Epidemiological Information Research Articles

Determinants of Hypertensive Disorders in Pregnant Women Attended at Parirenyatwa Group of Hospitals in Zimbabwe from January - December 2022

Background: Globally 2.73% of pregnant women suffer from hypertension. Currently, there is still a gap of knowledge in Zimbabwe on hypertensive disorders of pregnancy hence the present study. Methods: An analytical cross-sectional study was conducted. The structured checklist was used to extract data. HBP was measured two times on the right arm using an electronic device (OMRON HEM-7261) with an average of two readings. Patient records were used to collect secondary data from prenatal care visits and laboratory tests. We used simple random sampling methods to screen prenatal care records for pregnant women. All pregnant women at Parirenyatwa Group of Hospitals in 2022 were eligible and constituted our study population. The sample size was determined statistically by power analysis using epidemiological information, this yielded a sample of 240. The Prevalence of HBP in pregnancy and risk factors were determined by Fisher exact test Graph Pad (Prism version6.0), P < 0.05 was set as statistically significant. Results: 240 pregnant women were enrolled given a prevalence of HBP of 25%. Most pregnant women having HBP are 36 to 40 years old and located in urban areas (92%, n = 55). Gestational age 33 % (n = 5), Gravida 3-4 (33%, n = 13) Parity 3-4 (74%, n = 25), and Multiple Pregnancy (25%, n = 5) were the most associated with HBP. Pre-existing hypertension was the most common comorbidity 92%.Family history of HBP (OR = 4.62, 95%, CI = 1.4-15.1), p = 0.016) and age being < 30 years OR= 0.26, 95%, CI = 0.14-0.49), p = 0.0001) were associated with HBP. Conclusions: The prevalence of HBP in pregnancy was higher (25%) than the worldwide prevalence of 2.7% and risk factors are mainly age and family history of HBP.

Higher frequency of interstate over international transmission chains of SARS-CoV-2 virus at the Rio Grande do Sul - Brazil state borders.

Brazil's COVID-19 response has faced challenges due to the continuous emergence of variants of concern (VOCs), emphasizing the need for ongoing genomic surveillance and retrospective analyses of past epidemic waves to reassess and fine tune containment protocols. Rio Grande do Sul (RS), Brazil's southernmost state, has international borders and trades with Argentina and Uruguay, along with significant domestic connections within Brazil. The identification of source and sink transmission chains at national and international scales can identify main hubs and pathways to target future interventions. In this study we investigated the RS state role in the national and international SARS-CoV-2 transmission chains, which has not been fully explored. Nasopharyngeal samples from various municipalities in RS were collected between June 2020 and July 2022. SARS-CoV-2 whole genome amplification and sequencing were performed using high-throughput Illumina sequencing. Bioinformatics analysis encompassed the development of scripts and tools to perform subsampling taking into account epidemiological information to reduce sequencing disparities bias among the regions/countries, genome assembly, and large-scale alignment and phylogenetic reconstruction. We sequenced a total of 1,480 SARS-CoV-2 genomes from RS, covering all major regions. Sequences predominantly represented Gamma (April-June 2021) and Omicron (January-July 2022) lineages. Phylogenetic analysis revealed a regional pattern for transmission dynamics, particularly with Southeast Brazil for Gamma, and a range of inter-regional connections for Delta and Omicron within the country. On the other hand, international and cross-border transmission with Argentina and Uruguay was rather limited. We evaluated the three VOCs circulation over two years in RS using a new subsampling strategy based on the number of cases in each state during the circulation of each VOC. In summary, the retrospective analysis of genomic surveillance data demonstrated that virus transmission was less intense between country borders than within the country. These findings suggest that while non-pharmacological interventions were effective to mitigate transmission across international RS land borders, while they were insufficient to contain transmission at the domestic level.

Clinical and Epidemiological Information Required for Lyme Disease Surveillance in a Low-Incidence State, California 2011-2017.

