Epidemiological Analysis Research Articles

Epidemiological Analysis of Cancer Patients Diagnosed With Cranial Metastasis at Initial Presentation

Introduction: Metastatic lesions are the most common brain tumors, comprising 52% of all cases. Early diagnosis is crucial to improve patient outcomes, but many cases remain undiagnosed until advanced stages. This study aimed to investigate the characteristics of patients diagnosed with brain metastasis concurrently with their primary malignancy, examine prognostic factors, and compare these findings with brain metastases of known primary origins. Method: A retrospective analysis was conducted on 184 patients between 18-80 years diagnosed with brain tumors between January 2018 and January 2019. Patient data were collected from clinical records, and statistical analyses were performed using SPSS 26.0. Results: Out of the total patients, 43% were diagnosed brain metastases. Among these, 33% had no known primary malignancy at diagnosis. In this group, 92.3% were over 50 years old, and 77% were male. The most frequent primary cancer was lung cancer (81%). Males had an average time to metastasis diagnosis approximately twice as long as females. A higher incidence of metastasis correlated with a lower Karnofsky Performance Score, indicating reduced operability and quality of life. Conclusion: Early diagnosis is critical to improving outcomes. Routine cranial imaging for patients over 50 may aid in early intervention.

Epidemiological and Clinical Characteristics of Multiple Sclerosis in the Iraqi Population: A Study of 600 Cases

Background: These are two diseases of the central nervous system which are associated with demyelization of nerves and which has caused neurological disease and disability all over the world. Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) are chronic diseases exhibiting features of an autoimmune affection mainly affecting the central nervous system. To date, no study or report has looked at the epidemiology and clinical profile of these disorders in Middle Eastern countries, Iraq included, even though there is bibliographic evidence of the existence of these conditions in Western peoples. This project aims at encompassing this gap by carrying out a descriptive epidemiological analysis study of multiple sclerosis (MS)and neuromyelitis optica (NMO) in the Iraqi population. In this case, the research is going to be aimed at the demographic characteristics of patients, their clinical presentation and outcomes of their treatment. Methodology: A post hoc comparative cross-sectional examination of the medical records of 600 patients in Iraq was performed as part of the present investigation. For this study, data was gathered and analyzed. An additional 150 individuals with neuromyelitis optica and 450 patients with multiple sclerosis were recalled from the sample. The information was collected from Baghdad Teaching hospital in Medical City complex. The records of the patients were combed through for the previous 10 years in a row in order to determine the demographic and clinical features of the patients, as well as information on the relapses, treatment, and rehabilitation processes. In order to examine the prevalence and incidence of the two illnesses, the research used comparisons based on frequency and percentage analysis, as well as the t-test and the Chi square statistic. Results Although there were some similarities between NMO and MS, the relapse rate was notably higher in NMO patients (3. 4, compared with 2. 8 in patients with MS), and severe relapses were more frequent in the NMO group (38. ∗%, compared with 29. ∗% in the MS group; p = 0. 041). This means that NMO is much more aggressive than MS. Moreover, the NMO patients experienced more severe and longer lasting relapses than the Ms patients (median relapse duration 4. 1 weeks, p = 0. 008 compared to the 3. 2 weeks of Ms patients; 34. 7% degree of impairment in NMO patients, p = 0. 007 compared to the 21. 8% degree of impairment in Ms patients). The first notitur is that more patients with NMO received immunosuppressants (86. 7% versus 46. 7% of patients with multiple sclerosis who received immunosuppressive drugs; p = 0. 001) Thus, it is necessary to use other approaches with this group of patients. Despite this, the results showed that there was no significant difference between the two groups in relation to the time it took to resume work and/or a normal lifestyle. Thus, out of the sample, 28% showed complete recovery with the remainder 56%. Regarding the recoveries made, majority stated they had full recovery at 92 percent, 8 percent had partial recovery. Conclusion: The current study focuses on this problem in the Iraqi population and also acknowledge that NMO seems to be worse and more progressive than MS. It also puts much stress on the early diagnose of such cases as well as the use of treatment techniques that are both wide and intense especially with those who have other related complications of NMO. Each of the result supports the argument of the need to establish new treatment procedures that are relative to the area with the intention of enhancing the living standards of the patients. These results are a significant addendum to the overall shortage of knowledge of multiple sclerosis and neuromuscular disorder in the regarding of patients who belong to the developing world. In addition, they form a basis for future research that will help in the discovery of methods that can be utilised in enhancing disease treatment in the developing countries.

Laboratory, epidemiological and clinical characteristics of pertussis in children and close contacts: a cross-sectional study.

