Epidemiological Evaluation Research Articles

Brain Acetylcholinesterase and Blood Butyrylcholinesterase Levels in Carnaby's Cockatoos (Zanda latirostris) with Carnaby's Hindlimb Paralysis Syndrome (CHiPS).

Through evaluation of serum and plasma buterylcholinesterase (BChE) and brain acetylcholinesterase (AChE) activity, we investigated the possibility of the involvement of an acute organophosphate toxicosis in the pathogenesis of ongoing annual outbreaks of paresis and paralysis that in some cases progress to death, in endangered Western Australian Carnaby's cockatoos (Zanda latirostris). The condition, named Carnaby's hindlimb paralysis syndrome (CHiPS), was first described in 2012. Following initial investigations involving clinical, epidemiologic, toxicologic, gross necropsy, and histologic evaluation, a toxic etiology, specifically an organophosphate toxicosis, was considered most likely. The study aimed to validate the BChE assay for use in serum and plasma in Carnaby's cockatoos. This study found no evidence of changes in serum or plasma BChE or brain AChE that indicate an acute organophosphate toxicosis as the cause of CHiPS. Although these results render an acute organophosphate toxicosis unlikely, an organophosphate-induced delayed neuropathy has not been ruled out. Based on the results from the BChE validation study, the authors can recommend this assay for the evaluation of BChE measurement in plasma and serum from Carnaby's cockatoos with results showing excellent accuracy and precision.

Theoretical perspectives on biostatistics and its multifaceted applications in global health studies

Biostatistics plays a crucial role in global health studies by providing the tools necessary for analyzing complex health data and informing evidence-based public health decisions. This theoretical review explores the foundations of biostatistics and its diverse applications in the context of global health. At its core, biostatistics utilizes mathematical and statistical principles to analyze health data, enabling researchers to identify patterns, determine risk factors, assess interventions, and predict health outcomes across populations. Key theoretical concepts, including probability theory, statistical inference, and regression models, form the backbone of biostatistical analysis and are integral to understanding the dynamic relationships between health determinants and outcomes. The review highlights the various applications of biostatistics in global health, focusing on areas such as disease surveillance, epidemiology, and public health intervention evaluation. Biostatistical techniques are essential for analyzing epidemiological data, monitoring disease trends, and evaluating the effectiveness of health policies and interventions on a global scale. Furthermore, advanced statistical methods, including machine learning and Bayesian approaches, are becoming increasingly important in global health research. These methods allow for the analysis of large-scale data, predictive modeling, and more precise risk assessments, particularly in the context of emerging diseases, genetic research, and environmental health studies. Despite its strengths, biostatistics faces challenges in global health, including issues related to data quality, ethical considerations, and cross-cultural variations in health outcomes. Addressing these challenges is critical for ensuring accurate and equitable health assessments. Looking forward, biostatistics continues to evolve with innovations in data science, big data analytics, and real-time health data collection, making it an indispensable tool for improving global health outcomes and supporting health policies. This review emphasizes the theoretical underpinnings of biostatistics while highlighting its transformative potential in global health research and practice. Keywords: Theoretical Perspectives, Biostatistics, Multifaceted Applications, Global Health Studies.

