Epidemiological Information Research Articles

Changing Dynamics in the Spread and Management of Banana Xanthomonas Wilt Disease in Uganda Over Two Decades

Banana Xanthomonas wilt (BXW) is a destructive disease caused by Xanthomonas vasicola pv . musacearum ( Xvm), a bacterium that indiscriminately infects all banana varieties grown in East and Central Africa (ECA). In this region, BXW was first reported in 2001 in Uganda and was projected to eliminate >90% of Uganda's banana crops (worth USD4 billion) if not controlled in less than 10 years. Lack of basic information led to application of control approaches that were based on similarity of BXW symptoms to those of Moko disease of banana. However, the approaches were unsuccessful and, in 7 to 9 years, BXW had covered six countries and threatened to wipe out the banana industry in ECA. However, BXW has been tamed to date, mainly due to relentless and systematic deployment of carefully crafted and packaged cultural control practices based on epidemiological information generated within target banana cropping ecosystems. In Uganda, the initial “top-down” communication approaches reached >85% of banana farming communities but did not mobilize the communities enough into action; hence, only 30% impact in controlling BXW was registered. In contrast, participatory approaches mobilized farming communities into action and effectively controlled BXW at field and community levels to near eradication. The approaches effectively controlled BXW in Uganda and, consequently, in eastern Kenya, northern Tanzania, Rwanda, Burundi, and the Democratic Republic of Congo. This article reviews step-wise processes leading to success over the 2 decades and identifies critical research gaps. Deployment of resistant genotypes is urgently needed as a significant addition to the BXW management toolbox to create BXW-free banana cropping systems in ECA. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .

Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon.

To describe clinical, epidemiological and management information on cases of acute Chagas disease (ACD) by oral transmission in the state of Amazonas in western Amazon. Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included. There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas. The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.

Post-traumatic stress disorder and traumatic events in China: a nationally representative cross-sectional epidemiological study

Post-traumatic stress disorder (PTSD) is one of the most severe sequelae of trauma. But a nationally representative epidemiological data for PTSD and trauma events (TEs) was unavailable in China. This article firstly demonstrated detailed epidemiological information on PTSD, TEs, and related comorbidities in the national-wide community-based mental health survey in China. A total of 9,378 participants completed the PTSD-related interview of the CIDI 3.0. Lifetime prevalence and 12-month prevalence of PTSD in total respondents were 0.3% and 0.2%. while the conditional lifetime and 12-month prevalence of PTSD after trauma exposure were 1.8% and 1.1%. The prevalence of exposure to any type of TE was 17.2%. Among individuals with the exposed to TEs, younger, without regular work (being a homemaker or retried), and intimate relationship breakdown (separated/Widowed/Divorced), living rurally were associated with either the lifetime PTSD or the 12-month PTSD, while the count of a specific TE, the unexpected death of loved one, was related to both. Alcohol dependence was the most common comorbidity among male participants with PTSD but major depressive disorder (MDD) for female counterparts. Our study can provide a reliable reference for future identification and intervention for people with PTSD.

ESCV/PASCV Membership

Although influenza C virus is widely distributed throughout the world, epidemiological information, based on long-term surveillance, has not yet been acquired.To clarify the epidemiological features of influenza C virus infection, and to examine whether the prevalence of the antibodies against the influenza C virus is associated with the epidemics.Between 1996 and 2013, 36,973 respiratory specimens were collected from two pediatric outpatient clinics in Yamagata, Japan. The specimens were examined for the presence of influenza C virus using cell culture methods. Isolated viruses were antigenically analyzed. The differences in seropositivity, with respect to the different antigenic groups, were examined using serum samples collected in 2001 and 2011 by a hemagglutination inhibition assay.Influenza C viruses were isolated from 190 specimens during an 18-year period. Most influenza C viruses were isolated from winter to early summer in even-numbered years, and the frequency of virus isolation per year ranged from 0.43% to 1.73%. An antigenic analysis revealed that the dominant antigenic groups were the C/Yamagata/26/81 from 1996 to 2000, the C/Kanagawa/1/76 in 2002 and 2004, and the C/Sao Paulo/378/82 from 2006 to 2012. When compared to the other antigenic groups, the seroprevalence of the C/Sao Paulo/378/82 group was lower in 2001 for individuals older than 5 years and was higher in 2011 in individuals younger than 40 years.The results from our study suggest that epidemics of influenza C virus infection periodically occur and the replacement of the dominant antigenic group may be caused by immune selection within older children and/or adults in the community.