To investigate the epidemiological and clinical characteristics of pertussis in children and close contacts. Nasopharyngeal swabs and blood samples of clinically suspected children with pertussis and their close contacts from 2018 to 2022 were collected for pathogen detection of Bordetella pertussis. Questionnaires were designed to investigate the basic information and infection status of pertussis children cases and their close contacts. Descriptive epidemiological analysis was performed on the results. 1229 confirmed children cases of pertussis were collected and infants < 1 year old were the most affected (77.7%). Etiological data were collected from 587 close contacts of 269 confirmed cases and the infection rate was high (24.4%). The positive detection rate of parents, especially mothers, was significantly higher than that of other groups (32.2% vs. 18.4%, P < 0.001); The rates of misdiagnosis or missed diagnosis in pertussis children (92.2%) and close contacts (99.8%) were very high, and the distribution of symptoms between pertussis children and their close contacts was different (χ2 = 535.328, P < 0.001); The vast majority of pertussis children (84.0%) were diagnosed with upper respiratory tract infection or trachea/bronchitis while 91.0% of close contacts did not seek medical attention (χ2 = 685.373, P < 0.001). Infants < 1 year old are at high risk in pertussis. Pertussis infection in close contacts of confirmed children is underestimated. Caregivers who are positive for pertussis but missed or misdiagnosed seriously may be a main source of pertussis infections in children. Adjusting the current pertussis immunization strategy in China is necessary.

Epidemiological analysis of event-based surveillance data of Crimean-Congo Hemorrhagic Fever (CCHF) outbreaks across Balochistan Province, Pakistan, from 2000 to August 2021

Background Crimean-Congo hemorrhagic fever (CCHF) is endemic in Balochistan, caused by the Bunyaviridae family’s tick-borne virus (Nairovirus). The CCHF virus leads to severe viral hemorrhagic fever outbreaks with a fatality rate of 10–40%. This study aims to describe the epidemiological trend of CCHF in Balochistan and provide recommendations for controlling current and future outbreaks. Methods A descriptive approach was adopted for data analysis, utilizing the standard case definition of the Vector-Borne Diseases (VBD) program. “Any person of any age and gender residing in Balochistan from 2000 until August 10, 2021, presenting with the acute onset of illness, featuring a high-grade fever (38.5°C) persisting for more than 3 days but less than 10 days. Individuals should also exhibit any two of the following symptoms: hemorrhagic or purpuric rash, nosebleed, blood in vomit/sputum/stool, or other hemorrhagic symptoms. Moreover, there should be no known predisposing factors for hemorrhagic manifestations, and individuals must have had contact with a confirmed patient or engaged in handling animals and raw animal products.” The study covered cases identified from 2000 to August 10, 2021, and the descriptive study was conducted at the Provincial Disease Surveillance and Response Unit (PDSRU) in Quetta. Frequencies were calculated, and Excel 2016 was used to generate tables and graphs. Results Based on the case definition, 1418 laboratory-confirmed cases of CCHF were identified out of 2542 reported cases from 2000 to August 10, 2021. Most cases (89%, n = 1262) were found to be males. The case fatality rate increased from 5% to 13% over the last decade. The highest number of CCHF cases occurred in 2017 (n = 172), followed by 2005 (n = 108) and 2004 (n = 107). Direct animal contact was reported in 61% of cases, with 22% being butchers and farmers each. CCHF poses a significant public health issue in Balochistan. Conclusion This study provides a detailed overview of CCHF in Balochistan over the last 21 years, recommending the declaration of CCHF as a public health emergency. Establishing a comprehensive tick surveillance system, ecological studies, and health education sessions in collaboration with the livestock department is crucial to prevent future outbreaks.

Advances and trends in pressure ulcer care research over the last 20 years: A bibliometric and visual analysis

ObjectiveThis study aims to investigate the current status and trends of pressure ulcer care studies over the past two decades using bibliometric and visual analysis, with the objective of providing guidelines for the development of relevant clinical practices or further research. MethodsWe conducted a search on the Web of Science Core Collection database using the subject terms “pressure ulcers” or “pressure injuries” for the period from January 2002 to December 2021. Bibliometric tools such as CiteSpace (version 5.8.R3), VOS viewer (version 1.6.17) and the R software 4.0.3 were used to visualize and analyze annual publications, country, institution, author, keyword and cited literature. ResultsWe identified 5102 publications related to pressure ulcers during the 20-year period, including 4034 articles published in 1557 journals. The number of annual publications on the relevant topics has been increasing annually at an annual growth rate of 4.89 %. The keyword cluster analysis of these studies can be divided into four areas: epidemiology, risk assessment, caring intervention and prognostic analysis. Keyword temporal analysis revealed that the “Braden score” was the most commonly used keyword over a long-term span. The dissemination of knowledge and student training on pressure ulcers have become hot topics of research in recent years. Additionally, pressure ulcer care in COVID-19 patients has emerged as another research hotspot due to the pandemic. ConclusionBibliometric analyses have shown that there has been a steady increase in research on pressure ulcer care, with studies related to pressure ulcer risk scores accounting for a large portion of this research. In recent years, education on pressure ulcer-related knowledge and pressure ulcer care in COVID-19 patients have emerged as research hotspots. Future research on pressure ulcer care in the elderly may be a research hotspot as the aging population progresses.

