Epidemiological Characteristics Research Articles

Epidemiological and molecular characteristics of Infectious bursal disease virus naturally infected in the broiler flocks in the Mekong Delta of Vietnam during 2015 and 2018

Infectious bursal disease is a highly contagious and economically devastating disease in the poultry industry worldwide caused by Infectious bursal disease virus (IBDV). However, the data on epidemiological and molecular characteristics of the IBDV outbreak in broiler flocks in the Mekong Delta of Vietnam is unclear. Herein, the epidemiological data of IBDV–positive flocks over a period of 2015–2018 were recorded and the hypervariable region of the VP2 gene of IBDV was amplified to analyze the local phylogeny. The current investigation showed that the overall morbidity and mortality rates of IBDV–positive flocks were 45% and 4.81%, respectively. The IBDV–positive birds occurred clinical signs and macroscopic findings involved with the very virulent (vv) IBDV outbreak. Epidemiological results revealed that IBDV was frequently infected in broiler flocks at 12–42 days, and birds belonging to Tau Vang and Binh Dinh breeds were more sensitive to IBDV. Also, the morbidity rate of IBDV was dramatically decreased in the open farming system. Flocks with complete vaccination significantly dropped morbidity in comparison with other groups. Regarding phylogenetic analysis, all identified IBDV sequences clustered in the same branch of vv phenotype and closely homology with prior strains circulated in Vietnam and other countries. These findings first indicated the epidemiological characteristics of the IBDV–positive broiler flocks in the Mekong Delta and highlighted the IBDV strain circulating in this region.

Epidemiology and Clinical Features of Burkholderia Bacteremia at a Hospital in India.

Burkholderia spp. are opportunistic pathogens that cause infection in patients with disrupted immunity. The study intended to demonstrate the epidemiology and clinical features associated with Burkholderia spp. bacteremia. This retrospective study was performed to assess the clinical and laboratory characteristics of patients whose blood cultures were growing Burkholderia spp. and, based on their underlying comorbidities, were subjected to survival analysis from January 2022 to December 2022 at a university hospital in northern India. Three hundred patients with Burkholderia spp. bacteremia were included in this study conducted over 1 year. The mean age of the patients was 33.86 years with a male predominance of 56.67% (170/300, 56.67%). Underlying malignancies (207/300, 69.0%) were the most common clinical diagnosis, and catheter in situ (300/300, 100.0%) was the most common risk factor. Burkholderia cenocepacia (244/300, 81.33%) was the most common Burkholderia spp. isolated. All isolates were highly susceptible to minocycline. Kidney disease (P = 0.029), hypertension (P = 0.005), type 2 diabetes mellitus (P = 0.039), and respiratory disease (P <0.001) in patients were significantly associated with death owing to Burkholderia spp. bacteremia, whereas patients with malignancies (P <0.001) and undergoing treatment were significantly associated with a better outcome when the microorganism was susceptible to empirical antibiotics. The presence of indwelling devices, mechanical ventilation (P <0.001), and a hemodialysis catheter (P = 0.026) were statistically significant risk factors associated with poor outcomes.

Intramedullary nailing of proximal humerus fractures does not achieve superior functional results to non-operative treatment in the long term.

