Epidemiological Analysis Research Articles

OTHR-07 A DESCRIPTIVE EPIDEMIOLOGICAL PROFILE OF BRAIN TUMOURS IN CAMEROON

Abstract Cancer is a significant threat to public health and a leading cause of morbidity across the globe. In low- and middle-income countries, the delay in diagnosis and access to treatment has contributed to the poor outcome of brain tumors. In Cameroon, epidemiological studies on brain tumors are scarce, which contributes to the lack of knowledge of the disease behavior in our local community. We conducted a descriptive epidemiological analysis based on review of patient’s records at the Cameroon Oncology Center in Douala from 1/1/2018 to 31/12/2023. A total of 2600 charts were reviewed, of which 1.9% of the patients carried a brain tumors diagnosis. Females accounted for 34(68.0%) of the cases and the mean age was 45.4 years (SD=17.9). The most recorded types of brain tumors were brain metastasis (n=25, 50.0%), glioblastoma (n=7, 14.0%), and gliomas (n=6, 12.0%). The most common clinical manifestation associated with brain tumors included headaches (n=32, 34.4%), visual disturbance (n=18, 19.4%), and motor deficit (n=15, 16.1%).In this oncology center, Adults represent the most affected population with brain tumors because most of the children were managed at specialized pediatric oncology centers, with a female: male ratio of 3:1. Brain metastasis was the common type of brain tumor, headache was the most frequent clinical presentation.

Optimal control analysis on the spread of COVID-19: Impact of contact transmission and environmental contamination

The study investigates the intricate dynamics of SARS-CoV-2 transmission, with a particular focus on both close-contact interactions and environmental factors. Using advanced mathematical modeling and epidemiological analysis, explored the effects of these transmission pathways on the spread of COVID-19. The equilibrium points for both the disease-free and endemic states calculated and evaluated their global stability. Additionally, the basic reproduction number (R0) is derived to quantify the transmission potential of the virus.To ensure model accuracy, numerical simulations are performed using MATLAB, utilizing daily COVID-19 case data from India. Parameter values are sourced from existing literature, with certain parameters estimated through fitting the model to observed data. Crucially, the model incorporates environmental transmission factors, such as surface contamination and airborne spread. The inclusion of these factors provides a more comprehensive understanding of the virus’s spread, demonstrating the importance of interventions like use of face masks, environmental sanitization, vaccine efficacy, availability of treatment resources underappreciated when focusing solely on direct human contact. A sensitivity analysis is conducted to assess the impact of different parameters on R0, with results visualized through heat maps to identify the most influential factors.Furthermore, Pontryagin’s maximum principle is employed to develop an optimal control model, enabling the formulation of effective intervention strategies. By analysing both interpersonal and environmental transmission mechanisms, this study offers a more holistic framework for understanding SARS-CoV-2 transmission. The insights gained are critical for informing public health strategies, emphasizing the necessity of addressing both direct contact and environmental sources of infection to more effectively manage current and future outbreaks.

S2078 Trends in Malnutrition-Related Mortality in the United States, 1999-2020: An Epidemiological Analysis

S2078 Trends in Malnutrition-Related Mortality in the United States, 1999-2020: An Epidemiological Analysis

S1683 Trends and Disparities in Chronic Hepatitis-Related Mortality in the United States, 1999-2020: An Epidemiological Analysis

S1683 Trends and Disparities in Chronic Hepatitis-Related Mortality in the United States, 1999-2020: An Epidemiological Analysis

Prevalence of high neonatal thyroid stimulating hormone levels as an indicator of iodine deficiency in the province of La Pampa: An epidemiological analysis.