Unveiling the genetic landscape of Streptococcus agalactiae bacteremia: emergence of hypervirulent CC1 strains and new CC283 strains in Tehran, Iran

BackgroundThe emergence of Streptococcus agalactiae infections in patients with bacteremia is increasing. It is crucial to investigate the epidemiology, molecular characteristics, biofilm status, and virulence analysis of Streptococcus agalactiae in these patients.MethodsIn this cross-sectional study, 61 S. agalactiae isolated from blood infection were subjected to characterization through antimicrobial susceptibility tests, biofilm formation, multilocus sequence typing (MLST), and PCR analysis for detecting resistance (tet and erm family) and virulence genes (alp2/3, alp4, bca, bac, eps, rib, lmb, cylE, and pilus island genes).ResultsOverall, 32.7% of the isolates demonstrated an inducible clindamycin resistance phenotype. The results showed that 49.2, 24.6, and 8.2% of confirmed Streptococcus agalactiae strains were classified as strong, intermediate, and weak biofilm-forming strains, respectively. tet(M) (57.1%) was recovered most, followed by tet(M) + tet(L) (14.3%), tet(S) + tet(K) (10.7%), tet(M) + tet(K) (8.9%), tet(M) + tet(K) + tet(O) (5.4%), and tet(S) + tet(L) + tet(O) (3.6%). Three virulence gene profiles of cylE, lmb, bca, rib (24.6%; 15/61), cylE, lmb, rib, alp3 (19.7%; 12/61), and cylE, lmb, bac, rib (16.4%; 10/61) were detected in approximately two-thirds of the isolates. MLST revealed that the 61 isolates belonged to six clonal complexes, including CC1 (49.2%), followed by CC12 (18%), CC19 (13.1%), CC22 (9.8%), CC17 (6.6%), and CC283 (3.3%), and 11 different sequence types (STs), including ST1 (24.6%), ST7 (14.8%), ST918 (13.1%), ST2118 (9.8%), ST19 (9.8%), ST48 (6.6%), ST1372 (4.9%), ST22 (4.9%), ST40 (4.9%), ST734 (3.3%), and ST283 (3.3%). Remarkably, all CC1 and CC12 isolates, three-fourths of CC19, and half of CC22 were confirmed as biofilm producers. Conversely, CC17 and CC28 isolates were found to be nonproducers. The occurrence of strong biofilm formation was limited to specific CCs, namely CC1 (34.4%), CC12 (8.2%), CC19 (3.3%), and CC22 (3.3%).ConclusionThe high prevalence of CC1 and CC12 clones among S. agalactiae strains reflects the emergence of these lineages as successful clones in Iran, which is a serious concern and poses a potential threat to patients.

Epidemiology, genetic characterization and population structure analysis of lumpy skin disease virus from North India.

Lumpy skin disease (LSD) is a transboundary, viral disease of cattle with a significant economic impact on the livestock industry. This study describes the epidemiological investigations of outbreaks of LSD that occurred in 2022 in three Indian states viz., Haryana, Himachal Pradesh and Rajasthan and the genetic characterization of Lumpy skin disease viruses (LSDVs). Also, the population structure analysis of LSDVs was carried out. Out of 138 scab samples tested from suspected cattle for LSDV, 106 were found positive. Of these, nine representative scab samples were further genetically characterized. Phylogenetic analysis based on the P32 and EEV gene sequences depicted that the LSDV strains of the present study had nucleotide identity of 100% and 99.10-99.45%, respectively with the LSDV/2019 field strains of India. Multiple sequence alignment of the EEV glycoprotein gene sequences revealed nucleotide polymorphisms at three positions viz., G178A, G253A and A459G in circulating LSDV/2022 field strains. Based on the median joining network analysis of the EEV gene, 12 haplotypes were identified among the LSDV populations. Population structure analysis corresponding to the EEV gene revealed high haplotype (0.8486 ± 0.026) and low nucleotide diversities (0.00636 ± 0.0006) and negative values for neutrality indices, indicating a high number of closely related haplotypes and the studied population may have undergone a recent expansion. The findings will help in understanding the distribution and dynamics of LSDV populations, which will prove pivotal in designing and implementing effective management and control strategies.