Non-operative treatment (NOT) of proximal humerus fractures (PHF) has regained significance due to recent evidence. Additionally, positive outcomes of plate osteosynthesis and fracture arthroplasty prompt a reassessment of the role of intramedullary nailing (IMN). While favorable short and medium-term results have been documented following IMN, little is known regarding functional outcomes and quality of life in the long-term. Data from 180 patients with dislocated PHF of Neer types III, IV and V, treated at our level-I trauma center between 2004 and 2014 using IMN or NOT therapy, were scanned. Patients were re-evaluated after a minimum of 5 years to assess functional outcomes (age- and sex-adapted Constant Score, QuickDASH), quality of life (SF12), and complications or reoperations. Out of the initially identified 180 patients, 51 were unavailable for follow-up (FU) and 71 had deceased during the FU period. Functional outcomes and quality of life was, therefore, assessed in 58 patients (30 IMN, 28 NOT) with an average age at injury of 68 years after a mean FU time of 10.3 ± 3.4 years. Epidemiological patient characteristics did not exhibit significant differences between the two groups (p > .05). The functional outcome assessed by age- and sex-adapted Constant Score (NOT: 74 ± 28; IMN: 68 ± 24; p = .438), QuickDASH (NOT: 25 ± 27; IMN: 31 ± 23; p = .374) or quality of life using the SF12 (p > .05) revealed no significant disparities in long-term outcomes between the treatment groups. 10 of 30 patients in the IMN group underwent surgical revision to address complications, exceeding mere implant removal. Conversely, no patient in the NOT group underwent a revision surgery during the FU period. In the long-term, functional and quality of life-related outcomes of IMN did not diverge significantly from those of NOT, while causing a higher incidence of follow-up interventions.

Intracranial Empyemas: Experience of the Neurosurgery Department of Conakry University Hospital

Introduction: Intracranial empyemas are rare intracranial suppurations but carry serious and potentially fatal prognosis In the absence of adequate treatment. The objective of our study was to determine the epidemiological, clinical features, therapeutic and evolutionary characteristics of these suppurations in our department. Materials and methods: It was a descriptive retrospective study of 88 intracranial empyemas files collected over a period of 5 years (January 2014-December 2018) in the archives of the neurosurgery department of Conakry University Hospital. Results: The frequency was 43.1% for all intracranial suppurations. The mean age was 14.6 years (2-42 years) with a sex ratio of 1.8 (57 males/31 females). The port of infection was dominated by otorhinolaryngological infections, 76.5% and unknown in 19%. The clinical manifestations were dominated by fever (90%), intracranial hypertension (66%) and focal signs (45%). The site was subdural in 59 cases and extradural in 29 cases. Surgical treatment involved 91% of patients and 9%were treated with antibiotic therapy alone. The evolution was favorable in 68.1% of cases with a mortality rate of 13.6%. Conclusion: Intracranial empyemas are medical and surgical emergency. The forms of otorhinolaryngology origin are more frequent. Despite the therapeutic difficulties, the prognosis remains acceptable in our study with 13.6% of deaths.

The Epidemiologic and Clinical Features of Radiographic-Confirmed Community-Acquired Pneumonia Among Chinese Children: A Retrospective Hospital-Based Study.

To help understand the disease burden of vaccine-preventable bacterial disease, we delineated the epidemiologic and clinical characteristics of radiographic-confirmed community-acquired pneumonia (CXR-CAP) among Chinese children. We retrospectively screened the electronic database of the hospital information system to identify all pediatric CAP cases admitted to the Children's Hospital of Soochow University between 2010 and 2014. Radiographic findings and clinical data were extracted from the medical charts through individual chart reviews. CXR-CAP cases were defined as the presence of consolidation or pleural effusion noted on chest radiograph reports. We employed a multivariate logistic regression model to identify the potential risk factors associated with CXR-CAP. Among the 27,485 hospitalized CAP cases with radiologic data, 6322 (23.00%) were identified as CXR-CAP cases, while 21,163 (77.00%) were categorized as non-CXR-CAP cases. Children with CXR-CAP were notably older than those without CXR-CAP (non-CXR-CAP; χ2 = 1313.22; P < 0.01). CXR-CAP cases exhibited a higher rate of intensive care unit admission (3.55% vs. 1.94%; P < 0.01), extended hospital stays (73.87% vs. 63.79%; P < 0.01) and increased mortality rates (0.19% vs. 0.04%; P < 0.01). The factors associated with CXR-CAP included age (>12 months), season (summer and autumn), fever, abnormal breath sounds, C-reactive protein (>8 mg/L) and alanine transaminase (>40 U/L). CXR-CAP cases consisted of a substantial proportion of hospitalized patients with CAP and had more severe clinical manifestations than in-patients without CXR-CAP among Chinese children.