Introduction. Iodine plays a key role in human metabolism, growth, and development. During pregnancy and childhood, the demand for this micronutrient increases notably. Increased neonatal thyroid stimulating hormone (nTSH) levels, defined as nTSH ≥ 5 mIU/L, are a marker of iodine deficiency in a population if its prevalence is higher than 3%. Objective. To establish the prevalence of nTSH ≥ 5 in La Pampa in the 2021-2022 period, analyze its correlation with different variables, and compare it with data from a historical cohort. Population and methods. Cross-sectional, descriptive-analytical study in a population of newborn infants born in the 5 health regions of the province of La Pampa in 2021 and 2022. Results. Of the 5778 assessed newborn infants, 9.6% had nTSH levels ≥ 5 mIU/L. It was reported that 70.4% of these measurements were done after the third day of life. No significant differences were observed in the frequency of high nTSH levels by year of birth, birth weight, or days until sample collection. A higher prevalence was observed among male infants (10.6% versus 8.5%; p = 0.007) and term infants (9.8% versus 6.6%; p = 0.02). The prevalence of high TSH levels was superior to that observed in the 2001-2002 cohort. Conclusions. The prevalence of high nTSH levels in La Pampa during 2021 and 2022 was 9.6%, suggesting the presence of mild iodine deficiency in the population of this province, higher that what had been reported 2 decades ago.

Epidemiological analysis, pathological examination, and influencing factors associated with the Monizia parasite in cattle in New Valley, Upper Egypt.

Epidemiological analysis, pathological examination, and influencing factors associated with the Monizia parasite in cattle in New Valley, Upper Egypt.

Metastasis patterns and prognosis in patients with gastric cancer: a Surveillance, Epidemiology, and End Results-based analysis

Metastasis patterns and prognosis in patients with gastric cancer: a Surveillance, Epidemiology, and End Results-based analysis

Molecular epidemiology and vaccine compatibility analysis of seasonal influenza A viruses in the context of COVID-19 epidemic in Wuhan, China.

The COVID-19 pandemic had a significant impact on the global influenza vaccination and the epidemics of seasonal influenza. To further explore the molecular epidemiology of influenza viruses and assess vaccine effectiveness, we collected influenza cases in Wuhan during the 2022-2023 influenza season. Among 1312 clinical samples, 312 samples tested positive for influenza viruses using reverse transcription polymerase chain reaction. These positive samples included 146A/H1N1 subtypes (46.8%), 164A/H3N2 subtypes (52.6%) and 2 influenza B virus types (0.6%). Based on the whole genome sequence information of hemagglutinin (HA) and neuraminidase (NA) from 27A/H1N1 influenza virus strains and 26A/H3N2 influenza virus strains obtained in this study, a phylogenetic analysis was conducted. The analysis revealed that all A/H1N1 strains belonged to the evolutionary branch 6B.1A.5a.2a, and they exhibited specific substitutions at positions K71Q, Q206E, E241A, and R276K. Similarly, all A/H3N2 strains were classified into the 3C.2a1b.2a.1a subclade and displayed amino acid substitutions at positions S172H, N175Y, I176T, K187N, and S214P. Notably, the A/H3N2 strains also acquired a new potential glycosylation site at position N174. Using an epitope model, the predicted vaccine effectiveness was assessed for the A/H1N1 and A/H3N2 strains. The predicted vaccine effectiveness against the Wuhan influenza epidemic strain was over 85% for the A/H1N1 vaccine strain. However, the effectiveness against the A/H3N2 vaccine strain was only 48.7%. To further verify the protection of influenza vaccine against circulating influenza viruses in the region, we conducted in vivo and in vitro animal studies. The results of in vitro neutralization experiment showed that rabbit serum antibodies inoculated with quadrivalent isolated influenza vaccine had neutralization ability against all 24 isolated influenza viruses. In vivo experiments showed that vaccinated mice had fewer lung lesions when infected with the influenza strain circulating in Wuhan, suggesting that vaccination can effectively reduce the occurrence of severe lung damage. These findings emphasize the importance of accurately predicting seasonal influenza strains for effective influenza prevention and control, especially during the co-circulation of SARS-CoV-2 and influenza viruses. This study provides valuable information on the seasonal influenza virus in Wuhan during the COVID-19 pandemic and serves as a basis for vaccine prediction and updates.