Ferroptosis regulates hemolysis in stored murine and human red blood cells

AbstractRed blood cell (RBC) metabolism regulates hemolysis during aging in vivo and in the blood bank. However, the genetic underpinnings of RBC metabolic heterogeneity and extravascular hemolysis at population scale are incompletely understood. On the basis of the breeding of 8 founder strains with extreme genetic diversity, the Jackson Laboratory diversity outbred population can capture the impact of genetic heterogeneity in like manner to population-based studies. RBCs from 350 outbred mice, either fresh or stored for 7 days, were tested for posttransfusion recovery, as well as metabolomics and lipidomics analyses. Metabolite and lipid quantitative trait loci (QTL) mapped >400 gene-metabolite associations, which we collated into an online interactive portal. Relevant to RBC storage, we identified a QTL hotspot on chromosome 1, mapping on the region coding for the ferrireductase Steap3, a transcriptional target to p53. Steap3 regulated posttransfusion recovery, contributing to a ferroptosis-like process of lipid peroxidation, as validated via genetic manipulation in mice. Translational validation of murine findings in humans, STEAP3 polymorphisms were associated with RBC iron content, lipid peroxidation, and in vitro hemolysis in 13 091 blood donors from the Recipient Epidemiology and Donor Evaluation Study. QTL analyses in humans identified a network of gene products (fatty acid desaturases 1 and 2, epoxide hydrolase 2, lysophosphatidylcholine acetyl-transferase 3, SLC22A16, glucose 6-phosphate dehydrogenase, ELOVL, and phospholipase A2 group VI) associated with lower levels of oxylipins. These polymorphisms were prevalent in donors of African descent and were linked to allele frequency of hemolysis-linked polymorphisms for Steap3 or p53. These genetic variants were also associated with lower hemoglobin increments in thousands of single-unit transfusion recipients from the vein-to-vein database.

Epidemiological Profile and Treatment Evaluation of Patients with Type II Diabetes Mellitus at a Basic Health Unit in Jaraguá do Sul/SC

Epidemiological Profile and Treatment Evaluation of Patients with Type II Diabetes Mellitus at a Basic Health Unit in Jaraguá do Sul/SC

Epidemiological Evaluation of Suicidal Deaths due to Hanging: A Retrospective Medicolegal Study in Sylhet

Background: Suicidal hanging is the most common method of suicide in developing countries, especially among young people. During conventional autopsies, it is one of the significant causes of unnatural deaths in Bangladesh. This study was performed to determine the epidemiological evaluation of suicidal deaths due to suicidal hanging at the mortuary of the Forensic Medicine Department of Sylhet MAG Osmani Medical College, Sylhet. Materials and methods: An autopsy record-based retrospective study carried out to ascertain the epidemiological evaluation of 340 cases of suicidal hanging deaths from January 2015 to December 2018 in the Department of Forensic Medicine, Sylhet MAG Osmani Medical College, Sylhet. Results: Hanging was more common in the age ranges of 10-19 years (33.0%) and 20-29 years (29.1%), accounting for nearly two-thirds (62.1%) of all deaths. The incidence was higher in females (59.3%) than males (46.7%). Gowainghat (12.1%) and Kotwali (9.5%) had the highest incidences of victims. The most common autopsy findings were that the subcutaneous tissues underneath the ligature mark were found to be pale, white, hard and glistening in 94.2% of cases, cyanosis was found in 89.8% of cases, dribbling of saliva was seen in 66.3% of cases and subconjunctival petechial haemorrhage was observed in 46.0% of cases. Asphyxia (93.3%) was the most common cause of suicidal hanging deaths identified during autopsy. Conclusion: The majority of victims were female and young individuals were especially vulnerable to suicidal ideation, attempts and suicide by hanging. To reduce suicides, awareness programs, psychological counseling andsuicidal behavioral treatment are recommended. IAHS Medical Journal Vol 7(1), June 2024; 13-16

Epidemiology of Macrocephaly in the Texas Birth Defects Registry, 1999-2019.