Demographic and socioeconomic risk factors in treatment of malignant eccrine spiradenoma.

e21595 Background: Malignant Eccrine Spiradenoma (MES) is a rare malignancy that affects the eccrine sweat glands. Although a rare malignancy, MES commonly metastasizes to various regions of the body. Tumor resection with tumor-free margins has a recurrence-free survival of only 23%. There is a lack of analysis on the demographic and socioeconomic factors of MES patients in the literature. Therefore, the National Cancer Database (NCDB) database was utilized in order to address the insufficient epidemiological and demographic information in MES patients. Methods: The National Cancer Database (NCDB) retrospective cohort analysis from 2004 - 2020 included patients with histologically-confirmed diagnosis of MES (N = 188). Regression analysis was used to interpret demographic factors (race, Hispanic origin, facility type, urbanization, income, and Charleson-Deyo score). Results: A total of 188 confirmed cases of MES were identified in the database between 2004 – 2020 with a gradual increase of diagnosed patients per year (R2 = 0.2). The average age of diagnosis was 64.7 years (SD = 15.1, range = 19-90 years). The most common primary site of MES was the skin of the trunk (30.9%), however, primary sites on the skin of upper limb and shoulder (19.1%) and lower limbs and hip (16.5%) were also prevalent. A majority of patients (78.7%) had a Charlson-Deyo comorbidity score of 0. Out of the 188 cases, 83.5% were classified as White. Patients skewed more towards the top quartile in income (30.3%) followed by the second highest quartile (24.5%). The primary source of insurance for patients was Medicare (45.7%) followed by private insurance (41.5%). Most of the patients resided near a metropolitan area (93.6%). The majority of patients were treated in a non-academic facility (59%), rather than an academic facility (41.0%). On average, patients lived 42.3 miles (SD = 184.4, range = 0.6 – 2,319.5) away from their treatment facility. Conclusions: This is the first NCDB analysis on MES, addressing a discrepancy in knowledge on demographic factors contributing to MES. Most MES patients are non-Hispanic and White with their primary site diagnosis being found at the trunk, as seen in case reports. MES patients are more likely to live near a metropolitan area, be treated in a non-academic facility, and have Medicare insurance. More research is imperative to establish an effective treatment protocol for patients with metastatic involvement and to better comprehend the influence of socioeconomic factors on diagnosis and overall survival of patients.

Prostate cancer public health system database from Brazil: Racial disparities and heterogeneity of treatment interventions to understand evidence-based practice patterns in a large real-world database.

5025 Background: The Brazilian Public National Health System (SUS) provides an opportunity to understand epidemiologic information, treatments, discrepancies in care, and costs of men with prostate cancer (PCa) using a large real-world dataset. This analysis focuses on racial disparities and heterogeneity of specific interventions to understand evidence-based practice patterns in Brazil. Additionally, the dataset can serve as a model for other low-middle income countries (LMIC). Methods: Patients included in the database were those with a diagnosis of PCa receiving care in the SUS from 01/01/2008 to 08/31/2022. Data were analyzed using a proprietary Healthcare Data Science platform offered by TECHTRIALS and included information regarding stage, demographics, cancer-related information, treatment-related information, and resources utilized. Results: 657,609 PCa pts were diagnosed and treated at SUS during the 14.5-year study period of whom 382,263 (58%) were brown/black (non-white) and 262,820 (42%) white. Median age of the population was 72.6 years, and did not vary with race. 26.16% of the pts were diagnosed with stage IV and this was not impacted by race or localization, including state or type of city (capital or not). Rates of radical prostatectomy and radiation utilization were similar between race categories. Additionally, in patients with stage IV disease, rates of systemic therapy utilization including chemotherapy with docetaxel (7.7%), with a tendency to increase use in the last years, and androgen receptor signaling inhibitors (ARSI) with (0.6%) or enzalutamide (0.08%), were low and similar between race categories. Rates of first-generation anti-androgens and estrogens were higher (56%) The total costs of prostate cancer directed care was R$4.31 billions (US$820 millions) and race did not impact total cost of care and cost by procedure or therapy type options. Conclusions: This is one of the largest studies using public health-system databases for Prostate cancer with Real World Data ever published. Race had no impact in presenting stage, treatment received and even in the costs involved. Underutilization of chemotherapy (docetaxel) in a scenario of limiting resources and without the use of new hormonal therapies is a matter of concern, together with an overuse of agents without proven survival advantage. Our data highlights the need for increased access to life prolonging agents for patients with metastatic PCa in the SUS.