Background: Between January 1, 2011, and December 31, 2017, over 12,000 case reports of Lyme disease (LD) were submitted to the California Reportable Disease Information Exchange for further investigation. The number of case reports has tripled compared to previous years, emphasizing the need for efficient estimation and classification methods. We evaluated whether estimation procedures can be implemented in a low-incidence state such as California to correctly classify a case of LD, similar to those procedures used in high-incidence states. Objective: The purpose of this study was to identify whether a minimum number of variables was sufficient to reliably classify cases in California and potentially reduce workload while maintaining the ability to track LD trends in California. Methods: To determine the relative value of diagnostic information, we compared five candidate logistic regression models that were used to classify cases based on information that varied in its degree of difficulty for collection. Results: Our results using California's surveillance data showed that automatically reported data were not sufficient, additional information such as, a patient's clinical presentation and travel history were necessary in a low-incidence state to improve the overall sensitivity of the models. Conclusion: This study may help inform public health surveillance efforts by demonstrating that both clinical and travel information are required to accurately classify a case of LD in a low-incidence state.

Elevated Serum Uric Acid Levels Mediate the Associations of Ambient PM2.5 and Its Components with Glaucoma

Limited epidemiological information exists on the relationships between fine particulate matter (PM2.5) components and glaucoma risk. Moreover, the potential mediation effect of serum uric acid (UA) levels remains unexplored. Data from the China Health and Retirement Longitudinal Survey (CHARLS) spanning 2011–2020 were analyzed. Cox proportional hazard models and quantile-based g-computation (qg-computation) models were applied to determine the associations of PM2.5 and its five components (including sulfate [SO₄2⁻], nitrate [NO₃⁻], ammonium [NH₄⁺], organic matter [OM], and black carbon [BC]) with glaucoma risk. A causal mediation model was applied to assess the mediation effect of serum UA. Individual exposure to PM2.5 mass and its five components was positively associated with glaucoma risk, respectively. The mixture of PM2.5 components were significantly and positively associated with glaucoma risk (hazard ratio [HR] = 1.31, 95% confidence interval [CI]: 1.18–1.45), with NH₄⁺ and BC contributing the most (proportions: 81% and 19%, respectively). These associations were modified by sex and residence. Elevated serum UA levels played a mediated role in the association between PM2.5 mass and its five chemical components and glaucoma, with mediated proportions ranging from 12% to 15%. Prolonged exposure to PM2.5 components, especially NH4+ and BC, may elevate the glaucoma risk among Chinese middle-aged and older people, and elevated serum UA levels may play a key mediating role.

Understanding the biological processes of kidney carcinogenesis: an integrative multi-omics approach

Biological mechanisms related to cancer development can leave distinct molecular fingerprints in tumours. By leveraging multi-omics and epidemiological information, we can unveil relationships between carcinogenesis processes that would otherwise remain hidden. Our integrative analysis of DNA methylome, transcriptome, and somatic mutation profiles of kidney tumours linked ageing, epithelial–mesenchymal transition (EMT), and xenobiotic metabolism to kidney carcinogenesis. Ageing process was represented by associations with cellular mitotic clocks such as epiTOC2, SBS1, telomere length, and PBRM1 and SETD2 mutations, which ticked faster as tumours progressed. We identified a relationship between BAP1 driver mutations and the epigenetic upregulation of EMT genes (IL20RB and WT1), correlating with increased tumour immune infiltration, advanced stage, and poorer patient survival. We also observed an interaction between epigenetic silencing of the xenobiotic metabolism gene GSTP1 and tobacco use, suggesting a link to genotoxic effects and impaired xenobiotic metabolism. Our pan-cancer analysis showed these relationships in other tumour types. Our study enhances the understanding of kidney carcinogenesis and its relation to risk factors and progression, with implications for other tumour types.

Hepatobiliary Platynosomosis in Black-Tufted Marmosets (Callithrix penicillata): A Lethal Threat for Wildlife and Captive Populations.