Fungal keratitis among inpatients with corneal ulcers in Thai Binh, Vietnam: A retrospective observational study

Background: Infectious keratitis can be caused by bacteria, fungi, and viruses. Fungi are a common pathogen, especially in developing countries like India, Nepal, and Bangladesh where the prevalence ranges from 20% to 60%. In Vietnam, fungal keratitis accounted for the highest number of keratitis cases in a study conducted at the central eye hospital over a 5-year period (57%). Therefore, it is necessary to collect specific background information connected to the types of fungal keratitis in corneal ulcer cases in this region. Aims and Objectives: The aim of this study was to investigate the prevalence of fungal keratitis and the epidemiological features in 216 cases of fungal keratitis out of a total of 240 cases of infectious keratitis. Materials and Methods: This retrospective study collected secondary data from medical records of 240 inpatients with infectious keratitis who were treated at the ophthalmology hospital in Thai Binh, Vietnam, from January 01st, 2021 to June 30th, 2022. Patients with a positive fungal-directed smear were analyzed in detail for the type of fungus isolated, sociodemographic data, predisposing risk factors, prior treatment modalities, and laboratory results for the distribution pattern of fungus species. Results: Among the 240 cases, 126 (52.5%) were diagnosed with fungal keratitis by direct microscopic examination. Culture results showed the highest rate of Fusarium spp. (43.3%). The age group of 41–60 years was most commonly involved (40.5%). Males were more affected by fungal keratitis than females, (53.2% compared to 46.8%), with farmers being the most common occupation correlated with fungal keratitis (55.6%). The rate of fungal keratitis patients due to agricultural injuries was the highest compared to other risks (47.6%) and most patients self-medicated before going to the hospital, with many not knowing or remembering what medications they had taken (52.4%). Conclusion: The study revealed a high rate of fungal keratitis among the total of infectious keratitis cases in Thai Binh, Vietnam. Fusarium spp. was the most commonly isolated fungi. The study also highlighted the impact of agricultural injuries on fungal keratitis, especially in regions like Thai Binh.

Impact of dietary risk on global ischemic heart disease: findings from 1990–2019

Ischemic heart disease (IHD) is a condition in which the heart is starved of oxygen. Knowing the dietary risk factors implementing appropriate nutritional interventions in this regard seems essential. Therefore, the present study was carried out to determine the epidemiological features of IHD affected by dietary risks. This study used data from the Global Burden of Disease (GBD) study. In this study, we collected information on death, years lived with disability (YLD), and disability-adjusted life years (DALYs) of IHD affected by dietary risks in one hundred thousand people with 95% confidence based on the direct Age Standard Rate (ASR). We applied these data based on the Socio-demographic Index (SDI). In 2019, the number of IHD deaths, YLDs, and DALYs attributable to dietary risks was 62.43 million (95% UI [50.97–73.63] per 100,000 population), 36.88 (95% UI [23.87–53.32] per 100,000 population), and 1271.32 (95% UI [1061.29–1473.75] per 100,000 population), respectively. We found that the lowest DALYs of IHD affected by dietary risks by ASR are for high SDI countries. Most dietary risk factors related to IHD in countries with high and high middle SDI were related to a diet high in red and processed meat, sodium, and low in legumes, but in countries with low and low middle SDI, it was related to a diet low in fiber, fruit, nuts and seeds, PUFA, seafood W3 fatty acids, vegetables and whole grain. Considering that the dietary risk factors related to IHD are different based on SDI, it is necessary to consider nutritional interventions according to SDI.

Descriptive epidemiology of 399 histologically confirmed newly diagnosed meningeal solitary fibrous tumours and haemangiopericytomas in France: 2006-2015.