Epidemiological and genomic analysis revealed the significant role of flies in dissemination of carbapenem-resistant Enterobacteriaceae (CRE) in China

While the role of flies as potential vectors for bacterial transmission is well recognized, the epidemiological features and genomic characteristics of associated antimicrobial-resistant strains remain underexplored. This study conducted a nationwide surveillance including 3689 flies and 838 isolates from sixteen human communities (HCs) and eight animal farms (AFs) across 21 provinces in China. Our findings revealed high carriage rates of carbapenem-resistant Enterobacteriaceae (CRE) in flies, with 27.0 % in AFs and 15.3 % in HCs. Among the 705 CRE strains identified, Providencia spp. (n = 356) and Escherichia coli (n = 231) were predominant, with 90.6 % attributed to the dissemination of the blaNDM gene. Phylogenetic tree analysis highlighted frequent clonal transmission events, with over 18 and 13 clonal evolutionary clades in Providencia spp. and E. coli, respectively. Notably, spearman analysis linked the increase of CRE prevalence in AFs flies to environmental factors like precipitation (p < 0.028) and temperature (p < 0.037), while in HCs, it positively corelated with the total meat production (p < 0.027) in each province except for Hainan. Despite significant differences in ciprofloxacin resistance (p ≤ 0.001) among E. coli strains from HCs and AFs, core genome cluster analysis and Uniform Manifold Approximation and Projection (UMAP) approach indicated these strains exhibiting close relatedness to clinical strains. This comprehensive study underscores the critical role of flies in the escalation of CRE spread within the ecosystem in China. Flies found in both HCs and AFs contribute to the dissemination of CRE, highlighting the need for urgent interventions to address this pressing issue.

Prognostic factors of falls in hospitalized adults and elderly: An epidemiological and clinical analysis

BackgroundFalls are known to cause injuries ranging from minor to severe, resulting in local or systemic lesions. Addressing prognostic factors associated with falls is crucial for preventing this adverse event through the implementation of patient care protocols. This study aimed to explore the epidemiological, clinical, and pharmacological prognostic factors influencing falls in adult and elderly patients, assessing the timing and impact of these factors using survival curve analysis. MethodsA retrospective observational cohort study included 176 hospitalized patients experiencing falls, categorized into adults (<60 years) and elderly (≥60 years). Binomial tests and logistic regression assessed variable associations, while Kaplan-Meier curves and Cox proportional hazards models analyzed survival. ResultsOverall, 25.9 % of adults and 33.3 % of the elderly experienced some form of injury (minor or moderate). Patients were alone during the fall in 77.6 % of cases for those under 60, compared to 50 % for those 60 and older (p < 0.001). Falls from own height were the most common, occurring in 46.6 % of patients under 60 years and 66.7 % of elderly patients (p = 0.011). Among adults under 60, factors such as past alcohol history (p = 0.0276), falling alone (p = 0.0002), benzodiazepine use (p = 0.0001), antiarrhythmic/antihypertensive medication (p = 0.0005), and antipsychotics (p = 0.0001) were significantly associated with falls. In the elderly, significant factors included falling from one's own height (p = 0.0112), muscle weakness (p = 0.0183), gait disorders (p = 0.0443), vasodilators (p = 0.0107), antihistamines (p = 0.0003), and hypoglycemic agents (p = 0.0041). Survival curve analysis indicated women under 60 had a worse prognosis for falls compared to elderly women (p = 0.038). For the elderly, opioid use (p = 0.045) and muscle weakness (p = 0.037) represented poor prognostic factors compared to adults under 60. In Cox regression, only female sex in patients under 60 showed a higher risk (HR=1.47) compared to women over 60 (p = 0.0014). Although not significant in multivariate analysis, muscle weakness (p = 0.066) and opioid use (p = 0.0545) had proportional hazards of 1.37 and 1.12, respectively. ConclusionFemale sex indicated poorer prognosis in <60 s, while opioids and muscle weakness were concerning for the elderly. These findings emphasize the need for tailored care protocols to stratify patient fall risk and prognosis during hospitalization and develop effective preventive strategies in healthcare.