Helminthic infections, particularly those caused by trematodes, pose a significant health risk to both animals and humans. This study investigates hepatobiliary platynosomosis (HP) caused by Platynosomum illiciens in black-tufted marmosets (Callithrix penicillata) in Central Brazil. Data were retrospectively collected from autopsy records at the Laboratory of Veterinary Pathology and Forensics, University of Brasília, from January 2006 to July 2021. Epidemiological, clinical, and pathological information was analyzed, including comparisons between free-ranging and captive marmosets. A total of 1596 nonhuman primate (NHP) death records were examined, with black-tufted marmosets accounting for 75.6% (1206/1595) of autopsies. HP was identified in 10.8% (131/1206) of these cases. Captive marmosets showed a higher prevalence of HP (49.6%) than free-ranging ones (6.5%). This study revealed a significant seasonal trend, with higher HP prevalence observed during the wet season until the onset of the dry season. Pathological examinations revealed severe liver and bile duct damage in fatal HP cases, including fibrosis, bile duct thickening, and the presence of flukes. Captive marmosets exhibited pronounced clinical signs, such as weight loss and apathy. Morphological and molecular analysis of sampled flukes confirmed P. illiciens infecting the marmosets. These findings underscore the substantial impact of HP on marmoset populations, particularly in captive settings. The high lethality (58% overall; 81.6% in captivity) highlights the need for improved management and preventive measures in captive environments. This study contributes to understanding HP epidemiology, clinical manifestations, and pathological outcomes, underscoring the disease's significance for the health of both free-ranging and captive NHP populations. Our findings also support the need to develop targeted strategies to mitigate the impact of HP on primate species populations.

Genomic tools for post-elimination measles molecular epidemiology using Canadian surveillance data from 2018-2020.

Measles is caused by the highly infectious measles virus, MeV, for which there is an effective vaccine. Monitoring of progress of measles elimination requires enhanced surveillance and tracking of MeV strains, including documenting the absence of an endemically circulating strain. Due to a reduction in the number of circulating genotypes, additional sequence information, beyond the standardized 450 nucleotide window of the nucleoprotein (N450), is required to corroborate the information from epidemiological investigations and, ideally, fill in gaps in the surveillance data. This study applies MeV sequencing tools, namely the N450, the non-coding region between the matrix and fusion genes (MF-NCR), and the complete coding sequence of the genome (WGS-t), to clinical specimens obtained from cases occurring over a three-year time period in Canada. This data was systematically analyzed, including with Bayesian evolutionary analysis by sampling trees (BEAST) of the WGS-t. Of the 143 reported cases, N450, MF-NCR, and WGS-t sequences were obtained from 101, 81, and 75 cases, respectively. The BEAST analysis confirmed that the two most frequently detected lineages (B3 named strain MVi/Marikina City.PHL/10.18 and D8 named strain MVs/Gir Somnath.IND/42.16) were the result of repeated importations. Of the 16 outbreaks occurring during the study period, the analysis conclusively corroborated the epidemiological information for 13. BEAST analysis of the WGS-t convincingly demonstrated the expansion of two outbreaks by the inclusion of additional contemporary cases for which the epidemiological investigation had been unable to identify links. Furthermore, the analysis revealed the existence of three additional unrecognized outbreaks among the cases categorized as unknown source. One outbreak was without WGS-t and could not be resolved. Measles WGS-t data corroborated and expanded upon the outbreak analysis from traditional epidemiological investigations of measles outbreaks. However, both are needed for fulsome investigations in elimination settings.

The Amazonian snakebite burden: Unveiling seasonal dynamics in a region with tenfold higher incidence compared to the Brazilian average.