Epidemiological investigation and analysis of the infection of porcine circovirus in Xinjiang

Porcine circoviruses, particularly porcine circovirus type 2 (PCV2) and porcine circovirus type 3 (PCV3), significantly impact the global pig industry due to their high prevalence and pathogenicity. Conversely, porcine circovirus type 1 (PCV1) and porcine circovirus type 4 (PCV4) currently have low positivity rates. This study aimed to characterize the distribution and epidemiology of porcine circoviruses in Xinjiang, while also analyzing the genetic diversity and evolution of PCV2 and PCV3, which pose the greatest threats to the industry. In this study, we collected blood and tissue samples from 453 deceased pigs across eight regions in Xinjiang Province from 2022 to 2024. We utilized real-time PCR to detect the presence of PCV1, PCV2, PCV3, and PCV4. The positive rates were 15%, 71%, 25%, and 17%, respectively. Genetic analysis showed 9 PCV2 sequences and 12 PCV3 sequences. The capsid protein of PCV2 showed significant variability. In contrast, the amino acid sequences of capsid in PCV3 were relatively stable. Moreover, we predicted antigenic epitopes for PCV3 capsid using IEDB and ElliPro. The findings from this study provide valuable epidemiological data on PCV coinfection in the Xinjiang region and enhance the understanding of virus diversity nationwide. This research may serve as an important reference for the development of strategies to prevent and control porcine circovirus infections.

Reversing accidents involving pedestrians: an epidemiological investigation and cluster analysis using a novel database derived from Swedish National Register data

Objectives In contemporary urban environments, the intersection between Vulnerable Road Users, specifically unprotected pedestrians, and motor vehicles poses a persistent challenge to road safety. Reversing accidents, characterized by vehicles moving backward, often result in severe consequences for pedestrians due to limited visibility and inherent blind spots for the driver. This paper aims to provide a thorough examination of reversing accidents involving pedestrians in Sweden between 2000–2021; shedding light on the magnitude of the problem, contributing factors, consequences, and potential mitigation strategies. Method Using a national database, reversing accidents were compiled by classifying free text descriptions of traffic accidents reported to the Swedish Traffic Accident Data Acquisition. The database was then used to describe reversing accidents and their consequences for struck pedestrians using descriptive epidemiology and cluster analysis. Results The results show that reversing accidents accounted for 12% of all pedestrians injured in a collision with a motor vehicle in Sweden during the studied period. In terms of personal characteristics, the struck pedestrians were more often female and of old or young age, whilst the drivers of the reversing vehicles were more often between 18–54 years and men. Most accidents were non-fatal, with only roughly 2% resulting in fatalities. Through a cluster analysis, four distinct accident types were identified. Two of these were identified as particularly important to prioritize in future preventative work: accidents that are characterized by occur during daylight hours in the urban environment (often low speeds) and often result in fatality or serious injury. Conclusions Due to the low speeds, reversing accidents are rarely fatal. However, they account for a large proportion of accidents with pedestrians and can be grouped into clearly distinguishable accident types that can function as templates in road safety development in Sweden.

Etiological and epidemiological analysis of patella fractures: evaluation of COVID-19 pandemic and lockdown era effects

Background: Patella fractures are relatively rare, but significant public health burden with consequences ranging from skin problems to extensor mechanism deficiencies and patellofemoral arthrosis due to their significant effects on pain, functionality, and quality of life. It was aimed to present basic etiological, and epidemiological information about patella fractures and to evaluate the impact of the COVID-19 Pandemic and lockdown era period. Methods: All patellar fractures admitted to a stage-1 trauma center between 2016 and 2022 were collected retrospectively. Patient's gender, age, side, fracture classification, trauma mechanism, treatment method, admission day and season, accompanying extremity, and non-musculoskeletal/visceral pathologies were recorded and analyzed. Results: A retrospective evaluation was conducted on 304 patients, with 181 (59.5%) males and 123 (40.5%) females, with an average age of 46±19 years. Most patients were between 30-65 (51.4%) and the most common cause was simple falls (74%). Fractures mostly occurred in the winter (35.2%) and on Sundays (19.7%). 9.9% of the patients were accompanied by extremity traumas and 6.9% by non-musculoskeletal injuries. Regarding the descriptive classification, transverse, distal pole, and proximal pole; and according to the AO/OTA classification, C1 was the most common. Conclusion: The incidence of patella fractures is increasing. Non-surgical treatment is a priority, and the complication rates of surgical treatment are considerable. The study, which presents etiological and epidemiological data of level-1 trauma center patients, is a suitable sample for Türkiye. The study is unique in showing the potential effects of COVID-19 on the patient profile and treatment management of patella fractures.