Sri Lanka Child Growth Cohort (SLCGC): a population-based study on growth faltering of children

PurposeThis paper aims to describe the study design and baseline characteristics of the Sri Lanka Child Growth Cohort (SLCGC), which was established to assess the timing, pattern and determinants of...

Potential Use of Fourier-Transform Infrared Spectroscopy as a Rapid Screening Tool for Investigating Nosocomial Outbreaks of ST-80 Vancomycin-Resistant Enterococcus faecium

Core genome single-nucleotide polymorphism phylogeny was used to characterise a nosocomial outbreak caused by ST-80 Vancomycin-resistant Enterococcus faecium (VREf). It identified 22 of 25 epidemiologically related isolates as belonging to an outbreak cluster. The use of Fourier-transform infrared (FT-IR) spectroscopy with a cluster-defining cut-off of 0.071 resulted in the correct classification of 21 of 22 phylogenetically related isolates in a single cluster. It successfully distinguished three phylogenetically unrelated isolates from the outbreak cluster, along with five ST-80 unrelated control isolates, and five isolates from a previous outbreak in May 2023, yielding only one mischaracterised environmental isolate. These findings support the potential use of FT-IR spectroscopy as a rapid screening tool to assist outbreak investigations. Notably, this study is the first to focus on the performance of FT-IR spectroscopy in the epidemiological analysis of VREf isolates with the same sequence type.

Identification and Epidemiological Analysis of Antibiotic-Resistant Bacteria in the Oral Microbiome of the Population in Pakistan.

Background Antibiotic resistance in the oral microbiome poses serious health risks worldwide, particularly in developing countries like Pakistan. Public health efforts are challenged by the potential of the oral cavity to serve as a reservoir for resistant bacteria due to its frequent exposure to antibiotics. Objective This study aimed to identify and analyze the prevalence and epidemiology of antibiotic-resistant bacteria within the oral microbiome of the Pakistani population. Methodology A cross-sectional study was conducted at Akhtar Saeed Medical and Dental College, Lahore, and Gomal Medical College, Dera Ismail Khan, from January 2023 to December 2023. A total of 290 participants, aged 18 years or older, were recruited based on specific inclusion and exclusion criteria. Oral swabs were collected and analyzed using conventional culture methods. All descriptive and inferential statistical analyses were performed using SPSS version 25 (IBM Corp., Armonk, NY), with a significance level set at p <0.05. Results The most common antibiotic-resistant bacteria identified were Enterococcus faecalis (24.48%, n = 71), Staphylococcus aureus (27.24%, n = 79), and Streptococcus mutans (35.86%, n = 104). The most frequent resistances were to penicillin (32.14%, n = 93), tetracycline (23.45%, n = 68), and erythromycin (22.07%, n = 64). Recent antibiotic use was significantly associated with higher rates of resistance (p = 0.01), with 75.19% of individuals (n = 97) who had used antibiotics within the past three to six months showing resistance. Conclusion The study reveals a high prevalence of antibiotic-resistant bacteria, particularly to penicillin and tetracycline, in the oral microbiome of the Pakistani population.

Extracorporeal Membrane Oxygenation and Reperfusion Strategies in High-Risk Pulmonary Embolism Hospitalizations.