Meningeal solitary fibrous tumour (SFT) and haemangiopericytoma (HPC) are uncommon tumours that have been merged into a single entity in the last 2021 WHO Classification of Tumors of the Central Nervous System. To describe the epidemiology of SFT/HPC operated in France and, to assess their incidence. We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed SFT/HPC between 2006 and 2015. Our study included 399 SFT/HPC patients, operated in France between 2006 and 2015, in one of the 46 participating neurosurgical centres. The incidence reached 0.062, 95%CI[0.056-0.068] for 100,000 person-years. SFT accounted for 35.8% and, HPC for 64.2%. The ratio of SFT/HPC over meningioma operated during the same period was 0.013. SFT/HPC are about equally distributed in women and men (55.9% vs. 44.1%). For the whole population, mean age at surgery was 53.9 (SD ± 15.8) years. The incidence of SFT/HPC surgery increases with the age and, is maximal for the 50-55years category. Benign SFT/HPC accounted for 65.16%, SFT/HPC of uncertain behaviour for 11.53% and malignant ones for 23.31%. The number of resection progresses as the histopathological behaviour became more aggressive. 6.7% of the patients with a benign SFT/HPC had a second surgery vs.16.6% in case of uncertain behaviour and, 28.4% for malignant SFT/HPC patients. Meningeal SFT and HPC are rare CNS mesenchymal tumours which both share common epidemiological characteristics, asserting their merging under a common entity. SFT/HPC incidence is less that one case for 1 billion per year and, for around 100 meningiomas-like tumours removed, one SFT/HPC may be diagnosed. SFT/HPC are equally distributed in women and men and, are mainly diagnosed around 50-55years. The more aggressive the tumour, the higher the probability of recurrence.

Spatiotemporal Changes and Influencing Factors of Hand, Foot, and Mouth Disease in Guangzhou, China, From 2013 to 2022: Retrospective Analysis.

In the past 10 years, the number of hand, foot, and mouth disease (HFMD) cases reported in Guangzhou, China, has averaged about 60,000 per year. It is necessary to conduct an in-depth analysis to understand the epidemiological pattern and related influencing factors of HFMD in this region. This study aims to describe the epidemiological characteristics and spatiotemporal distribution of HFMD cases in Guangzhou from 2013 to 2022 and explore the relationship between sociodemographic factors and HFMD incidence. The data of HFMD cases in Guangzhou come from the Infectious Disease Information Management System of the Guangzhou Center for Disease Control and Prevention. Spatial analysis and space-time scan statistics were used to visualize the spatiotemporal distribution of HFMD cases. Multifactor ordinary minimum regression model, geographically weighted regression, and geographically and temporally weighted regression were used to analyze the influencing factors, including population, economy, education, and medical care. From 2013 to 2022, a total of 599,353 HFMD cases were reported in Guangzhou, with an average annual incidence rate of 403.62/100,000. Children aged 5 years and younger accounted for 93.64% (561,218/599,353) of all cases. HFMD cases showed obvious bimodal distribution characteristics, with the peak period from May to July and the secondary peak period from August to October. HFMDs in Guangzhou exhibited a spatial aggregation trend, with the central urban area showing a pattern of low-low aggregation and the peripheral urban area demonstrating high-high aggregation. High-risk areas showed a dynamic trend of shifting from the west to the east of peripheral urban areas, with coverage first increasing and then decreasing. The geographically and temporally weighted regression model results indicated that population density (β=-0.016) and average annual income of employees (β=-0.007) were protective factors for HFMD incidence, while the average number of students in each primary school (β=1.416) and kindergarten (β=0.412) was a risk factor. HFMD cases in Guangzhou were mainly infants and young children, and there were obvious differences in time and space. HFMD is highly prevalent in summer and autumn, and peripheral urban areas were identified as high-risk areas. Improving the economic level of peripheral urban areas and reducing the number of students in preschool education institutions are key strategies to controlling HFMD.

Epidemiologic and Virologic Characteristics of Influenza in Lao PDR, 2016-2023.