Molecular Epidemiology and Phyloevolutionary Analysis of Porcine Parvoviruses (PPV1 through PPV7) Detected in Replacement Gilts from Colombia.

Eight porcine parvovirus (PPV) species, designated as PPV1 through PPV8, have been identified in swine. Despite their similarities, knowledge about their distribution and genetic differences remains limited, resulting in a gap in the genetic classification of these viruses. In this study, we conducted a comprehensive analysis using PPV1 to PPV7 genome sequences from Colombia and others available in the GenBank database to propose a classification scheme for all PPVs. Sera from 234 gilts aged 180 to 200 days were collected from 40 herds in Colombia. Individual detection of each PPV (PPV1 through PPV7) was performed using end-point PCR. Complete nucleotide (nt) sequencing was performed on the PPV1 viral protein (VP), and near-complete genome (NCG) sequencing was carried out for novel porcine parvoviruses (nPPVs) (PPV2 through PPV7). Phylogenetic analyses were conducted by comparing PPV1-VP sequences to 94 available sequences and nPPVs with 565 NCG, 846 nPPV-VP, and 667 nPPV-nonstructural protein (NS) sequences. Bayesian phylogenetic analysis was used to estimate substitution rates and the time to the most recent common ancestor for each PPV. The highest prevalence was detected for PPV3 (40.1%), followed by PPV5 (20.5%), PPV6 (17%), PPV1 (14.5%), PPV2 (9.8%), PPV4 (4.2%), and PPV7 (1.3%). Notably, all tested sera were negative for PPV8 genomes. An analysis of the PPV1-VP sequences revealed two main clades (PPV1-I and PPV1-II), with the sequences recovered in this study grouped in the PPV1-II clade. Comparative analysis showed significant genetic distances for PPV2 to PPV7 at the NCG (>6.5%), NS (>6.3%), and VP (>7.5%) regions, particularly when compared to equivalent regions of PPV genomes recovered worldwide. This study highlights the endemic circulation of nPPVs in Colombian pig herds, specifically among gilts. Additionally, it contributes to the phylogenetic classification and evolutionary studies of these viruses. The proposed method aims to categorize and divide subtypes based on current knowledge and the genomes available in databanks.

Risk of central nervous system tumors in the offspring of individuals exposed to production radiation

Aim. To assess the risk of malignant central nervous system (CNS) tumors among the first-generation offspring of workers from the Mayak Production Association.Materials and Methods. A retrospective epidemiological analysis was conducted in a cohort of the offspring of workers from Russia's first nuclear power plant (n = 8890), born between 1949 and 1973. The comparison group consisted of 4345 offspring born during the same period to non-exposed parents. The observation period covered 72 years (1949−2020), with a total of 818,208 person-years of follow-up. The analysis focused on the frequency, dynamics, and structure of CNS malignancies. The relative risk of CNS tumors and the excess relative risk per unit dose of parental occupational radiation exposure were calculated with 95% confidence intervals.Results. Overall, the frequency of CNS tumors in both groups over the entire observation period did not differ significantly (3.4 per 1000 in the main group, 1.8 per 1000 in the comparison group). Analysis of CNS tumor incidence dynamics across calendar periods showed no significant differences, with the peak in the main group occurring during 2001−2010. No significant differences were found in the age of CNS tumor onset or the average age of parents at the time of offspring birth. Histological structure and localization of CNS tumors varied across groups. The relative risk assessment for CNS tumors showed a statistically insignificant increase in risk among the offspring in the main group when considering total observations and sex-specific analyses. Among the offspring of mothers with confirmed preconceptional and intrauterine occupational radiation exposure, the relative risk of CNS tumors was higher for males and both sexes combined (3.6 [1.06−12.28] and 2.74 [1.08−6.93]; 4.34 [1.27−14.77] and 3.3 [1.31−8.36], respectively). However, the analysis of excess relative risk did not indicate significant risk estimates for maternal radiation exposure, neither in general nor across different dose intervals.Conclusion. The study did not confirm the hypothesis that parental occupational radiation exposure influences the risk of CNS tumors in offspring. Given the relatively young age of the cohort and the low number of CNS tumor cases, issues related to maternal radiation exposure require further observation.