Macrocephaly is a clinical observation denoted as an occipitofrontal head circumference exceeding two standard deviations above same age and sex norms. By its definition, macrocephaly occurs in approximately 3% of the population. Descriptive epidemiologic evaluations of macrocephaly are lacking in the literature. The primary objective of this study was to describe the prevalence of macrocephaly captured by the Texas Birth Defects Registry (TBDR) by infant sex, rural/urban residence, and select maternal characteristics. Cases of TBDR between 1999 and 2019 with a six-digit Centers for Disease Control modified-British Pediatric Association (BPA) code of 742.400 (enlarged brain/head, large head, macrocephaly, megalencephaly) were identified. All pregnancy outcomes and diagnostic certainties were included. Prevalence (per 10,000 live births) and 95% confidence intervals (CIs) were calculated using a Poisson table by rural/urban residence, infant sex, maternal age, education, race/ethnicity, history of diabetes, and body mass index (BMI). Prevalence calculations were repeated across multiple sensitivity analyses including (1) definite, isolated cases excluding those with indication of being either "benign" or "familial", (2) definite, non-isolated cases, (3) definite non-isolated cases excluding chromosomal and syndromic cases, and (4) definite, proportionate (at birth) cases. A secondary objective was to describe the most common co-occurring congenital defects among definite, non-isolated cases. Overall, between 1999 and 2019, 14,637 cases of macrocephaly were identified in the TBDR resulting in a prevalence of 18.12/10,000 live births (95% CI: 17.83-18.42). Most cases were live born (99%), had a definite diagnosis (87%), and were non-isolated (57%). Prevalence was significantly higher among males, among those with an urban residence, and among mothers who were older, Non-Hispanic White, who had greater than high school education, who had a history of diabetes, and who were obese. Prevalence patterns remained consistent across all sensitivity analyses. The most common co-occurring congenital defects among definite, non-isolated cases were minor and primarily included skull and facial bone anomalies (e.g., plagiocephaly [18%]). To our knowledge, this is the first epidemiologic evaluation of macrocephaly in a birth defects registry. The long-term clinical impact of isolated macrocephaly is not well understood and should be the focus of future investigations.

Investigation of Carbapenemase-Producing Pseudomonas aeruginosa at Secondary Care Hospital in Bolu, Turkey.

The global increase in carbapenem resistance poses a significant public health threat due to the potential emergence of multidrug-resistant pathogens and limited treatment options. To learn more about this issue and offer potential solutions, we conducted a study of carbapenem-resistant Pseudomonas aeruginosa (CRPA) infections in a secondary care hospital setting. The study utilized the carbapenem inactivation method (CIM), a leading phenotypic analysis, to determine carbapenemase activity in 63 CRPA isolates. Additionally, polymerase chain reaction (PCR) analysis was conducted to test for the presence of carbapenemase genes associated with the production or expression of various carbapenemase enzymes, including blaKPC, blaNDM, blaVIM, blaOXA-48, blaIMP, and blaGES. Arbitrary primed PCR (AP-PCR) was performed to assess the clonal relationship between different isolates. The isolates were also classified as either health care-associated infections or community-acquired infections, and their clonal relationship and gene positivity were evaluated. A total of 63 CRPA samples underwent evaluation, with 14 isolates determined to be carbapenemase producers via CIM tests. PCR assays revealed that 14 isolates carried carbapenemase genes, with 9 carrying blaNDM, 2 carrying blaGES, 2 carrying blaVIM, and 1 carrying blaIMP. CRPA exhibited a 22% prevalence of carbapenemase genes, of which 64% were attributed to the NDM gene responsible for multidrug resistance. AP-PCR revealed high clonal diversity among the isolates. Molecular epidemiological evaluation also showed no dominant outbreak strain among PA isolates. This study presents significant data on the prevalence and distribution of carbapenemase-producing CRPA strains isolated from secondary health care facilities. Typically, the literature focuses on resistance rates in tertiary care public hospitals. These findings may aid in understanding resistance and its mechanisms, as well as in developing effective treatment strategies and infection control measures.

The Epidemiological, Entomological and Socio-Economic Evaluation of Ivermectin Treatment in Imo River Basin, Nigeria

To assess the effectiveness of annual mass ivermectin treatment over 20 years in achieving elimination of onchocerciasis, we conducted a cross-sectional study between May 2021 and March 2022. A total of 540 individuals aged 5 years and above from rural farming communities selected were skin-snipped for dermal microfilariae (mf) by standard technique. Prospection of Simulium black flies was done at Lolo and Ibii Rivers. Structured questionnaires were used for the level of awareness, attitude and perceptions (KAP): onchocerciasis, vectors, treatment, drug compliance, benefits and socio-economy. Results revealed an overall mf prevalence of 12.8% and black fly infection rate (0.7%), infectivity and transmission potentials of (0.0%) indicative of non-transmission. These values contrasted with earlier reports in the range of 22%-68% for mf and 20.2%-48.2% infective rates suggesting the efficacy of mass ivermectin treatment in halting onchocerciasis. Participants had a high level of awareness about drug distribution. Benefits, dislikes and challenges of ivermectin were reported. We concluded that annual mass ivermectin treatment creditably reduced the microfilarial load and treatment in the study communities.