Influenza sentinel surveillance in Lao PDR is used to inform seasonal vaccination programs. This analysis reviews epidemiologic and virologic characteristics of influenza virus infection over 8 years, before and after emergence of SARS-CoV-2. Data collected for ILI and SARI surveillance during January 2016 through December 2023 were analyzed from nine hospitals. Respiratory specimens from ILI and SARI cases were tested by reverse transcriptase polymerase chain reaction to determine influenza positivity and subtype and lineage. Aggregate counts of outpatient visits and hospitalizations were collected from hospital logbooks. Epidemiologic trends of influenza activity were described, and the proportional contribution of influenza-associated ILI and SARI to outpatient and inpatient loads was estimated. Influenza was detected year-round with positivity peaking during September through January and occurring in most years approximately 1 month earlier in the south than the north. After decreasing in 2 years following the emergence of SARS-CoV-2, influenza positivity increased in 2022 and resumed its typical temporal trend. Influenza-associated ILI contribution to outpatient visits was highest among children ages 5-14 years (3.0% of all outpatient visits in 2023), and influenza-associated SARI contribution to inpatient hospitalizations was highest among children ages 2-4 years (2.2% of all hospitalizations in 2023). Influenza surveillance in Lao PDR provides clinicians and public health authorities with information on geographic and temporal patterns of influenza transmission. Influenza surveillance data support current vaccination timing and recommendations to vaccinate certain populations, especially young children.

Lentigo maligna: a comprehensive review on diagnosis and treatment.

Lentigo maligna (LM), a form of melanoma in situ, and LM melanoma (LMM), its invasive counterpart, exhibit distinctive epidemiology, risk factors, and clinical features compared to other melanoma subtypes. Notably, LM occurs on chronically sun-damaged skin presenting as a slow-growing, ill-defined patch which makes it difficult to diagnose and to treat. Additionally, while LM generally presents a favourable prognosis, it can also lead to dermal invasion and behave similarly to other melanomas with the same Breslow thickness. Hence, surgery continues to be the cornerstone treatment. Wide excisions are often necessary, but challenges arise when these lesions manifest in cosmetically sensitive regions, limiting the feasibility and desirability of large excisions. Specialized approaches, including margin-controlled surgery and image-guided treatment with reflectance confocal microscopy, have been developed to address these issues. Other non-surgical treatments such as cryosurgery, imiquimod, radiotherapy, or photodynamic therapy, may also be used but commonly present with recurrent/persistent disease. Herein we comprehensively review the existing literature on the management of LM/LMM, and discus the potential new advances on managing this challenging skin cancer.

Performance analysis of mathematical methods used to forecast the 2022 New York City Mpox outbreak.

In mid-2022, New York City (NYC) became the epicenter of the US mpox outbreak. We provided real-time mpox case forecasts to the NYC Department of Health and Mental Hygiene to aid in outbreak response. Forecasting methodologies evolved as the epidemic progressed. Initially, lacking knowledge of at-risk population size, we used exponential growth models to forecast cases. Once exponential growth slowed, we used a Susceptible-Exposed-Infectious-Recovered (SEIR) model. Retrospectively, we explored if forecasts could have been improved using an SEIR model in place of our early exponential growth model, with or without knowing the case detection rate. Early forecasts from exponential growth models performed poorly, as 2-week mean absolute error (MAE) grew from 53 cases/week (July 1-14)to 457 cases/week (July 15-28).However, when exponential growth slowed, providing insight into susceptible population size, an SEIR model was able to accurately predict the remainder of the outbreak (7-week MAE: 13.4 cases/week). Retrospectively, we found there was not enough known about the epidemiological characteristics of the outbreak to parameterize an SEIR model early on. However, if the at-risk population and case detection rate were known, an SEIR model could have improved accuracy over exponential growth models early in the outbreak.

Proposal for a Global Classification and Nomenclature System for A/H9 Influenza Viruses.

