study of the changes in blood lipids profiles in populations of the Russian Federation (RF) and the United States of America (USA) in different age and gender groups over the period from 1975 to 2014. Material and methods. Using a secondary analysis of data obtained from the RF population studies carried out in 1975-1982, the multicenter epidemiological study of cardiovascular diseases in different regions of the RF (ESSE-RF), conducted in 2012-2014, as well as the NHANES series of crosssectional surveys in the civilian non-institutionalized population of the USA (NHANES II in 1976-1980 and Continuous NHANES in 2007-2012), we evaluated average lipids in blood tests in men and women of different age groups, with a total number of 48,974 observations. Results. At present, in the RF population, as compared to the USA one, most age groups demonstrate a higher concentration of total cholesterol, i.e. p<0.05 in all groups except for men aged 25-34 years (distinctions are absent) and women aged 25-34 (the concentrations are lower in Russia, p=0.05); a higher concentration of high-density lipoprotein cholesterol, i.e. p<0.005 in all men and p≤0.05 in women younger than 45 years, while in women aged 45-54 years the differences are non-significant; in 55-64-year-old women high-density lipoprotein cholesterol is higher in the USA; the concentration of triglycerides in Russia is lower in comparison with the USA in all age groups of men and women (p<0.01). Over the three decades, the total cholesterol concentration has declined in both countries; the patterns in theUnited States in comparison withRussia are characterized by an increase in the concentration of high-density lipoprotein cholesterol in all age groups and by the absence of a negative trend in triglyceride concentrations. Conclusion. Currently, inRussia, the total cholesterol and low-density lipoprotein cholesterol levels are worse, while triglycerides and partly high-density lipoprotein cholesterol concentrations are better than in theUSA. In general, the thirty-year trends for the aggregate of lipid metabolism parameters are better in theUSA population as compared toRussia.

Comparison of microbiota and allergen profile in house dust from homes of allergic and non-allergic subjects- results from the GUSTO study

Background The prevalence of allergic diseases, such as asthma, allergic rhinitis, eczema and food allergy, has been increasing worldwide, as shown in a large number of studies, including the International Study of Asthma and Allergies in Childhood (ISAAC). However, there is significant variation in the prevalence of these diseases in different regions, suggesting that there may be location-specific factors such as environment and microbial exposure affecting allergic disease prevalence. Hence, in this study we determine if there is a difference in microbiota composition and allergen concentration of household dust collected from the homes of non-allergic and allergic subjects from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort.Methods From the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort, 25 allergic subjects and 25 non-allergic subjects were selected at the year 5.5 follow up. Definitions of allergic outcomes were standardized in the questionnaires administered at 3, 6, 9, 12, 15, 18, 24, 36, 48 and 60 months to ensure consistency during interviews and home visits. Allergen sensitization was determined by skin prick testing (SPT) at 18, 36 and 60 months. Dust samples were collected from the subject’s bed, sofa, and play area. DNA extraction was carried out and V3-V4 hypervariable regions of bacterial 16S rRNA gene were sequenced. Protein extraction was performed and allergens assayed by using multiplex assay and ELISA.Results The most abundant phyla in house dust were Actinobacteria (29.8%), Firmicutes (27.7%), and Proteobacteria (22.4%). Although there were no differences in bacteria abundance and diversity between house dust samples of allergic and non-allergic subjects, the relative abundance of Anaplasmataceae, Bacteroidaceae, and Leptospiraceae were significantly higher in dust samples of allergic subjects as compared to non-allergic subjects in 2 or more locations. The concentration of Der p 1 was significantly lower in bed dust samples of allergic subjects (Median [Interquartile range], 174 ng/g [115–299 ng/g]) as compared to non-allergic subjects (309 ng/g [201–400 ng/g]; P < 0.05). The concentration of tropomyosin was significantly higher in sofa dust samples of allergic subjects (175 ng/g [145–284 ng/g] as compared to non-allergic subjects (116 ng/g [52.8–170 ng/g]; P < 0.05).Conclusion In conclusion, we found a differential microbiota and allergen profile between homes of allergic and non-allergic subjects.Trial registrationNCT01174875 Registered 1 July 2010, retrospectively registered.