Proximal avulsion of the hamstring in young athlete patients: a case series and review of literature.

Hamstring injuries are a frequent occurrence of athletes, leading to a stop in practice and long-term alterations in sports performance. About 12% of these lesions involve avulsion at the level of the proximal insertion that can be complete (about 6%) or partial. Starting from an epidemiological and treatment evaluation of these lesions in literature, the aim of this study was to examine the functional outcomes and the rate of "return to play" in a population composed of athletes of various levels who have undergone surgery to reinsert the hamstring muscles at the ischial insertion, for a complete detachment of one or more tendon heads. Therefore, a retrospective study was carried out where 18 patients treated at the Orthopedics and Traumatology Unit of the I.R.C.C.S. San Matteo in Pavia (Italy) were identified in a time span ranging from March 2012 to August 2020. The sample was analysed taking into account age, sex and risk factors, as well as the pathophysiology and anatomy of the injury using the Wood classification, the time elapsed before surgery, the duration of the rehabilitation protocol and the possible return to sports activity, comparing the level of sports performance in the pre- and post-operative period using the Tegner Activity Score (TAS). Different post-operative outcome evaluation scores (Perth Hamstring Assessment Tool PHAT and Lower Extremity Functional ScaleLEFS) were also compared with each other in order to find a correlation with the real level of return to sporting activity. The mean age at surgery was 26.4 11.6 years. The population is composed of 14 males (77.8%) and 4 females (22.2%). All 18 patients returned to sports following surgery (100%). Of these patients, 17 (94%) maintained a level of sports performance equal to that before the injury. 100% of patients rated the outcome of the surgery as satisfactory. This study has shown that Hamstring reinsertion surgery is a correct indication in all athletes, allowing them a satisfactory return to sports practice.

A decade of gastrocnemius injuries in elite men’s Australian Football: A descriptive epidemiological evaluation

A decade of gastrocnemius injuries in elite men’s Australian Football: A descriptive epidemiological evaluation

Bleeding recurrence risk among hospitalized patients undergoing therapeutic plasma exchange: a multi-center study.

In hospitalized patients undergoing therapeutic plasma exchange (TPE), it is not known how TPE-associated bleeding risk is impacted by a prior bleeding episode. Therefore, to assess the prevalence and predictors of bleeding recurrence, we analyzed data from the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). Using a retrospective cross-sectional analysis of REDS-III public use files, we identified hospitalized adults who had a major bleeding episode prior to their first TPE procedure. Patients were classified into two cohorts based on bleeding recurrence (no-recurrence vs recurrence). After identifying potential predictors, we used multiple imputation by chained equations to impute variables with <30% missing data. Variable selection was optimized using a 10-fold cross validated least absolute shrinkage and selection operator. Final predictors were identified by fitting a logistic regression model. In 310 patients with major bleeding prior to TPE initiation, bleeding recurred in 121 (39.0%). We identified the following seven unique predictors: 1) >10 TPE procedures (OR 2.23); 2) intensive care unit stay (OR 1.35); 3) thrombocytopenia (OR 1.26); 4) surgery (OR 1.22); 5) hepatic disease (OR 1.21); 6) 6-10 TPE procedures (OR 1.04); and 7) Asian race (OR 1.01). We also identified the following five interactions: 1) surgery and therapeutic anticoagulation (OR 1.50); 2) 6-10 TPE procedures and therapeutic anticoagulation (OR 1.05); 3) 6-10 TPE procedures and antiplatelets (OR 1.02); 4) >10 TPE procedures and antiplatelets (OR 1.00); and 5) albumin-only TPE and antiplatelets (OR 0.53). When assessed for adjusted performance, the prediction model had a C-statistic of 0.617 (95% CI 0.613-0.619) and Brier Score of 0.342 (95% CI 0.340-0.347). In this study assessing predictors of bleeding recurrence among hospitalized patients undergoing TPE, we identified seven variables and five interactions. These findings should be validated in future studies.