To investigate the contemporary use of extracorporeal membrane oxygenation (ECMO) in conjunction with reperfusion strategies in high-risk pulmonary embolism (PE). Observational epidemiological analysis. The U.S. Nationwide Inpatient Sample (NIS) (years 2016-2020). High-risk PE hospitalizations. Use of ECMO in conjunction with thrombolysis-based reperfusion (systemic thrombolysis or catheter-directed thrombolysis) or mechanical reperfusion (surgical embolectomy or catheter-based thrombectomy) with regards to in-hospital mortality and major bleeding. We identified high-risk PE hospitalizations in the NIS (years 2016-2020) and investigated the use of ECMO in conjunction with thrombolysis-based (systemic thrombolysis or catheter-directed thrombolysis) and mechanical (surgical embolectomy or catheter-based thrombectomy) reperfusion strategies with regards to in-hospital mortality and major bleeding. Among 122,735 hospitalizations for high-risk PE, ECMO was used in 2,805 (2.3%); stand-alone in 1.4%, thrombolysis-based reperfusion in 0.4%, and mechanical reperfusion in 0.5%. Compared with neither reperfusion nor ECMO, ECMO plus thrombolysis-based reperfusion was associated with reduced in-hospital mortality (adjusted odds ratio [aOR] 0.61; 95% CI, 0.38-0.98), whereas no difference was found with ECMO plus mechanical reperfusion (aOR 1.03; 95% CI, 0.67-1.60), and ECMO stand-alone was associated with increased in-hospital mortality (aOR 1.60; 95% CI, 1.22-2.10). In the cardiac arrest subgroup, ECMO was associated with reduced in-hospital mortality (aOR 0.71; 95% CI, 0.53-0.93). Among all patients on ECMO, thrombolysis-based reperfusion was significantly associated (aOR 0.55; 95% CI, 0.33-0.91), and mechanical reperfusion showed a trend (aOR 0.75; 95% CI, 0.47-1.19) toward reduced in-hospital mortality compared with no reperfusion, without increases in major bleeding. In patients with high-risk PE and refractory hemodynamic instability, ECMO may be a valuable supportive treatment in conjunction with reperfusion treatment but not as a stand-alone treatment especially for patients suffering from cardiac arrest.

Epidemiological analysis of Road Accident Data Management System (RADMS) data in Tamil Nadu, India from 2011 to 2016: Future directions for an integrated national database

ABSTRACT Introduction: Globally, road traffic injuries (RTIs) are the eighth leading cause of death, with an estimated 1.35 million deaths yearly. In India, road traffic accidents (RTAs) are one of the major causes of mortality among the younger generation. We analyzed Tamil Nadu’s comprehensive Road Accident Data Management System (RADMS) data and described the epidemiological indicators of RTI in this setting. Methods: We obtained the data from the RADMS database for 2011–2016 and used 2011 population census data to project and standardize for different age groups and genders to calculate incidence. We calculated average annual percentage changes (AAPC) with a 95% confidence interval for the whole period. We computed Joinpoint regression analysis for trends and calculated the age-adjusted incidence rate with standard error (SE) using R statistical computing software. Results: We included 3,67,094 RTAs and 5,50,447 RTIs. We observed that the incidence of RTAs and RTIs declined between 2011 and 2016. Most injured were males (82%) and aged 20–39 years (49%). The highest number of accidents occurred on the state highways (65.2%) and on Sundays (17%). Age-adjusted incidence (per 1,00,000) declined from 121.87 (SE 0.4) in 2011 to 92.73 (SE 0.34) in 2016 (AAPC = -4.5% (95% CI = -7.8 to -1)). The age groups 30–39 and 20–29 were 9.82 (z = 8.98; P &lt; 0.05) and 9.02 (z = 8.65; P &lt; 0.05) times at a higher risk compared to 0–9 years old. The motorcyclists (14–27 times; P &lt; 0.05) and pedestrians (12–23 times; P &lt; 0.05) had the maximum risk of RTIs. Conclusion: Young adults, drivers, motorcyclists, and pedestrians remain vulnerable populations for RTIs. More accidents occurred in the state highways and on Sundays. The analysis provides insights on RTIs and RTAs, which will be used to reduce the burden of RTIs and save millions of lives.

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.