Geographic Information System (GIS) as a Tool in the Epidemiological Assessment of Wetwood Disease on Elm Trees in Tabriz City, Iran

AbstractPlants disease epidemiology provides us with some information about the spread of diseases in different regions with various climates and helps us conduct suitable managing operations and predictions about the spread of disease to other areas. Geographic Information System (GIS) has been widely used as an important tool in epidemiological studies. Wetwood disease is one of the most important bacterial diseases on elm trees found in the Northwest of Iran. The disease has spread in different regions of Tabriz (located in the Northwest of Iran), which has become terribly epidemic. Geographic Information System as an appropriate tool in epidemiological examination of plant disease is useful in various ways. In this study, the epidemiology of bacterial wetwood disease on elm trees in Tabriz was investigated using GIS databases. The results indicate that the disease has become epidemic in different areas of Tabriz. According to the results, although the disease was not found in some regions, its severity was very high in some other areas. Based on the distribution map, the wetwood disease most highly exists in the central regions and some parts of the northern regions of the city, but eastern regions are least affected.

Prevalence of arterial hypertension in the Krasnoyarsk Krai (Siberia, Russia)

BackgroundTo estimate the prevalence, awareness, treatment and control of arterial hypertension among adult inhabitants of Krasnoyarsk Krai using the data from Russian multicenter epidemiological study ESSE-RF (Epidemiological Survey of cardiovascular diSEases in different regions of the Russian Federation).MethodsThe study included 1603 subjects 25 to 64 years old selected by means of systemic multistage stratified randomization among urban and rural inhabitants of Krasnoyarsk Krai recruited between February 2014 and June 2014. Office blood pressure (BP) was measured twice with “Omron” automated BP device on the right arm in the sitting position in presence of medical personnel. Arterial hypertension (HTN) was defined as systolic BP of at least 140 mmHg and/or diastolic BP of at least 90 mmHg or self-reported previous elevated BP registration or use of antihypertensive treatment. Treatment efficacy was defined as percentage of patients achieved the target BP level among those who received antihypertensive medications, and HTN control as percentage of people achieved the target BP level among all hypertensives.ResultsThe gender distribution was 652 males (39.4%) and 951 females (60.6%). The average level of systolic BP was 133.4 ± 0.5 mmHg, diastolic BP – 82.9 ± 0.3 mmHg. The average prevalence of HTN was estimated at 49.4% and appeared to be higher than similar parameter based on the data of 10 regions from the ESSE-RF study (44%). The average prevalence of HTN was estimated at 56.3% in males and 43.7% in females. The HTN prevalence in rural community was significantly higher in comparison with urban community (63.4 ± 2.4 vs. 44.2 ± 1.5%, p < 0.01). The average rate of HTN awareness in Krasnoyarsk Krai was 77.9% (average Russian value from ESSE-RF study was 73.1%). The average use of antihypertensive treatment, its efficacy and HTN control in Krasnoyarsk Krai were estimated at 59.5%, 31.6% and 18.8%, respectively.ConclusionsEstimated prevalence of HTN in Krasnoyarsk Krai is higher than the average Russian parameter. The average HTN prevalence among men is higher than in women. The rural inhabitants are more likely to have hypertension compared with urban inhabitants. Despite high levels of HTN awareness and antihypertensive medication intake, the antihypertensive treatment efficacy in Krasnoyarsk Krai appeared to be lower in comparison with average Russian ESSE-RF values.

Frequency of detection of congenital heart diseases in different regions of Kyrgyz Republic

In this article, we present preliminary results of screening for congenital heart diseases (CHD) in Kyrgyz Republic. Pilot project for early diagnostics of CHD, launched in this year, shows initial results of screening in remote areas of our country.