Epidemiological Evaluation of Next-Generation Sequencing and MLPA Results in Patients with a Presumptive Cystic Fibrosis Diagnosis

Epidemiological Evaluation of Next-Generation Sequencing and MLPA Results in Patients with a Presumptive Cystic Fibrosis Diagnosis

Epidemiology and Clinical Evaluation of Patients Enrolled for Keratoplasty - A Retrospective Study

Epidemiology and Clinical Evaluation of Patients Enrolled for Keratoplasty - A Retrospective Study

Prescribing Practices in Pediatrics and Drug Utilization Studies Promoting Pediatric Health

Knowledge of drug administration in children and infants lags behind that of adults for many reasons. These include developmental differences that affect the pharmacodynamic and pharmacokinetic profiles of drugs, ethical and financial reasons, research capabilities, and regulatory guidelines and constraints. Most of the drugs prescribed for children have not been tested in the pediatric population due to the difficulties in carrying out clinical studies in children and ethical issues due to children not being able to make their own decisions to participate in a clinical trial. Epidemiological evaluation of medicine use in elderly is now a highly visible topic, but drug prescribing studies in pediatric patients have been limited. The higher incidence of infections in pediatric population as compared to adults leads to higher prescription of Antimicrobial Drugs (AMDs), at times more than two in single prescription. The use of antibiotics in children has been a major area of concern. . Periodic prescriptions analysis and effective feedback to clinician should be done based on results to ensure rational prescribing and effective health care management, which will ultimately lead to a better child health. In this review article, we will to analyze prescribing practices in pediatrics and drug utilization studies promoting pediatric health.

Evaluation of the blended public health empowerment program-basic field epidemiology in the Eastern Mediterranean Region.

The COVID-19 pandemic encouraged the shift toward technology-based learning globally, impacting education systems profoundly. In response to this emerging need, the Eastern Mediterranean Public Health Network (EMPHNET) adapted its Public Health Empowerment Program-Basic Field Epidemiology (PHEP-BFE) to a Blended Learning Model. This study evaluates the Blended PHEP-BFE program in Iraq, Egypt, and Lebanon, focusing on participant reactions and learning outcomes. A descriptive evaluation was conducted, aligned with the first two levels of Kirkpatrick's model. Online questionnaires were administered to participants and facilitators through EMPHNET's Learning Management System (LMS). Qualitative and quantitative data were analyzed to assess program effectiveness, satisfaction, and challenges. A total of 138 PHEP-BFE participants (119 (86.2%) males and 19 (13.8%) females) from Iraq (n = 61), Egypt (n = 66), and Lebanon (n = 11) responded to the questionnaire. The majority of the participants (96.4%) reported that they were satisfied with PHEP-BFE. Notably, 77.5% of participants rated the blended learning program as very good or excellent, 18.1% rated it good, and 3.6% found it average, with a minimal 0.7% expressing dissatisfaction. The majority of participants agreed that the blended PHEP-BFE enhanced their capacity to conduct, review and monitor surveillance data (95.7%), perform descriptive data analysis (94.2%), effectively communicate information with agency staff and the local community (95.7%), write summaries of surveillance findings or outbreak investigations (95.7%), use MS Excel to enter, analyze, and display public health surveillance data (91.3%), prepare and administer an oral presentation for fieldwork (94.9%), and increase their knowledge of fundamental field epidemiology (94.9%). The participants responded positively to the program's content, training duration, learning platform, facilitators and mentors, and fieldwork. The study showcases the success of the blended PHEP-BFE in diverse contexts, emphasizing positive participant reactions and improved competencies. The evaluation underscores the program's success in advancing public health training in the EMR. Blended learning models prove promising for future FETP initiatives, contributing valuable insights to public health workforce development. Positive outcomes and identified challenges, provide a roadmap for continuous improvement.