Epidemiological Analysis of Foot and Mouth Disease (FMD) Outbreak in 2014 in Sri Lanka

Sri Lanka faced a massive Foot and Mouth Disease (FMD) outbreak in 2014, which was initiated in Jaffna district in December 2013, and lasted for a period of more than a year, until January 2015. The disease spread throughout the country, affecting 68895 domestic animals, and causing 2007 deaths. The aim of this study was to epidemiologically analyze the data of 2014 FMD outbreak in order to understand the pattern and determinants of the massive disease distribution. Data were collected regarding the number of cases and deaths in relation to the time and location. Data in Disease Outbreak Reports, Follow-up Reports, Disease Investigation Reports and Laboratory Investigation Reports were reviewed, and descriptive and simple statistical analyses were carried out concerning the 57 epidemiological week study period. Disease Incidence, Period Prevalence, Mortality Rate, and Case Fatality Ratio of the disease were determined to be 68895, 6.11%, 0.18% and 2.91%, respectively. Seasonal animal movements and unauthorized livestock transportation appeared to be the main causes for the extensive spreading of the disease, while inadequate vaccination and poor awareness seemingly facilitated the development of three epidemic curves during the outbreak period. Newly identified causative agent, the sub-lineage O/ME-SA/Ind-2001d has led to a more severe FMD outbreak in 2014 compared to the previous outbreaks occurred in Sri Lanka.

Modern aspects of rabies in Cameroon

The article presents the results of an epidemiological study of the incidence of rabies in the population of the Republic of Cameroon in the period from 2014 to 2022. The system of epidemiological surveillance and monitoring of rabies in Cameroon is presented. According to WHO, human and animal rabies is recognized as endemic to Central Africa as a whole, and in Cameroon, in particular, this infectious goiter is classified as the first priority zoonosis within the framework of the National Program for the Prevention and Control of Recurrent and Re-emerging Zoonosis (PNPLZER). The average annual incidence of rabies recorded between 2014 and 2022 was 405.7% (95% CI: 401.9% – 409.5%). Based on the results of a retrospective epidemiological analysis, the dynamics of rabies cases among people in Cameroon is presented in accordance with data recorded at the Operational Center for Public Health Emergencies (CCOUSP). The highest rates were recorded in the period from 2018 (547.4%) to 2019 (276.8%), and the lowest in 2021 (10.7%) to 2022 (3.1%). To identify socio-demographic risk factors, a survey of rabies foci was conducted using specially designed questionnaires (epidemiological information collection cards). Mapping of registered cases of rabies in humans was carried out for 10 administrative regions of the country using the LTR QGIS (quantum GIS) program, which allowed us to show the distribution of cases across the country and dynamics over time. It has been established that the distribution of cases of the disease across the territory does not always depend on the population density in administrative districts, but is associated with specific socio-demographic risk factors such as profession, gender, age, type of animal reservoir of the virus, which affect the activity of the pathogen circulation among natural hosts.

Children With Acute Lymphoblastic Leukemia in Romania: Results From a Decade-Long Single-Center Study.

Acute lymphoblastic leukemia (ALL) is the most prevalent cancer in children, with continuously improving survival rates. As few studies in Romania have analyzed ALL patients and disease characteristics or survival, we conducted a retrospective study on 158 patients diagnosed with ALL admitted to the Department of Pediatric Oncology and Hematology at the Emergency Hospital for Children, Cluj-Napoca, Romania, from January 2011 until April 2021. The most important objectives of the study are to establish full profiles of the patients and ALL, remission rates, relapses, and deaths, an epidemiology analysis to determine the incidence of ALL for comparison with the standard European population, and also to assess survival by the most important parameters, including minimal residual disease (MRD). This was a retrospective study that focused on patients with newly diagnosed ALL from January 2011 to April 2021 in the Department of Pediatric Hematology and Oncology of the Emergency Hospital for Children, Cluj-Napoca, Romania. The inclusion criteria were: patients with de novo ALL, patients who were younger than 18 years of age, and patients with signed informed consents. The exclusion criteria included patients who were older than 18 years of age; patients with relapsed ALL; and patients who did not have a signed informed consent. A total of 158 patients were included in the study, aged between 0 and 17 years. The information about patient characteristics and all variables was taken from the patients' files, where informed consent is mandatorily stored. Descriptive statistics were used to evaluate variables such as age, gender, leukocyte number, immunophenotype, prednisone response, risk group assessment, cytogenetics, relapse, and MRD. Kaplan-Meier curves were used to assess survival, for which patients were divided into two subcohorts: a 2011-2015 subcohort and a 2016-2020 subcohort. The statistical analyses used Prism version 10.2.3 (GraphPad Software, La Jolla, CA). For the analysis, we used Kaplan-Meier curves, the log-rank (Mantel-Cox) test, the log-rank test for trends, the Gehan-Breslow-Wilcoxon test, survival proportions, the chi-square test, and correlations. A shift in risk groups was observed after the introduction of MRD testing in 2017, with more patients being stratified in the medium-risk group (MRG) and high-risk group (HRG). At the survival analyses between bone marrow (BM) aspiration and MRD on day 15, we discovered that patients with MRD>10% had much higher overall survival (OS) and event-free survival (EFS) compared to patients with >25% blasts in the BM; 24(11.4%) patients relapsed, of which, nine (3.8%) were very early relapses and 10 (4.1%) were late relapses. The five-year OS and EFS for patients with the T-cell immunophenotype of ALL and those with leukocyte counts >100,000/mm3were identical to those at one year. The OS of the 2016-2020 subcohort was higher than that of the 2011-2015 subcohort, and more patients were stratified into MRG and HRGs due to the implementation of MRD testing. Minimal residual disease testing helped to improve significantly the survival rates of patients with more than 10% residual disease. None of the patients with very early relapses entered complete remission (CR), but all late relapses achieved CR. All events experienced by patients with the T-cell immunophenotype, or leukocyte counts of >100,000/mm3 occurred in the first year after diagnosis.