P9: Teaching Health Disparities as Regards Cardiopulmonary Support Technologies for Underepresented/ Underserved Patients

Background: There is a growing interest in addressing health care disparities faced by underrepresented/ underserved (U/U) populations across all fields of medicine. To that end, my goal was to introduce to the undergraduate (UG) and graduate (G) bioengineering classes that I teach the challenges faced by U/U patients as regards state-of-the art cardiopulonary support technologies (CPST) for treatment of end-stage cardiac or pulmonary failure. Methods: At the University of Pittsburgh (UoP) I teach two separate UG artificial organs (AO) classes; one class focuses on cardiac assist devices and the other on pulmonary assist devices. I also teach the cardiac assist module for a G cardiovasuclar organ replacement class. Through a long-standing NSF-funded collaboration with North Carolina Agricultural and Technical State University (Greensboro, NC), a Historically Black College and University (HBCU), I also teach my AO classes to NCAT students. The NCAT courses are taught remotely (via ZOOM). For the past several years, the term projects for my UG and G artificial organs classes at UoP and NCAT have focused on i) investigating health inequities/ disparities in CPST as applied to U/U patients; and, ii) proposing innovative improvements to current CPST that benefit, particularly, U/U patients. Students are asked to address the following in their term papers and class PPT presentations: 1) current state-of-the art in CPST; 2) limitations of current CPST as applied to U/U patients; 3) unmet clinical needs for U/U patients; 4) the feasibility of the proposed innovative improvements from a product specification, regulatory and societal viewpoint. Results: Students identified numerous reference materials that highlight the inequities/ disparities that U/U patients face. The American Heart Association, the CDC and NHLBI all maintain detailed epidemiological information related to the term project topic. There also exists a plethora of peer-reviewed published articles in this regard; a few examples being, Frech et al, “Ventricular Assist Device Technology and Black-White Disparities on the Heart Transplant Wait List.” Progress in Transplantation 2021; 31(1): 80-87; Nyak et al, “Understanding the Complexity of Heart Failure Risk and Treatment in Black Patients.” Circulation Heart Failure 2020; 13: 301-314. Among the student term project topics were, “Improving VAD Technology for the African American Community;” “Blood Pressure Measurement and Management in Black Ventricular Assist Device Users;” “A Multi-Factor Approach to Improve African American Heart Health;” “Innovative Design for Cystic Fibrosis in Women of Color.” Conclusions: Student response to the term project assignment was positive. Meetings with the students demonstrated the students’ interest in the topic. The ultimate success of this assignment will be achieved, if these students are sensitive to the special needs of U/U patients and incorporate these needs in their design of biomedical devices.

How people use information about changes in infections and disease prevalence.