Accidents caused by snakes constitute a serious public health problem in Latin America and worldwide. The situation in the Brazilian Amazon region is neglected, resulting in the highest incidence of cases per capita in the country. Furthermore, the distance from urban areas makes it difficult for the population to access timely and effective medical care, including antivenom treatment. The Brazilian Amazon is characterised by high ethnic and cultural diversity, yet it lacks robust epidemiological information that would allow for the development of surveillance and prevention policies. This study aimed to assess the epidemiological profile of individuals affected by snakebite accidents from 2007 to 2021 in a poorly studied region of the Brazilian Amazon. To assess the relationship between snakebite accidents, rainfall and river flood levels, cross-correlation functions were employed. Data from the public healthcare system database was used for this analysis. The results indicate that the study area experiences a snakebite rate 10 times greater than the Brazilian average and double that of other Amazonian regions. The most affected victims consist of adult males residing in rural areas, with snakebite accidents being more common during the rainy season. Viperid snakes were responsible for most bites, with the lower limbs being the most common location of injury. The data revealed a positive correlation between the number of snakebite accidents both rainfall and fluvial data. The accident peak coincides with the Brazil nut harvest season, a highly significant forest product for the economy of rural communities. Our data reinforces the need for public policies focused on environmental education and prevention, such as the use of boots and leg guards. These preventive measures have the potential to reduce the number of snakebites accidents by approximately 85%.

Epidemiology and clinical management of canine Leishmaniasis in northeastern Algeria: A preliminary study

Canine leishmaniasis (CanL) caused by Leishmania infantum is a prevalent vector-borne disease in the Mediterranean region, notably Algeria. This research aims to assess the epidemiology and the clinical management practices of CanL employed by veterinarians in the Skikda and Constantine regions in the northeastern part of Algeria. A retrospective survey comprising 37 open and closed questions was distributed to 139 veterinary clinics between 2022 and 2023. The objective was to collect comparable epidemiological information on clinical presentations, diagnostic approaches, treatment protocols, preventive strategies, and awareness of the disease's public health implications. The findings from this study have revealed a notable prevalence of CanL in both regions, accompanied by similar clinical manifestations. Serological techniques, particularly rapid detection kits, are predominantly utilized alongside direct methods, while euthanasia remains the primary approach to combat the disease. The results show that only a few veterinarians educate pet owners about zoonotic diseases and prevention measures (32,79 %), while most do not provide this information. This investigation sheds more light on the current status of CanL in the selected studied area and suggests the need for standardizing diagnosis and treatment of CanL using evidence-based medicine criteria to enhance disease management. This will provide a proper way of conducting a more comprehensive epidemiological assessment of the condition for improving the handling and management of CanL in Algeria.

Immune-related adverse events in cancer patients referred to the palliative care team of a tertiary care center: a retrospective observational study.

The application of immune checkpoint inhibitors (ICIs) can cause multi-organ adverse events, namely immune-related adverse events (irAEs) in patients with cancer. This study aimed to characterize the epidemiological information on irAEs in patients with cancer referred to the palliative care team (PCT). The medical records of cancer patients with a history of ICI therapy referred to the PCT at a tertiary care center between January 2017 and July 2022 were retrospectively reviewed in this single-center, observational study. The median age of the 140 patients was 68years, and lung (39.3%) being the most common primary site. We observed irAEs in 46 patients (32.9%), and hypothyroidism was the most common irAE. For irAEs graded ≥ 3 in 21 patients, pneumonitis was the most common adverse event. As for strategies for management with irAEs, seventeen patients were treated with systemic steroids. irAEs ( +) had a significantly lower Performance Status at the start of ICI, a higher total number of ICI doses, and longer duration from start of ICI to date of death than irAEs (-). Among 140 cancer patients with a history of ICIs therapy consulted to the PCT, the prevalence of irAEs was 32.9%, and 21 patients (15.0%) developed irAEs with grade ≥ 3. As the use of ICI is expected to increase in the future, it is important for palliative care physicians to increase their awareness of the management of irAEs and collaborate with oncologists from an early stage.

Possibility of Vertical Transmission of Sarcocystis Spp. in Sika Deer in Japan.