Cardiovascular risk factors in people with high normal blood pressure in Russian population (based on data obtained in ESSE-RF epidemiological study)

Introduction. High normal blood pressure (HNBP) is reported to result in arterial hypertension (AH), especially when associated with various risk factors. Still only few studies on HNBP prevalence in Russian population have been carried out. Objective. To study the prevalence of HNBP and its association with age, gender, and traditional cardiovascular risk factors (CVRFs) in adult population of 12 regions of Russia. The study is based on data obtained in ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Regions of Russian Federation) study. Materials and methods. The analysis of data obtained in ESSE-RF study, which included 21 887 patients aged 25-64 years, was performed. The group of patients not taking antihypertensive and/or statin therapy (n=12 897, 41 % male, 59% female) was selected for the analysis. The patients were divided into 3 groups according to blood pressure (BP) levels. The first group included 7095 patients with normal BP, the second group included 2415 patients with HNBP (130-139/85-89 mmHg), the third - 3387 patients with AH. A detailed analysis of CVRFs was performed, including family history, obesity, diabetes mellitus (DM), ischemic heart disease (IHD), low density lipoprotein (LDL) and cholesterol levels, and glucose level. Results. The prevalence of HNBP was 19% (22% in male population, 16% in female). The prevalence rates were higher in younger age male groups (&lt; 45 years); in female groups the prevalence rates correlated with age. The patients with HNBP had more CVRFs than ones with normal BP. According to multivariant analysis, HNBP was associated with obesity with odds ratio (OR) from 1.32, (95% confidence interval [CI]), to 1.7 (95% CI); gender with OR from 1.54 (95% CI) to 3.89 (95% CI); high LDL and cholesterol levels, and high glucose levels. No direct relation between HNBP and positive family history, DM or IHD was found. Conclusion: The study demonstrates that HNBP is a relevant issue in Russia that requires further research. It also illustrates the necessity of targeting the individuals with HNBP in order to control CVRFs.

Sensitization to common allergens among patients with allergies in major Iranian cities: a systematic review and meta-analysis.

Various allergens are implicated in the pathogenesis of allergic diseases in different regions. This study attempted to identify the most common allergens among patients with allergies based on the results of skin prick tests in different parts of Iran. Relevant studies conducted from 2000 to 2016 were identified from the MEDLINE database. Six common groups of allergen types, including animal, cockroach, food, fungus, house dust mite, and pollen were considered. Subgroup analysis was performed to determine the prevalence of each type of allergen. The Egger test was used to assess publication bias. We included 44 studies in this meta-analysis. The overall prevalence of positive skin test results for at least one allergen was estimated to be 59% in patients with allergies in various parts of Iran. The number of patients was 11,646 (56% male and 44% female), with a mean age of 17.46±11.12 years. The most common allergen sources were pollen (47.0%), mites (35.2%), and food (15.3%). The prevalence of sensitization to food and cockroach allergens among children was greater than among adults. Pollen is the most common allergen sensitization in cities of Iran with a warm and dry climate; however, sensitization to house dust mites is predominant in northern and southern coastal areas of Iran.

Occupational inequalities in self-rated health and non-communicable diseases in different regions of Europe: findings from the European Social Survey (2014) special module on the social determinants of health.

Socioeconomic inequalities in the prevalence of non-communicable diseases (NCDs) are evident across European populations. Several previous studies have addressed the question of whether occupational inequalities in health differ across European regions. It is uncertain however, the degree to which occupational inequalities in NCDs are similar or dissimilar across different European regions. Using 2014 European Social Survey data from 20 countries, this article examines occupational inequalities in poor self-rated health (SRH) and 14 self-reported NCDs separately for women and men, by European region: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. Age-controlled adjusted risk ratios were calculated and separately compared a working class and intermediate occupational group with a salariat group. Working class Europeans appear to have the highest risk of reporting poor SRH and a number of NCDs. We find inequalities in some NCDS to be the largest in the Northern region, suggesting further evidence of a Nordic paradox. Like some previous work, we did not find larger inequalities in poor SRH in the Central/East region. However, we did find the largest inequalities in this region for some NCDs. Our results do not align completely with previous work which finds smaller health inequalities in Southern Europe. This work provides a first look at occupational inequalities across a range of NCDs for European men and women by region. Future work is needed to identify the underlying determinants behind regional differences.