To determine the influence of two representative metrics of epidemiological risk, changes in new infections, and disease prevalence, on people's risk judgments and disease-prevention behaviors. Four experiments were conducted from August 2020 to May 2021. In Experiments 1 and 2, participants were exposed to information about different directions of change (upward and downward) and varying levels of prevalence of an infectious disease. In Experiments 3 and 4, participants were exposed to information about only one direction of change (upward or downward) and varying levels of prevalence. Participants reported risk judgments and intentions to engage in disease-prevention behaviors for each disease situation presented to them. When both the direction of change and levels of prevalence varied, risk judgments and intentions were more influenced by change (vs. prevalence) information. Participants' reliance on prevalence information to guide risk judgments increased when they were presented with only an upward or downward change, particularly for situations with worsening infections. In all cases, the effects of epidemiological information on behavioral intentions were mediated by its effects on risk judgments. Information about changes in infections consistently influences people's risk judgments and drive subsequent behavioral response. The impact of prevalence information, however, is limited to situations in which changes in infections are stable, such that it affects risk judgments and behavior decisions only when changes in infections demonstrate a constant upward or downward direction. The results point to the need for public health interventions to increase the impact of prevalence information. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Consideration of Comparing Empirical and Evidence-Based Knowledge on Nephrology in the Example of Ahi Çelebi's Fifteenth Century Turkish Treatise on the Urinary Calculus.

The objective of the study is to discuss the question, "how did physicians come to grasp some facts in the absence of scientific experimentation and medical technology?" within the framework of examples from Ahı? Ahmed Çelebi's fifteenth century Turkish treatise on the urinary calculus. Çelebi's monograph on the urinary calculus in the kidneys and the bladder written in Turkish in Arabic alphabet is transliterated and studied within the framework of the medical theory of the period. The sample information for this study was randomly chosen. Examples of epidemiological information, diets against urinary calculus formation, diagnoses of kidney and urinary bladder calculi, and symptomatic therapies noted in Çelebi's treatise are discussed, with results briefly compared with today's data. The study of Çelebi's treatise shows that it was possible to reach some medical facts with the methods of the period.

A Multiaxial Rehabilitation Programme for Workers with COVID-19 Sequelae Using a Conventional and Technological-Robotic Approach: The Proposal of INAIL and Fondazione Don Carlo Gnocchi.

The COVID-19 sequelae have been shown to affect respiratory and cardiological functions as well as neuro-psychological functions, and, in some cases, metabolic/nutritional aspects. The Italian National Institute for Insurance against Accidents at Work (Istituto Nazionale Assicurazione Infortuni sul Lavoro, INAIL) recorded that, until December 2022, 315,055 workers were affected by COVID-19; therefore, there is a need to identify an effective approach to treat such patients. Robotic and technological devices could be integrated into the rehabilitation programme of people with long COVID conditions. A review of the literature showed that telerehabilitation may improve functional capacity, dyspnoea, performance, and quality of life in these patients, but no studies were found evaluating the effects of robot-mediated therapy or virtual reality systems. Considering the above, Fondazione Don Carlo Gnocchi and INAIL propose a multi-axial rehabilitation for workers with COVID-19 sequelae. To accomplish this goal, the two institutions merged the epidemiological information gathered by INAIL, the expertise in robotic and technological rehabilitation of Fondazione Don Carlo Gnocchi, and the literature review. Our proposal aims to facilitate a multi-axial rehabilitation approach customized to meet the unique needs of each individual, with a particular emphasis on utilizing advanced technologies to address the current and future challenges of patient care.

Identification of Risk Areas of Dengue Transmission in Culiacan, Mexico

Dengue is a public health problem in more than 100 countries around the world and in virtually the entire region of the Americas, including Mexico. Mosquitoes of the genus Aedes aegypti transmit dengue; its reproduction requires certain geographical, epidemiological, demographic and socioeconomic conditions. Detailed information on socioeconomic, epidemiological and entomological data is available, but detailed meteorological information is not. The objective of this study was to identify the areas of risk of dengue transmission for each month of the year based on environmental, social, entomological and epidemiological information from 2010 to 2020, in Culiacan, Mexico. LST, NDVI and NDMI were calculated from Landsat 8 satellite images with remote sensing techniques. Additional variables were human population density and overcrowding; mosquito egg density from positive ovitraps; and probable cases of dengue. A descriptive analysis of the study variables and a multiple linear regression analysis were performed to determine the significant variables. In addition, a multicriteria spatial analysis was applied through the AHP technique to identify areas at risk of dengue transmission. The results revealed that the variables NDVI, NDMI and overcrowding were not significant; however, the LST, population density, egg density per positive ovitrap and probable cases were. The highest population in the transmission risk areas was in November, and the highest transmission area was identified in October. In conclusion, it was possible to identify which of the study variables were significant; in addition, monthly maps of risk areas of dengue transmission for Culiacan were obtained. Each geographical area had its own characteristics that influenced, in one way or another, the incidence of dengue, highlighting that the strategies for control of dengue must be specific to each region.