In recent years, the wild deer population in Japan has grown exponentially, causing severe feeding damage to the agricultural and forestry industries. Therefore, the game meat industry is being promoted for effective utilization of hunted animals. Wild animals are not hygienically controlled and can serve as reservoirs for pathogenic microorganisms. However, epidemiological information on wild animals in Japan remains insufficient. Recently, food poisoning-like cases have occurred because of raw venison infection with Sarcocystis spp. As the prevalence of Sarcocystis spp. in sika deer is very high in Japan and even fawns are infected, this study attempted to verify the vertical infection of Sarcocystis spp. in sika deer in Japan. Genetic detection of Sarcocystis 18S ribosomal RNA in fetal and maternal tissues from early to late gestation in sika deer revealed Sarcocystis Types 1-5 and Sarcocystis fayeri in the mother and fetus. Types 1, 2, 4, and 5 were detected in the maternal tissues of Ezo sika deer (Cervus nippon yesoensis) in Hokkaido, whereas Types 1 and 2 and S. fayeri were detected in fetuses. Types 1-5 were detected in Honshu sika deer (Cervus nippon centralis) in Mie Prefecture but not in the fetuses. Types 1, 2, and 4 were detected in the udder and milk samples. This indicates that Sarcocystis Types 1 and 2 and S. fayeri have the ability to pass through the placenta of sika deer and invade fetal tissues and Types 1, 2, and 4 may be transmitted orally via milk. These findings suggest that there is transplacental and transmammary transmission of Sarcocystis spp. in sika deer.

Genotyping of human isolates from human toxoplasmosis outbreak: Restriction Fragment Length Polymorphism and Sanger Sequencing.

Toxoplasmosis is a parasitic disease caused by infection with Toxoplasma gondii, capable of infecting a wide range of hosts. The parasite exhibits a broad genetic diversity, necessitating genotypic characterization for genotype identification and associations with epidemiological information. Therefore, the Restriction Fragment Length Polymorphism (RFLP) technique is used for characterization. This study aimed to perform genotypic characterization of isolates from pregnant women infected during a human toxoplasmosis outbreak, comparing the RFLP and Sanger Sequencing methodologies. For this purpose, six human isolates were subjected to conventional PCR, Multiplex PCR, Nested PCR, Enzymatic Digestion, and Sanger Sequencing. Additionally, the standard strains GTI (Type I), PTG (Type II), and CTG (Type III) were also subjected to the same techniques described above. Subsequently, the amplified DNA products were compared with the standard strains. As a result, it was observed that Sanger Sequencing provides the same information as RFLP PCR, as well as the possibility of cost reduction for genotypic characterization, and providing greater agility in issuing results. Additionally, Sanger Sequencing of T. gondii isolates allows for detailed evaluation of nucleotide sequences, including the assessment of SNPs and enzymatic restriction sites, which the RFLP technique does not.

HTLV infection in urban population from Mato Grosso do Sul, Central Brazil.

Brazil has the highest number of HTLV-1 infection in Latin America, with around one million cases spread unevenly across regions. However, there is a limited number of studies on this infection in the general population. This cross-sectional study aimed to estimate the prevalence of HTLV as well as identify types, and subtypes of HTLV among the urban population of Campo Grande, capital of Mato Grosso do Sul state (MS). Between July 2023 and March 2024, all information was obtained from self-reported interviews, and blood samples were collected and screened for anti-HTLV-1/2 by immunoassay and confirmed using the immunoblot method. The proviral DNA of HTLV-1/2 in positive samples was quantified by real-time PCR (qPCR) and genotyped by nucleotide sequencing (Sanger's method). The study enrolled 611 participants, with the majority being women (90.54%), mixed race (46.32%), heterosexual (87.64%), and with a median age of 39years. The prevalence rate of anti-HTLV-1 infection was 0.82% (CI 95% 0.34-1.96). All positive samples (n = 5) were identified as belonging to the Cosmopolitan subtype, one belonging to Japanese and four to Transcontinental subgroups. Among the five positive individuals, two presented symptoms associated with HTLV-1 infection. This study highlights an intermediate prevalence of HTLV-1 in the urban population of Campo Grande, Mato Grosso do Sul, and provides epidemiological information that could help bridge the gaps in the distribution of HTLV in the general population. Also, medical care was provided for individuals presenting clinical manifestations who were previously unaware of their serological status.