Biological and genetic determinants of glycolysis: Phosphofructokinase isoforms boost energy status of stored red blood cells and transfusion outcomes

Mature red blood cells (RBCs) lack mitochondria and thus exclusively rely on glycolysis to generate adenosine triphosphate (ATP) during aging invivo or storage in blood banks. Here, we leveraged 13,029 volunteers from the Recipient Epidemiology and Donor Evaluation Study to identify associations between end-of-storage levels of glycolytic metabolites and donor age, sex, and ancestry-specific genetic polymorphisms in regions encoding phosphofructokinase 1, platelet (detected in mature RBCs); hexokinase 1 (HK1); and ADP-ribosyl cyclase 1 and 2 (CD38/BST1). Gene-metabolite associations were validated in fresh and stored RBCs from 525 Diversity Outbred mice and via multi-omics characterization of 1,929 samples from 643 human RBC units during storage. ATP and hypoxanthine (HYPX) levels-and the genetic traits linked to them-were associated with hemolysis invitro and invivo, both in healthy autologous transfusion recipients and in 5,816 critically ill patients receiving heterologous transfusions, suggesting their potential as markers to improve transfusion outcomes.

Longitudinal Trends and Disparities in Diabetic Retinopathy Within an Aggregate Health Care Network

Diabetic retinopathy (DR) is a leading cause of blindness in the US, warranting updates on its prevalence and incidence in the setting of advancements in diabetic care over recent years. To determine recent trends in DR prevalence stratified by baseline demographics to identify those populations at greater risk. This was a cross-sectional epidemiologic evaluation conducted using deidentified data from the large federated TriNetX Analytics health research network composed of 56 health care organizations in the US. Patients from 2015 to 2022 who had an International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code of type 1 DR (T1DR) or type 2 DR (T2DR) were included in this analysis. Patients were further stratified by age cohorts (20-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, and 70 years or older), race and ethnicity, and sex. Prevalence per 100 000 patients and prevalence odds ratios (ORs) were calculated in Microsoft Excel and Posit (formerly RStudio). A total of 359 126 patients with T1DR or T2DR (mean [SD] age, 67 [14] years; 52% female) were included in this study between January 1, 2015, and December 21, 2022. T1DR increased in prevalence from 2015 to 2022, with T1DR increasing 1.15-fold affecting 70.4 patients per 100 000 in 2022. T2DR increased 1.07-fold affecting 461.7 patients per 100 000 in 2022. For T1DR, the cohort aged 20 to 39 years had the most substantial increase at 4.7 and 1.96 fold. Overall, White males had the largest prevalence ORs of T1DR at 1.41 (95% CI, 1.36-1.47) compared with White females (reference group). In T2DR, patients aged 20 to 39 years again had a 2.5- and 1.6-fold prevalence increase from 2015 to 2022. Regardless of age group, Hispanic males demonstrated larger prevalence OR at 4.08 (95% CI, 3.97-4.19) compared with White females followed by Hispanic females at 2.49 (95% CI, 2.42-2.56), Black males at 2.23 (95% CI, 2.17-2.29), and Black females at 2.00 (95% CI, 1.95-2.05). The prevalence of both T1DR and T2DR increased in this network from 2015 to 2022, with individuals aged 20 to 39 years showing large increases. Additionally, T2DR was associated with greater increases in both Hispanic and Black communities. These findings support DR screening in young adults and for T2DR interventions specifically designed for racial and ethnic minoritized patients most affected by disease. Future investigations are warranted to further investigate these trends among young adults.

MYOCARDIAL AND PERICARDIAL DISEASES INCIDENCE IN COVID

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), also referred to as COVID–19, was declared a pandemic by the World Health Organization in March 2020. The manifestations of COVID–19 are widely variable and range from asymptomatic infection to multi–organ failure and death. Like other viral illnesses, acute myocarditis and/or pericarditis has been reported to be associated with COVID–19 infection. The guidelines for the diagnosis of COVID–19 introduced the echocardiogram for diagnosis of carditis in these patients. Purpose In our study we investigated the incidences of myocarditis and/or pericarditis in a consecutive series of 1540 Athletes undergo to agonostic certification that performed echocardiogram, and subdivided the incidence of carditis depend on the period and the possible subtype of the covid (alpha, beta, gamma, delta, epsilon). Methods From March 2020 to October 2022 we enrolled in this epidemiological evaluation 1540 patients that was affected by COVID. Every patients was admitted to ambulatory of sport medicine of 2 Italian centres on the major islands to perform a return to play agonist certificate. Overall, 69% males and 31%. females were enrolled with a mean age of 24.3 years (12–67 years). None presented a risk factor of a cardiac disease. Results The incidence of Echocardiographic abnormality was 3,2% in our population The kind and the incidence of alteration was showed in table 1, and consist in dilated cardiomiopathy (0,4%), regional cinetic dysfunction (0,4%), pericardial effusion (1,9%), aspecific alterations (0,2%). Based on the period we evaluated the incidence of the echocardiographic alterations during the seasons and in corralation of variant of COVID . The results was showed in figure 1. Conclusions Based on our evalution the incidence of echocardiographic findings in COVID was 3,2% in all period, with a progressive reduction long the time, from alpha variant to epsilon variant.