Факторы риска сердечно-сосудистых заболеваний у лиц с высоким нормальным артериальным давлением в Российской Федерации (по данным эпидемиологического исследования ЭССЕ-РФ)

Introduction. High normal blood pressure (HNBP) is reported to result in arterial hypertension (AH), especially when associated with various risk factors. Still only few studies on HNBP prevalence in Russian population have been carried out. Objective. To study the prevalence of HNBP and its association with age, gender, and traditional cardiovascular risk factors (CVRFs) in adult population of 12 regions of Russia. The study is based on data obtained in ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Regions of Russian Federation) study. Materials and methods. The analysis of data obtained in ESSE-RF study, which included 21 887 patients aged 25-64 years, was performed. The group of patients not taking antihypertensive and/or statin therapy (n=12 897, 41 % male, 59% female) was selected for the analysis. The patients were divided into 3 groups according to blood pressure (BP) levels. The first group included 7095 patients with normal BP, the second group included 2415 patients with HNBP (130-139/85-89 mmHg), the third - 3387 patients with AH. A detailed analysis of CVRFs was performed, including family history, obesity, diabetes mellitus (DM), ischemic heart disease (IHD), low density lipoprotein (LDL) and cholesterol levels, and glucose level. Results. The prevalence of HNBP was 19% (22% in male population, 16% in female). The prevalence rates were higher in younger age male groups (< 45 years); in female groups the prevalence rates correlated with age. The patients with HNBP had more CVRFs than ones with normal BP. According to multivariant analysis, HNBP was associated with obesity with odds ratio (OR) from 1.32, (95% confidence interval [CI]), to 1.7 (95% CI); gender with OR from 1.54 (95% CI) to 3.89 (95% CI); high LDL and cholesterol levels, and high glucose levels. No direct relation between HNBP and positive family history, DM or IHD was found. Conclusion: The study demonstrates that HNBP is a relevant issue in Russia that requires further research. It also illustrates the necessity of targeting the individuals with HNBP in order to control CVRFs.

Spray dried plasma as an alternative to antibiotics in piglet feeds, mode of action and biosafety.

The use of growth promoting and therapeutic antibiotics in piglet feed has been a concerning subject over the last few decades because of the risk of generating antimicrobial resistance that could be transferred to humans. As a result, many products have been proposed as potential alternatives to the use of antibiotics, and among these, spray dried plasma is considered one of the most promising. However, there have been concerns about its biosafety, particularly during periods of emergence or re-emergence of swine diseases in different regions of the world, such as the recent porcine epidemic diarrhea virus outbreak in North America. The objectives of this paper are to review recent publications about the use of spray dried plasma as an alternative to antibiotics in weaned pig diets, the possible mechanisms of action of spray dried plasma, and the existing evidence related to the biosafety of spray dried animal plasma. Particular attention is given to studies in which spray dried plasma has been directly compared to antibiotics or other alternative antimicrobial products. Several studies on the possible modes of action for spray dried plasma, such as preservation of gut barrier function or modulation of the immune response, are also reviewed. Finally, the paper focuses on the review of the existing studies on the risks of disease transmission with the use of spray dried plasma from porcine origin. Overall, spray dried plasma is a promising alternative to in-feed antimicrobials for piglets, particularly during the early stages of the post-weaning phase. Additionally, there is enough evidence to support that commercial spray dried porcine plasma is a safe product for pigs.

Quantifying the Impact of Floods on Bacillary Dysentery in Dalian City, China, From 2004 to 2010.

Studies quantifying relationships between floods and diarrheal diseases have mainly been conducted in low-latitude regions. It's therefore increasingly important to examine these relationships in midlatitude regions, where they may have significant public health implications. This study aimed to examine the association between floods and bacillary dysentery in the city of Dalian, China. A generalized additive mixed model was applied to examine the association between floods and bacillary dysentery. The relative risk (RR) of flood impact on bacillary dysentery was estimated. A total of 18,976 cases of bacillary dysentery were reported in Dalian during the study period. Two weeks' lagged effect was detected from the impact of floods on bacillary dysentery. The RR of flood impact on bacillary dysentery was 1.17 (95% CI: 1.03-1.33). Floods have significantly increased the risk of bacillary dysentery in Dalian. More studies should focus on the association between floods and infectious diseases in different regions. Our findings have significant implications for managing the negative health impact of floods in the midlatitude region of China. (Disaster Med Public Health Preparedness. 2017;11:190-195).