Estimating monthly NO2, O3, and SO2 concentrations via an ensemble three-stage procedure with downscaled satellite remote sensing data and ground measurements

The gaseous air pollutants nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2), in addition to particulate matter (PM2.5), are known to be associated with many adverse health effects. However, exposure estimates may not be available in rural or mountainous areas without monitoring stations. In this study, we retrieved satellite remote sensing data for NO2, O3, and SO2 from the Ozone Monitoring Instrument (OMI) L3 products. Together with ground measurements (air monitoring stations and meteorological and land use data), we estimated the monthly NO2, O3, and SO2 concentrations with a spatial resolution of 3×3 km across Taiwan from 2005 to 2019. A three-stage estimation procedure was utilized: in Stage 1, an ensemble generalized additive model (GAM) and machine learning method were used to determine the spatiotemporal variations; in Stage 2, the remote sensing data were downscaled; and in Stage 3, the downscaled concentrations were reused in the Stage 1 procedure for fine-tuning estimations. We obtained overall leave-one-out cross-validation (LOOCV) R2 values ranging from 0.927–0.950, 0.704–0.721, and 0.601–0.716, and root-mean-square-errors (RMSEs) ranging from 1.59–2.28, 3.81–4.18, and 0.67–1.32 ppb for NO2, O3, and SO2, respectively, via the random forest procedure. The annual NO2 and SO2 concentrations greatly improved from 2005–2019, especially in the western residential area of Taiwan. However, despite these improvements in air quality, the annual O3 concentrations tended to increase from 2015–2019. This might be due to the complex mixtures of precursors (e.g., NO2), atmospheric circulation, barriers of the Central Mountain Ridge, and increasing ground temperatures over the past decade. The proposed multistage estimation procedure performed well over the whole island with complex terrain and topography. The study outcomes may provide epidemiological information for long-term ambient exposure estimates and guidance for future administrative policies.

Rabies surveillance in the United States during 2022.

To provide comprehensive epidemiological information about the distribution and occurrence of rabies during 2022 in the US, Canada, and Mexico. The US National Rabies Surveillance System collected 2022 animal rabies data from US state and territorial public health departments and USDA Wildlife Services. Temporal and geographic analyses were conducted to evaluate trends in animal rabies cases. During 2022, 54 US jurisdictions reported 3,579 animal rabies cases, reflecting a 2.3% decline from 3,663 cases reported in 2021. Six states collectively reported > 50% of animal rabies cases: Texas (395 [11.0%]), Virginia (337 [9.4%]), Pennsylvania (329 [9.2%]), New York (267 [7.5%]), North Carolina (264 [7.4%]), and California (241 [6.7%]). Out of the total reported rabies animal cases, 3,234 (90.4%) were attributed to wildlife, with bats (1,218 [34.0%]), raccoons (1,014 [28.3%]), skunks (660 [18.4%]), and foxes (269 [7.5%]) representing the primary hosts confirmed with rabies. Rabid cats (222 [6.2%]), cattle (42 [1.2%]), and dogs (50 [1.4%]) constituted > 90% of reported domestic animal rabies cases. In 2022, there was an increase in the number of animal samples submitted for rabies testing in the US and Canada. A notable geographic expansion of gray fox rabies virus variant was detected in the US. Three human rabies deaths due to vampire bat rabies infection occurred in Mexico; none were reported from the US and Canada. Laboratory diagnosis of rabies in animals is critical to ensure judicious use of human rabies postexposure prophylaxis.

Analysis of 2019 Ohio Disease Intervention Specialist (DIS) Records for Syphilis Cases Using Clustering Algorithms.

Developments in natural language processing (NLP) and unsupervised machine learning methodologies (e.g., clustering) have given researchers new tools to analyze both structured and unstructured health data. We applied these methods to 2019 Ohio disease intervention specialist (DIS) syphilis records, to determine whether these methods can uncover novel patterns of co-occurrence of individual characteristics, risk factors, and clinical characteristics of syphilis that are not yet reported in the literature. The 2019 DIS syphilis records (n=1,996) contain both structured data (categorical and numerical variables) and unstructured notes. In the structured data, we examined case demographics, syphilis risk factors, and clinical characteristics of syphilis. For the unstructured text, we applied TF-IDF (term frequency multiplied by inverse document frequency) weights, a common way to convert text into numerical representations. We performed agglomerative clustering with cosine similarity using the CLUTO software. The cluster analysis yielded six clusters of syphilis cases based on patterns in the structured and unstructured data. The average internal similarities were much higher than the average external similarities, indicating that the clusters were well-formed. The factors underlying three of the clusters related to patterns of missing data. The factors underlying the other three clusters were sexual behaviors and partnerships. Notably, one of the three consisted of individuals who reported oral sex with male or anonymous partners while intoxicated, and one was comprised mainly of males who have sex with females. Our analysis resulted in clusters that were well-formed mathematically, but did not reveal novel epidemiological information about syphilis risk factors or transmission that were not already known.