Drastic reduction in the notification of acute cases of Chagas disease in the Northeast region of Brazil. Epidemiological evaluation in the period 2001–2021

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), is a neglected disease endemic to some Latin American countries, including Brazil. Soon after infection, individuals develop an acute phase, which in most cases is asymptomatic and may go undetected. However, when CD is detected early, notification in the Notifiable Diseases Information System (SINAN), is mandatory. This study aimed to evaluate the information registered in the SINAN database and to determine the epidemiological profile of acute CD in Northeast Brazil, an endemic region, from 2001 to 2021. According to this survey, 1,444 cases of acute CD were reported in the Northeastern region of Brazil during this period. During the first six years, referred to as period 1, 90.24% of the notifications were registered, while the number of notifications significantly decreased in the subsequent years, referred to as period 2. Most individuals diagnosed with acute CD were Afro-Brazilian adults. All known routes of infection by the parasite were reported. Vector-borne transmission was predominant during period 1 (73.29%) and oral transmission during period 2 (58.87%). All nine states in Northeast Brazil reported cases in both periods. A higher incidence of disease was reported in Rio Grande do Norte (RN) during period 1, and in Maranhão (MA) during period 2. Our results show that CD remains a significant public health challenge.

Syphilis and Beyond: A Comprehensive Analysis of Associated Infections and Comorbidities in a Five-Year Retrospective Study in the United Arab Emirates (2018-2022)

Objectives This study explores the clinical characteristics, associated infections, and management outcomes of syphilis within a specific population over the years 2018 to 2022. With a focus on the frequency, clinical manifestations, and co-infections of syphilis, the research addresses a critical gap in understanding the nuanced dynamics of this sexually transmitted infection and its impact on public health. Methods The study employs a retrospective analysis of data collected from 2018 to 2022, utilizing three key serological tests (Syphilis AB, RPR/VDRL, and TPHA) to characterize syphilis infections within the population. Clinical manifestations and associated infections, including HIV, HBV, HCV, Chlamydia, Gonorrhea, and HPV, are systematically assessed. Treatment rates and re-infection patterns are also analyzed, providing a comprehensive overview of syphilis epidemiology within the studied timeframe. Results The frequency of syphilis, particularly indicated by the Syphilis AB test, exhibited a marked increase in 2020, reaching 96%, suggesting a heightened frequency within the population. RPR/VDRL test results demonstrated consistent frequency, emphasizing the persistent presence of active syphilis infections. Clinical manifestations, such as chancre, skin rashes, alopecia syphilitica, and lymphadenopathy, displayed dynamic patterns over the study years. Co-infection rates varied, with fluctuations observed in HIV, Chlamydia, Gonorrhea, and HPV, while HBV and HCV showed infrequent but stable frequency. The management of syphilis cases demonstrated commendable treatment rates, but an increase in re-infection rates in 2021 highlights the need for continued vigilance. Conclusion This study provides a comprehensive evaluation of syphilis epidemiology, clinical characteristics, and associated infections within the studied population. The results offer valuable insights into the dynamic nature of syphilis and its co-infections, informing public health initiatives and interventions. The findings contribute to our understanding of the epidemiological landscape and underscore the importance of sustained efforts in both prevention and treatment to curb the transmission of syphilis and its associated infections. The study, however, calls for continued vigilance and research to address the evolving trends and challenges in syphilis management within the specified population.