Modern epidemiological features of viral acute intestinal infections in children and adolescents of Sakhalin region

Objective: to identify modern epidemiological features of viral acute intestinal infections in children and adolescents in the Sakhalin Region.Materials and methods. Data on acute intestinal infection incidence obtained from statistical reports of the Rospotrebnadzor during 2021-2023 was compared with long-term average incidence rates calculated over the period before the COVID-19 pandemic (2010-2019) to perform epidemiological analysis. Incidence was calculated for different age groups; according to months of the year, monthly long-term average incidence rates were established. Index of seasonality, coefficient of seasonality, and index of seasonal growth were determined.Results and discussion. Manifestations of acute intestinal infections epidemic process in the Sakhalin Region indicate persisting conditions for an increase in the registration of both sporadic cases of diseases and outbreaks of infectious diarrhea. Viruses were prevailing in the structure of cases of known etiology (mainly caused by rotaviruses and noroviruses). Their intra-annual dynamics showed changes in rotavirus and norovirus infection incidence rates: a shift in periods of increased incidence, a decrease in the coefficient of seasonality, and for rotavirus infection, a decrease in the index of seasonal growth. Age-adjusted rotavirus infection incidence showed predominance of the infection among preschool-aged children; norovirus infection was frequently detected among schoolchildren and adolescents. An increase in the focality index may indicate ongoing problems in the public catering sector, non-compliance with sanitary rules and hygiene standards, and untimely detection and isolation of patients with acute intestinal infections.Conclusion. Obtained results confirm the epidemiological significance of viral gastroenteritis and the necessity of anti-epidemic measures optimization.

An outbreak of acute diarrhoeal disease caused by Shigella sonnei in a village in Dibrugarh district, Assam.

Background & objectives Food and waterborne illnesses remain a neglected public health issue in India. Events with large gatherings frequently witness outbreaks of acute diarrheal diseases due to consumption of contaminated food or water or poor food handling practices. In the present study, an outbreak of acute diarrhoeal disease (ADD) occurring among the attendees of a birthday party in rural Dibrugarh district in the northeastern Indian State of Assam was investigated. Methods Sociodemographic information along with details of ADD outbreak that included information about source of foods, food handlers, illness details, etc., were collected using an outbreak investigation form for descriptive and analytical epidemiology. Rectal swabs from affected individuals and food handlers were collected along with bore-well water samples and tested in the laboratory by performing bacterial culture, biochemical analysis and polymerase chain reaction. Due to the delayed report on the outbreak, collecting leftover food for laboratory testing and analysis was impossible. Results A total of 25 cases of ADD had similar signs and symptoms. The mean incubation period for developing acute diarrhoea was 26.36±8.76 (± standard deviation) hours from food consumption. The overall attack rate was 60.04 per cent (25/41); 20 per cent (5/25) required hospitalization. Thirteen rectal swab samples were tested for pathogens and found positive for Shigella sonnei. Antibiotic susceptibility test of isolated S. sonnei showed resistance to nalidixic acid, ciprofloxacin and cefotaxime. Consumption of one of the food items - chicken curry was significantly associated with illness (Odds Ratio=14.8; 95% Confidence Interval: 2.75-85.11); P value<0.05 and Population Attributable Fraction (PAF) was 70.18 per cent. The water samples were found satisfactory for human consumption. Interpretation & conclusions The findings suggested that S. sonnei infection could be implicated in the investigated food-borne diarrhoeal disease outbreak and that there was a potential for human-poultry cross-infection. Additionally, the study revealed concerning levels of S. sonnei resistance to recommended antibiotics and drew attention to their public health relevance.