A Survey of Knowledge, Attitudes, and Practices in Relation to Mosquitoes and Mosquito-Borne Disease in Western Australia.

On average, more than 1,000 individuals will acquire a mosquito-borne disease in Western Australia (WA) each year. Knowledge, attitudes, and practices (KAP) in relation to mosquitoes and mosquito-borne disease have not yet been investigated within Australia. A randomized telephone survey of 2,500 households across 12 regions in WA was undertaken between February and May 2014. The aim of the survey was to obtain baseline KAP data surrounding mosquitoes and mosquito-borne diseases in different regions of WA, across a range of age groups and between males and females. The results of this survey indicate that the majority of respondents are aware of the potential for mosquitoes in WA to transmit Ross River virus, while awareness of other endemic mosquito-borne diseases remains limited. Common misconceptions exist in relation to exotic mosquito-borne diseases, with respondents incorrectly identifying malaria and dengue as endemic diseases in WA. The survey also highlighted a range of important issues, such as limited awareness of the potential for backyard breeding in domestic containers, occupational exposure to mosquitoes in regions with a large employment base in the mining and resources sector, increased exposure to mosquitoes as a result of participation in outdoor recreational activities in the north of the State, and reduced awareness of mosquito-borne disease in individuals aged 18–34 years. The results of this study will be used to inform the development of a new communication strategy by the Department of Health, to further raise awareness of mosquito-borne disease in WA. The data will then provide a baseline against which to compare future survey results, facilitating the rigorous evaluation of new communication efforts.

EMOTIONAL STATUS AND FOOD PREFERENCE STYLE: THE RESULTS OF THE EPIDEMIOLOGICAL STUDY ESSE-RF IN SAINT-PETERSBURG, SAMARA AND ORENBURG

Aim. To study the relation of emotional status with negative tendencies in food preference style in Russian population, including regional specifics of Saint-Petersburg, Samara and Orenburg. Material and methods. The study is the part of ESSE-RF (Epidemiology of Cardiovascular diseases in different regions of Russian Federation). Totally 1941 men and 2859 women studied at the age 25-64 y.o. — citizens of Saint-Petersburg, Samara and Orenburg. The socio- demographic data assessed, as absence/presence of cardiovascular disorders, diabetes and gastrointestinal disorders (by self-report), some parameters of the food preference style and emotional status using the Hospital Score of depression and anxiety. Results. The preference of animal fats was registered in 4,8%, daily intake of sausages in 22,4%, confectionery — in 48,4%, &gt;6 tea spoons of sugar — in 36,5% respondents. The risk factors for pernicious habits were male gender, younger age, lower income, and tendency to spend most part of the income for food. In 51,3% of participants there were increased values on anxiety score and in 30,3% — increased depression scores. Probability of animal fats preference — odds ratio (OR)=1,89, confidence interval (CI) 95%=1,40-2,57 (p&lt;0,001), and regular intake of sausages and meat plucks — OR=1,67, CI 95%=1,41-1,96 (p&lt;0,01), was higher in persons with depressive states; at the same time the probability of daily intake of confectioneries and sweets was significantly lowered — OR=0,83, CI 95%=0,72-0,96 (p=0,01). Inhabitants of Orenburg and Samara had much more probably prefer sausages and animal fats comparing to Saint-Petersburg citizens, and the risk of depression was significantly variable in regions: being maximum in Orenburg — 43,9% vs 20,6% in Saint-Petersburg and 26,3% in Samara (p&lt;0,001) without significant differences by anxiety levels. Conclusion. There is an interdependence of emotional status and food preference of a person. Emotional state, at the most related to an actualization of "pernicious" eating habits, reflects the depression. Presence of depression signs is linked with more common intake of animal fats and sausages, but less common intake of confectioneries and sweets. Interregional differences in the eating style and risks of the health disorders might probably be defined with the differences in life quality of the people.