A time-series analysis of morbidity and mortality of viral hepatitis in Venezuela, 1990–2016

BackgroundViral hepatitis (VH) is a leading contributor to morbidity and mortality worldwide, constituting a public health problem associated with the level of human development. In recent years, Venezuela has experienced a political, social, and economic crisis and has been impacted by natural disasters that have led to the deterioration of sanitary and health infrastructures modifying the determinants of VH. Despite epidemiological studies conducted in specific regions of the country or populations, the national epidemiological behaviour of VH remains unclear.MethodsThis is a time series study involving records of morbidity and mortality by VH in Venezuela reported during the period from 1990 to 2016. The Venezuelan population was taken as the denominator of the morbidity and mortality rates, according to the Venezuelan National Institute of Statistics and the 2016 population projections from the latest census published on the website of the responsible Venezuelan agency.ResultsDuring the study period, 630,502 cases and 4,679 deaths from VH in Venezuela were analysed. Most of the cases (n = 457,278; 72.6%) were classified as unspecific VH (UVH). The deaths were mainly attributed to VHB (n = 1,532; 32.7%), UVH (n = 1,287; 27.5%), and sequelae of VH (n = 977; 20.8%). The mean rates of cases and deaths from VH in the country were 95 ± 40.4 cases per 100,000 inhabitants and 0.7 ± 0.1 deaths per 100,000 inhabitants, respectively, showing a large dispersion that is evident from the calculation of the coefficients of variation. There was document a strong correlation between UVH and VHA cases (0.78, p < 0.01) morbidity rates. VHB mortality rate was very strongly correlated with sequelae of VH (–0.9, p < 0.01).ConclusionsVH is a major burden of morbidity and mortality in Venezuela with an endemic-epidemic trend and an intermediate prevalence for VHA, VHB, and VHC. Epidemiological information is not published in a timely manner and diagnostic tests are insufficient in primary health services. There is an urgent need to resume epidemiological surveillance of VH and to optimise the classification system for a better understanding of UVH cases and deaths due to sequelae of VHB and VHC.

Phylogenetic diversity of Clavibacter michiganensis subsp. michiganensis isolates causing bacterial canker of tomato in Greece

Tomato bacterial canker, caused by Clavibacter michiganensis subsp. michiganensis (Cmm) (Li et al. 2018), is a common destructive disease worldwide. The bacterium colonizes plant’s vascular system causing characteristic symptoms such as wilting, cankers, brown and black discoloration of vessels, white spots on the fruit and leaves. In the present work, isolates were collected from infected tomato plants of 11 Greek Prefectures during the years 2003-2018, and the genetic variability was investigated. After initial identification, 93 selected Cmm strains were subjected to phylogenetic analyses based on the sequencing of multiple loci (Multi-Locus Sequencing Analysis, MLSA) utilizing four housekeeping genes (atpD, ppk, kdpA and sdhA). MLSA highlighted 4.1% variability in nucleotide sequences and classified the 93 Cmm strains into 38 haplotypes. Nevertheless, the phylogenetic grouping of the strains was not in accordance with the geographical distribution, a fact that probably advocates the introduction of the disease from infected propagating material. However, strains isolated from the same area in a different year were placed in the same group which means that the pathogen can remain active between growing seasons. The study provides important epidemiological information on the disease outbreaks and the spread of Cmm in Greece.