Evolving epidemiology, clinical features, and genotyping of dengue outbreaks in Bangladesh, 2000-2024: a systematic review.

The 2023 dengue outbreak has proven that dengue is not only an endemic disease but also an emerging health threat in Bangladesh. Integrated studies on the epidemiology, clinical characteristics, seasonality, and genotype of dengue are limited. This study was conducted to determine recent trends in the molecular epidemiology, clinical features, and seasonality of dengue outbreaks. We analyzed data from 41 original studies, extracting epidemiological information from all 41 articles, clinical symptoms from 30 articles, and genotypic diversity from 11 articles. The study adhered to the standards of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement and Cochrane Collaboration guidelines. A total of 565,438 dengue cases and 2,587 fatalities were documented from January 2000 to March 2024. Notably, 60% of cases during the 2019 and 2023 outbreaks were reported in regions previously considered non-endemic. Fatalities were more frequent among women (70%). The majority of the studies (95-100%) used the NS1Ag test, followed by IgG or IgM and RT-PCR tests. New hotspots of dengue transmission were identified in the southern (Khulna, 10.8% and Barishal, 11.8%) and southeastern (Chattogram, 13.8%) regions of Bangladesh. Serotyping was conducted on 92.4% (1,456 of 1,575) of isolates between 2012 and 2023. Of the four serotypes, DENV3 was the most prevalent (57%), followed by DENV2 (30%), DENV1 (11%), and DENV4 (<1%). Genotype DENV3-I (43 of 59 isolates) was the most prevalent, followed by DENV3-II (8 of 59). The highest frequency of dengue cases was observed in August (26.3%), followed by September (22.5%), October (20.2%), and November (13.08%). Fever (90.51, 95% CI 85-100%) was the most prevalent symptom, followed by headache (57.98, 95% CI 12-100%), vomiting (51.16, 95% CI 23-91%), abdominal pain (34.12, 95% CI 12-85%), and myalgia (25.53, 95% CI 13-85%), respectively. This study provides integrated insights into the molecular epidemiology, clinical features, seasonality, and transmission of dengue in Bangladesh and highlights research gaps for future studies.

Study on the relationship between KCNQ1 gene-environment interaction and abnormal glucose metabolism in the elderly in a county of Hechi City, Guangxi.