Epidemic Characteristics and Spatio-Temporal Patterns of HFRS in Qingdao City, China, 2010–2022

ObjectiveThis study investigated the epidemic characteristics and spatio-temporal dynamics of hemorrhagic fever with renal syndrome (HFRS) in Qingdao City, China. MethodsInformation was collected on HFRS cases in Qingdao City from 2010 to 2022. Descriptive epidemiologic, seasonal decomposition, spatial autocorrelation, and spatio-temporal cluster analyses were performed. ResultsA total of 2,220 patients with HFRS were reported over the study period, with an average annual incidence of 1.89/100,000 and a case fatality rate of 2.52%. The male:female ratio was 2.8:1. 75.3% of patients were aged between 16 and 60 years old, 75.3% of patients were farmers, and 11.6% had both “three red” and “three pain” symptoms. The HFRS epidemic showed two-peak seasonality: the primary fall-winter peak and the minor spring peak. The HFRS epidemic presented highly spatially heterogeneous, street/township-level hot spots that were mostly distributed in Huangdao, Pingdu, and Jiaozhou. The spatio-temporal cluster analysis revealed three cluster areas in Qingdao City that were located in the south of Huangdao District during the fall-winter peak. ConclusionThe distribution of HFRS in Qingdao exhibited periodic, seasonal, and regional characteristics, with high spatial clustering heterogeneity. The typical symptoms of “three red” and “three pain” in patients with HFRS were not obvious.

Cardiogenic shock in general intensive care unit: a nationwide prospective analysis of epidemiology and outcome

Abstract Aims Cardiogenic shock (CS) is a life-threatening disease burdened by a mortality up to 50%. The epidemiology has changed with non-ischaemic aetiologies being predominant, although data were mainly derived from patients admitted to dedicated acute cardiac care. We report the epidemiology and outcome of patients with CS admitted to general intensive care unit (ICU). Methods and results Prospective multicentric epidemiological study including 314 general ICU adhering to the GiViTI nationwide registry from 2011 to 2018, excluding cardiac arrest. The primary endpoint of the study was mortality. The association between clinical factors and mortality was evaluated using a logistic regression model. The odds ratios (ORs) of the covariates quantify their association with mortality during hospitalization. A total of 11 052 patients admitted to general ICU {incidence 2.17%; median age 72 [interquartile range (66–81)], 38.7% were women} with CS were included. Forty-seven per cent of patients had more than three organ insufficiency at the time of admission. The most common CS aetiologies were left heart failure (LHF, 5247—47.5%); acute myocardial infarction (3612—32.6%); right heart failure (RHF, 515—4.6%); and biventricular failure (532—4.8%). A total of 85.5% were mechanically ventilated during the ICU hospitalization. The overall ICU mortality was 44.8%, increasing to 53.4% during the hospitalization in the index hospital and to 54.3% at the latest hospital. Right heart failure–cardiogenic shock patients exhibited the highest mortality risk [OR: 1.19, 95% confidence interval (CI) (0.94–1.50); P &amp;lt; 0.001], followed by biventricular CS [OR 1.04, 95% CI (0.82–1.32)]. Respiratory failure [OR 1.13 (95% CI 1.08–1.19)], coagulation disorder [1.17 (95% CI 1.1–1.24)], renal dysfunction [OR 1.55 (95% CI 1.50–1.61)], and neurological alteration [OR 1.45 (95% CI 1.39–1.50)] were associated with worsen outcome along with severe hypotension [systolic blood pressure &amp;lt; 70 mmHg—OR 2.35, 95% CI (2.06–2.67)], increasing age [OR 2.21 95% CI (2.01–2.42)], and longer ICU stay prior to admission (two-fold increase for each 4.7 days). Conclusion In the general ICU, the aetiology of CS, excluding cardiac arrest, remains characterized mostly by LHF with RHF–CS burdened by higher mortality. Multiorgan failure at admission and longer hospital stay before ICU admission predispose to worsen outcome.

Summary Analysis of National Surveillance on Kashin-Beck Disease from 1990 to 2023

ObjectiveTo analyze the epidemiological characteristics and epidemic situation of children with Kashin-Beck disease (KBD) in China, and provide the basis for formulating prevention and control measures. MethodsFixed-point monitoring, moving-point monitoring, and full coverage of monitoring were promoted successively from 1990 to 2023. Some children (7–12 years old) underwent clinical and righthand X-ray examinations every year. According to the KBD diagnosis criteria, clinical and X-ray assessments were used to confirm the diagnosis. ResultsIn 1990, the national KBD detectable rate was 21.01%. X-ray detection decreased to below 10% in 2003 and below 5% in 2007. Between 2010 and 2018, the prevalence of KBD in children was less than 0.4%, which fluctuated at a low level, and has decreased to 0% since 2019. Spatial epidemiological analysis indicated a spatial clustering of adult patients prevalence rate in the KBD areas. ConclusionThe evaluation results of the elimination of KBD in China over the last 5 years showed that all villages in the monitored areas have reached the elimination standard. While the adult KBD patients still need for policy consideration and care.