Influenza A/H9 viruses circulate worldwide in wild and domestic avian species, continuing to evolve and posing a zoonotic risk. A substantial increase in human infections with A/H9N2 subtype avian influenza viruses (AIVs) and the emergence of novel reassortants carrying A/H9N2-origin internal genes has occurred in recent years. Different names have been used to describe the circulating and emerging A/H9 lineages. To address this issue, an international group of experts from animal and public health laboratories, endorsed by the WOAH/FAO Network of Expertise on Animal Influenza, has created a practical lineage classification and nomenclature system based on the analysis of 10,638 hemagglutinin sequences from A/H9 AIVs sampled worldwide. This system incorporates phylogenetic relationships and epidemiologic characteristics designed to trace emerging and circulating lineages and clades. To aid in lineage and clade assignment, an online tool has been created. This proposed classification enables rapid comprehension of the global spread and evolution of A/H9 AIVs.

Epidemiological features of spinal intradural tumors, a single-center clinical study in Beijing, China

BackgroundSpinal intradural tumors are rare and heterogeneous in histological type, aggressiveness, and symptomatology, and there is a lack of data about them. This study investigated the epidemiological features of spinal intradural tumors.MethodsThis retrospective analysis included patients with spinal intradural tumors who underwent surgical treatment at the Myelopathy and Spondylosis Ward Beijing Jishuitan Hospital between January 2012 and December 2022.ResultsThis study included 1321 patients [aged 47.19 ± 14.90 years, 603 (45.65%) males] with spinal intradural tumors. The most common histological subtype was schwannoma [n = 511 (38.68%)], followed by spinal meningioma [n = 184 (13.93%)] and ependymoma [n = 101 (7.65%)]. Fifteen (1.14%) patients were diagnosed with metastatic spinal intradural tumors as a presentation of another primary cancer type. The spinal intradural tumors were mostly found in the lumbar region [n = 436 (33.01%)], followed by the thoracic vertebrae [n = 390 (29.52%)], cervical vertebrae [n = 154 (11.66%)], and thoracolumbar region [n = 111 (8.40%)]. Schwannomas mostly affected the lumbar region [n = 256 (52.64%)], spinal meningiomas in the thoracic region [n = 153 (83.15)], and ependymomas in the lumbar region [56 (55.45%)]. The de novo metastases were mostly found in the lumbar region [n = 8 (53.33%)].ConclusionAccording to the results of our single-center study, the most common spinal intradural tumor in Northern China is schwannoma, followed by spinal meningioma and ependymoma.

Clinical and epidemiological characterization of patients with acute heart failure

Clinical and epidemiological characterization of patients with acute heart failure

SARS-CoV-2 Antibody Level after Homologous and Heterologous Booster Vaccines: an 18-month Longitudinal Observational Cohort Study in Indonesia

Background Recently, there have been reports of the rise of COVID-19 cases in several sites. The effectiveness of the COVID-19 vaccine was reported elsewhere. There are still questions on how the kinetics of antibody response during relatively long periods, the need for additional doses, and the effect of homologous and heterologous boosters. The study was conducted to analyze the kinetics of antibody response after the primary dose and the third dose of the ChAdOx1 vaccine in individuals previously receiving two doses of the ChAdOx1 [homologous] and CoronaVac [heterologous] COVID-19 vaccines. Methods The study population comprised 52 men and 98 women, divided into CoronaVac Recipients and ChAdOx1 Recipients for the first two doses according to the recommended schedule by the Ministry of Health of Indonesia [MoH].Six months after the second dose, the third dose of ChAdOx1 was administered as a homologous and heterologous booster. COVID-19 antibody levels were measured by the CMIA method before the first dose [time-point or TP1], two weeks after the first dose [TP2], before the second dose [TP3], 1 month after the second dose [TP4], 12 months after the second dose [TP5], and 18 months [TP6] after the second dose administration. Six months after the second dose, the third dose of ChAdOx1 was administered as a homologous and heterologous booster. Along with these, several epidemiological data were collected from subjects on TP1. Results A total of 153 serum samples were collected from subjects who had received the third dose, and the antibody response was measured. On TP1, COVID-19 antibody reactivity [the level was &gt;50 AU/mL] was detected on 100 [66,67%] of subjects, indicating a possible previous exposure to SARS-CoV-2. On TP2, the sharp increase in antibody level was documented in the ChAdOx1 group. However, in the following data during the cohort, the gap was narrowing, and on the TP6, the antibody levels showed no significant difference between groups [p&gt;0.05]. Likewise, no significant differences were shown between groups with or without a history of COVID-19 antibody reactivity on TP1 [p&gt;0.05]. Considering epidemiological characteristics, no significant differences were documented based on sex, age groups, and BMI level. Conclusion This study provides a deeper understanding of the kinetics of antibody levels longitudinally among those with and without previous history of SARS CoV-2 infection, among the recipients of different vaccines, and the recipients of homologous and heterologous boosters. It is necessary to elucidate further in the next study how the level of antibody reflects the neutralizing antibody level as an indicator of protection against the infection risk.