Editorial: Frontiers in Autoimmune Disease: Rheumatic Fever and Rheumatic Heart Disease.

Rheumatic fever (RF) and rheumatic heart disease (RHD), its most clinically consequence, resulting from untreated throat Streptococcus pyogenes infection in susceptible children, are considered as models of autoimmune post-infectious disease. This Research Topic compiled clinical and scientific data and brings interesting viewpoints of clinicians and basic researchers. The ensemble of data and ideas certainly makes a new portrait of the mechanisms leading the autoimmune reactions. On the other hand, the clinical data contributes with the diagnosis and prevention of the disease. Rheumatic fever and RHD are still prevalent in diverse regions of the world (1–3). The correct diagnosis is very important as well as the clinical treatment. Briefly, in Brazil, both RF and RHD are still important diseases in different regions (4). A RF prevention program involving more than 700 children with RF/RHD was performed. This program evaluated the long-term evolution and outcomes after the control of recurrences. These data are presented and discussed by Mota et al. (5). Another interesting article, done by Spina et al., discusses the clinical diagnosis of acute rheumatic myocarditis in asymptomatic RHD patients (6). As RF and RHD are autoimmune diseases, the mechanisms leading to autoimmune reactions involve several molecules that play a role in the immune response against the bacteria (7, 8). As we know, protective response involves several molecules that are genetically controlled, from both innate and adaptive immune response, in order to eradicate an infection (8). Among these molecules, complement plays an important role in the immune response against S. pyogenes. The lectin pathway of complement and RHD is discussed by the group de Messias-Reason (9). Another interesting article on autoimmune targets is presented by Root-Bernstein. In his article, a parallel between molecular mimicry reactions on RHD and autoimmune myocarditis is established (10). Rheumatic fever and RHD are considered as prototypes of human autoimmune diseases, and no animal models could reproduce accurately the disease. In the past few years, however, experiments on Lewis rat showed some similar autoimmune reactions in the myocardium of S. pyogenes immunized mice. The article by the group of Ketheesan presented a historical overview of animal models that were used to investigate the pathogenesis of RF/RHD (11). I hope the readers enjoy this collection, and I and my co-editors are grateful of having the opportunity to prepare this Research Topic for Frontiers in Pediatrics.

How Do Plant Diseases Caused by Xylella fastidiosa Emerge?

Emerging plant diseases frequently have significant economic, environmental, cultural, and social impacts. The prediction of new disease emergence, associated with new pathogens or not, remains a difficult and controversial topic. The main factors driving epidemics are often only identified several years after outbreaks, generally revealing that a limited number of factors are associated with the emergence of specific groups of pathogens. This pattern is illustrated in the insect-borne xylem-limited bacterium Xylella fastidiosa, an organism associated with several new plant diseases in different regions of the globe. Research during the last decade focusing on several severe disease outbreaks has led to substantial changes in our understanding of X. fastidiosa biology, ecology, and evolution. This new information has not only led to new insights into aspects of the biology of this bacterium and its interactions with plant and insect hosts, but also made available a phylogenetic framework that has allowed for better inferences concerning factors leading to the emergence of diseases. Here we identify and discuss these main pathways leading to epidemics caused by X. fastidiosa. Our ultimate goal was to raise critical questions and issues for academics and regulatory agencies alike, since the information generated during the last decade has both raised new questions but also clarified old ones.