This study aimed to understand the potassium voltage-gated channel KQT-like subfamily, member 1 gene polymorphism in a rural elderly population in a county in Guangxi and to explore the possible relationship between its gene polymorphism and blood sugar. The 6 SNP loci of blood DNA samples from 4355 individuals were typed using the imLDRTM Multiple SNP Typing Kit from Shanghai Tianhao Biotechnology Co. The data combining epidemiological information (baseline questionnaire and physical examination results) and genotyping results were statistically analyzed using GMDR0.9 software and SPSS22.0 software. A total of 4355 elderly people aged 60 years and above were surveyed in this survey, and the total abnormal rate of glucose metabolism was 16·11 % (699/4355). Among them, male:female ratio was 1:1·48; the age group of 60-69 years old accounted for the highest proportion, with 2337 people, accounting for 53·66 % (2337/4355). The results of multivariate analysis showed that usually not doing farm work (OR 1·26; 95 % CI 1·06, 1·50), TAG ≥ 1·70 mmol/l (OR 1·19; 95 % CI 1·11, 1·27), hyperuricaemia (OR 1·034; 95 % CI 1·01, 1·66) and BMI ≥ 24 kg/m2 (OR 1·06; 95 % CI 1·03, 1·09) may be risk factors for abnormal glucose metabolism. Among all participants, rs151290 locus AA genotype, A allele carriers (AA+AC) were 0.70 times more likely (0.54 to 0.91) and 0.82 times more likely (0.70 to 0.97) to develop abnormal glucose metabolism than CC genotype carriers, respectively. Carriers of the T allele at the rs2237892 locus (CT+TT) were 0.85 times more likely to have abnormal glucose metabolism than carriers of the CC genotype (0.72 to 0.99); rs2237897 locus CT gene. The possibility of abnormal glucose metabolism in the carriers of CC genotype, TT genotype and T allele (CT + TT) is 0·79 times (0·67-0·94), 0·74 times (0·55-0·99) and 0·78 times (0·66, 0·92). The results of multifactor dimensionality reduction showed that the optimal interaction model was a three-factor model consisting of farm work, TAG and rs2237897. The best model dendrogram found that the interaction between TAG and rs2237897 had the strongest effect on fasting blood glucose in the elderly in rural areas, and they were mutually antagonistic. Environment-gene interaction is an important factor affecting abnormal glucose metabolism in the elderly of a county in Hechi City, Guangxi.

Benzodiazepines: Predominant Reported Acute Poisoning to Private Sector Tertiary Care Hospitals in Karachi

Background: Acute poisoning is a major medical emergency that translates into morbidity and mortality across all age groups, it is a potentially preventable cause of illness and death. This study was carried out to assess the epidemiological information of acute poisoning among the general population presented to the three campuses of a private tertiary care teaching hospital in Karachi, Pakistan. Method: The cross-sectional study was conducted at three campuses of a private tertiary care teaching hospital, Dr. Ziauddin Hospital in Karachi, comprising of records from January 1, 2018, to December 31, 2022, of patients reporting acute poisoning. These records were accessed after getting approval from the Ethical review committee. Consecutive sampling technique was applied while data was collected. All cases of acute poisoning reporting to the emergency department with complete records were included. While data of those with any other diagnosis or incomplete record were excluded. Descriptive analysis was performed for quantitative variables. For categorical data frequency and percentages were extracted. The chi-square test was used to associate categorical variables. P value less than 0.05 was taken as statistically significant. Results: The total number of cases was n=518 out of which n=235 (45.4%) were males while n=283 (54.6%) were females and the maximum number of cases n=111 (21.4%) were associated with Benzodiazepines followed by insecticide poisoning and ingestion of rodenticides. Conclusions: The most susceptible groups to acute poisoning were found to be women and children. A prevalent agent that caused toxicity was benzodiazepines; the biggest number of cases occurred in April, while the lowest number occurred in December. The year 2020 was linked to the highest number of cases.

Characteristics and survival of adults with differentiated thyroid cancer in a Peruvian hospital.

Motivation for the study. There are few clinical and survival studies in Peru on thyroid cancer. Main findings. Between the years 2010 to 2020, differentiated thyroid cancer was more frequent in women with early-stage disease, but survival was lower at five years compared to reports from other countries. Implications. Thyroid cancer has increased in recent decades worldwide. It is important to have specialized and decentralized centers for the initial management and follow-up of these patients to avoid long-term complications or fatal outcomes and to have updated epidemiological information. This study aimed at studying the clinical and anatomopathological characteristics, treatment and survival of patients with differentiated thyroid cancer. A retrospective cohort study was conducted with data from 150 patients from a Peruvian hospital between the years 2010 to 2020. Characteristics and survival (Kaplan-Meier method) were described. The mean age was 48.3 years, 130 participants (86.7%) were women and the most frequent histologic type was papillary 94.6%. Of the participants, 74.2% had TNM stage I, 70.7% had total thyroidectomy and 68.7% received radioactive iodine. Overall survival at 5 years was 89.3%, being lower in those with TNM stage IV and higher in those who used radioactive iodine. In conclusion, in a hospital in Cusco, differentiated thyroid cancer was more frequent in women and survival was lower compared to reports from other countries.