Epidemiological Features of Chronic Low-Back Pain

Introduction: Chronic low back pain (LBP) is a major cause of abstinence from work in the world. Objective: The aim of the present study was to assess the epidemiological features of chronic low back pain patients in tertiary care teaching hospital. Materials and Methods: A descriptive cross sectional study was conducted from January 2018 to June 2018 among 70 patients attending at Physical Medicine and Rehabilitation outpatient department of the Shaheed Suhrawardy Medical College and Hospital after obtaining requisite consent from the patients. Data were collected through interviewing of the patients. The collected data were entered into the computer and analyzed by using SPSS (version 20.1) to assess the epidemiological features of chronic low back pain patients. Results: In a pool of 70 patients, most of the patients (n=34, 48.5%) belong to 31-40 year age group. In a pool of 70 patients, Male patients (52.85%) were more than the female patients (47.14%) at the Shaheed Suhrawardy Medical College and Hospital. In occupational status, most of the patients were Housewife (n=19, 27.14%) followed by service-holder (n=17, 24.28%). In a pool of 70 patients, most of the patients BMI were normal (n=49, 70%). Conclusion: Epidemiological features were characterized by male patients, as from the 31-40 years of life and housewife. Physical functional profile was primarily characterized by patients with normal BMI and overweight. Medicine Today 2024, Vol.36 (2): 107-109

Re-Emerging, Under-Recognized Zoonotic, and Neglected Tropical Diseases in Hawai'i.

Hawai'i, the United States' most western geographic state in the Pacific, lies between the North and South American continents and the Indo-Pacific regions, including Japan. The tropical environmental conditions of the Hawaiian Islands provide favorable ecosystems for various infectious pathogens, their vectors, and reservoirs. This creates an environment conducive to the transmission of zoonotic diseases affecting both humans and animals. Hawai'i has experienced an increase in dengue, leptospirosis, and murine typhus outbreaks. Furthermore, toxoplasmosis and neuroangiostrongyliasis cases remain prevalent throughout the state, and the putative presence of autochthonous Zika cases identified in a retrospective study may be of national public health concern. Understanding the factors that affect the transmission and distribution of zoonoses is necessary to identify at-risk locations and populations. The One Health approach seeks to understand, report, and interpret these factors and requires collaboration between private and governmental institutions. One Health should focus on neglected tropical diseases (NTD) and prioritize development of interventions to control and prevent the transmission of diseases that spread between animals and humans. This review focuses on the epidemiological and clinical characteristics of under-recognized zoonotic and NTD affecting Hawai'i, including leptospirosis, murine typhus, neuroangiostrongyliasis, toxoplasmosis, dengue, and Zika.

Molecular Evolutionary Dynamics of Coxsackievirus A6 Causing Hand, Foot, and Mouth Disease From 2021 to 2023 in China: Genomic Epidemiology Study.