English

Several studies have been conducted on congenital heart disease in different regions of Saudi Arabia. However, no recent systematic review has examined the growing scientific evidence with respect to the epidemiology of CHD in the Kingdom. The aim of this review is to provide a comprehensive summary of CHD incidence, prevalence, burden and impact on the Saudi population. A literature search was conducted through PubMed and Google Scholar using relevant keywords to identify studies performed in Saudi Arabia regarding CHD from 1993 to December 2013. Articles written in English that described or investigated the epidemiology, etiology, distribution, impact and burden of CHD in the Saudi Arabian population were included. Twenty one articles met these criteria. Cross-sectional studies found the prevalence of CHD ranging between 2.1 and 10.7 per 1,000 persons. The most prevalent type of CHD was the ventricular septal defect ranging from 29.5 to 39.5% of all diagnosed CHDs, followed by atrial septal defect (8.9 to 18.1%) and pulmonary stenosis (6 to 12.4%). Overall, the incidence of severe CHD was approximately 5.4 per 1,000 live births per year. Occurrence of CHD in Saudi Arabia was significantly associated with Down’s syndrome, consanguinity and maternal diabetes. Studies on the burden of these anomalies on children, families and society are scarce. This systematic review found that prevalence of CHD is comparable to that in other developing countries. Several modifiable risk factors have been identified emphasizing the importance of public health programs that are aimed at tackling such potentially preventable risk determinants. Keywords: Heart, congenital, defect, epidemiology, prevalence, Saudi

Morphological, physiological and molecular characterization of Phytophthora alni isolates from Western Spain

During extensive surveys for Phytophthora associated with alder mortality in western Spain, isolates were consistently recovered from necrotic bark of the collar and lower stem of Alnus glutinosa. Morphological and molecular characteristics of the selected isolates together with their physiology were examined. Morphologically, the isolates were homothallic and characterized by abundant production of terminal oogonia predominantly with two-celled amphigynous antheridia exhibiting ornamentation. Simple sporangiophores were observed bearing terminal, non-papillate, ellipsoid to ovoid sporangia. Colony growth patterns developed on V8 juice agar (V8A), carrot agar (CA), corn-meal agar (CMA) and potato-dextrose agar (PDA) showed uniform, radial or irregular growth patterns with appressed and/or woolly morphology. Temperature (2 °C, 5 °C, 10 °C, 15 °C, 20 °C, 25 °C, 27 °C, 30 °C and 32 °C), pH (5, 7, 9 and 11) and osmotic potential (−0.6, −1.2, −1.8 and −2.4 MPa) significantly influenced radial mycelial growth of the isolates under laboratory conditions. Molecular analyses including ITS DNA region sequencing and subspecies specific primers amplification confirmed identification of the isolates as Phytophthora alni ssp. alni. Further research is under way to carry out more surveys in order to determine the extent of damage and severity of the disease in different regions of Spain.

An epidemiological study of cutaneous leishmaniasis using active case finding among elementary school students in Pakdasht, southeast of Tehran, Iran 2013-2014.

Cutaneous leishmaniasis is one of the prevalent health problems in tropical and subtropical areas including Iran. Therefore, it is essential to identify the prevalence and new foci of this disease in different regions of Iran. This study aimed to determine the epidemiology of cutaneous leishmaniasis by active surveillance in elementary schools in Pakdasht City, Southeast of Tehran, Iran 2013-2014. This cross sectional study was carried out on 4800 students from 60 elementary schools in Pakdasht during October 2013 to March 2014. After examining the students, some epidemiological data such as age, gender, date, anatomic location of the lesion(s) in the body, number and size of lesion(s), lesion type, and travel history to endemic areas was recorded in a checklist. Students with active lesions were examined using parasitological and molecular methods (PCR). Totally, 31 students (0.64%) had leishmaniasis, of which 15 (0.31%, 95% CI, 0.15%, 0.47%) had active lesions and 16 (0.33%, 95% CI, 0.17%, 0.49%) had leishmaniasis scars. Molecular testing showed that Leishmania major was the causative agent of leishmaniasis in all patients with active lesion. The highest frequency of cutaneous leishmaniasis was found in the age group 10-12 years (P=0.03). There was a significant difference between the frequency of the disease in different months (P=0.04) and the anatomic location of the lesion/scar (P=0.04). Moreover, t-test revealed that there was a significant relationship between number of lesions/scars and the age group (P<0.001). The leishmanial type diagnosed in all patients was L. major. This finding suggests that Pakdasht might be a new focus for zoonotic cutaneous leishmaniasis.