Hand, foot, and mouth disease (HFMD) is a global public health concern, notably within the Asia-Pacific region. Recently, the primary pathogen causing HFMD outbreaks across numerous countries, including China, is coxsackievirus (CV) A6, one of the most prevalent enteroviruses in the world. It is a new variant that has undergone genetic recombination and evolution, which might not only induce modifications in the clinical manifestations of HFMD but also heighten its pathogenicity because of nucleotide mutation accumulation. The study assessed the epidemiological characteristics of HFMD in China and characterized the molecular epidemiology of the major pathogen (CV-A6) causing HFMD. We attempted to establish the association between disease progression and viral genetic evolution through a molecular epidemiological study. Surveillance data from the Chinese Center for Disease Control and Prevention from 2021 to 2023 were used to analyze the epidemiological seasons and peaks of HFMD in Henan, China, and capture the results of HFMD pathogen typing. We analyzed the evolutionary characteristics of all full-length CV-A6 sequences in the NCBI database and the isolated sequences in Henan. To characterize the molecular evolution of CV-A6, time-scaled tree and historical population dynamics regarding CV-A6 sequences were estimated. Additionally, we analyzed the isolated strains for mutated or missing amino acid sites compared to the prototype CV-A6 strain. The 2021-2023 epidemic seasons for HFMD in Henan usually lasted from June to August, with peaks around June and July. The monthly case reporting rate during the peak period ranged from 20.7% (4854/23,440) to 35% (12,135/34,706) of the total annual number of cases. Analysis of the pathogen composition of 2850 laboratory-confirmed cases identified 8 enterovirus serotypes, among which CV-A6 accounted for the highest proportion (652/2850, 22.88%). CV-A6 emerged as the major pathogen for HFMD in 2022 (203/732, 27.73%) and 2023 (262/708, 37.01%). We analyzed all CV-A6 full-length sequences in the NCBI database and the evolutionary features of viruses isolated in Henan. In China, the D3 subtype gradually appeared from 2011, and by 2019, all CV-A6 virus strains belonged to the D3 subtype. The VP1 sequences analyzed in Henan showed that its subtypes were consistent with the national subtypes. Furthermore, we analyzed the molecular evolutionary features of CV-A6 using Bayesian phylogeny and found that the most recent common ancestor of CV-A6 D3 dates back to 2006 in China, earlier than the 2011 HFMD outbreak. Moreover, the strains isolated in 2023 had mutations at several amino acid sites compared to the original strain. The CV-A6 virus may have been introduced and circulating covertly within China prior to the large-scale HFMD outbreak. Our laboratory testing data confirmed the fluctuation and periodic patterns of CV-A6 prevalence. Our study provides valuable insights into understanding the evolutionary dynamics of CV-A6.

Blue paper on Alzheimer's disease in China(simplified version)

With the population aging in China, the prevalence and mortality rate of Alzheimer's disease (AD) have been rising in China. AD has become one of the major threats to people's health and social sustainable development. In order to support the Healthy China Initiative and promote health in China, "Chinese Alzheimer's Disease Blue Book (Simplified Edition)"(refer to as the Blue Book) was compiled by experts and scholars from the National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University; the National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention; the National Health Commission Capacity Building and Continuing Education Center; and the China Population and Development Research Center. The epidemiological characteristics, diagnosis and treatment status, prevention and treatment management of AD and related cognitive disorders in China were systematically reviewed in the Blue Paper, aiming to provide references for the prevention of AD, provide support for the standardized diagnosis and treatment of the disease, and provide a reference for the government to formulate relevant health policies. Specifically, the Blue Book covers the following topics of AD and related cognitive disorders: (1)epidemiology characteristics; (2)economic burden; (3)influencing factors; (4)China Brain Cognitive Health Index; (5) diagnosis status; (6)treatment status; (7)construction of national center for cognitive disorders;(8)community-based prevention and control; (9) AD patients care; (10)public health resources for prevention and control.