The Russian database of HIV antiretroviral drug resistance

The development of sequencing technologies and bioinformatic analysis made it possible to conduct molecular and epidemiological studies, in which nucleotide sequences of the human immunodeficiency virus (HIV) are used as information added to the patient profile. From a practical perspective, studies of prevalence of HIV drug resistance (HIVDR) are of the highest significance. To promote such studies, different countries use databases that serve as repositories of genetic and epidemiological information. The Russian HIVDR database (https://hivresist.ru/) was created in 2009. Nevertheless, it was characterized by limited applicability for a long time. Since 2021, after the regulatory documents had been revised and updated, the entry of HIVDR research results into the Russian HIVDR database has been mandatory. Therefore, the priority attention has been given to upgrading the database and improving its functional capabilities. Different methods have been developed to enter clinical, epidemiological and genetic data. At the time of this study, the Russian database HIVDR contained 10,626 unique records about patients and 13,126 nucleotide sequences deposited by 10 institutions. The following functions have been provided for data analysis: quality control of the epidemiological and clinical information about a patient, quality control of nucleotide sequences, contamination check, subtyping, detection of DR mutations, identification of viral tropism and generation of standardized reports. The efforts toward further development of the Russian HIVDR database will be focused on designing tools for detection and analysis of molecular clusters, adaptation to routine application for epidemiological surveillance of HIV infection.

Prevalence and Associated Factors of Intestinal Parasites among Food Handlers Working in Food Service Establishments in Northwest Ethiopia, 2022.

As in most of African countries, intestinal parasites have been widely distributed in Ethiopia and are among the 10 top causes of morbidity and mortality nationwide. Statistics for food-borne illness in various industrialized countries show that up to 60% of cases may be caused by poor food handling techniques and by contaminated food served in food service establishments. Epidemiological information on the prevalence of various intestinal parasitic infections in different regions/localities is a prerequisite to develop appropriate strategies. This study aimed to determine the magnitude of intestinal parasites among food handlers working in different food service establishments in Gondar city. A cross-sectional study was conducted with food handlers working in different food service establishments in Gondar city. Stool samples were collected from 350 food handlers and processed using the formol-ether concentration method and then microscopically examined for intestinal parasitic infections. Pre-tested and structured questionnaire was used to study the socio-demographic characteristics of food handlers. Chi-square test and p-value were used to assess the associations between risk factors and the parasite isolation rate. The p-value ≤0.05 was considered as statistically significant. Of the 350 food handlers, 160 (45.71%) had parasites. Among the isolated parasites, Ascaris lumbricoides was found to be the most prevalent parasite 35.63%, followed by hookworm 19.38%, Entamoeba histolytica/dispar 16.25%, Trichuris trichiura 10.00%, Strongyloides stercoralis 8.13%, Schistosoma mansoni 6.88%, and Cystoisospora belli, Hymenolepis nana, and Taenia species each accounting 1.25%. The result of the study indicated that the magnitude of intestinal parasitosis among food handlers working at different levels of food establishments in Gondar, Ethiopia, was found to be high. Being at lower educational level and inactive role of the town's municipality are determined as a risk factor for parasitic positivity of food handlers.

Epidemiology and genetic characteristics of coxsackievirus A16 associated with hand-foot-and-mouth disease in Yantai city, China in 2018–2021

In 2008, China launched a national surveillance system for hand-foot-and-mouth disease (HFMD). Several million cases of HFMD are reported every year, coxsackievirus A16 (CVA16) was the leading cause of HFMD epidemic in Yantai city, China in recent years, but the information of epidemiology and molecular characterization of CVA16 in Yantai is limited. The aim of this study is to investigate the epidemiological characteristics and pathogenic spectrum of HFMD, and most importantly, the molecular characterization of CVA16 in Yantai from 2018 to 2021. A total of 2,000 clinical samples were collected in Yantai city from 2018 to 2021 and the enterovirus typing was performed using real-time reverse transcriptase–polymerase chain reaction (qRT-PCR). VP1 coding regions of 41 CVA16 isolates were amplified and Sanger sequenced, and phylogenetic analysis was performed. During the study period, HFMD became prevalent from May to August each year. It peaked in June and declined in September. The incidence was highest in children aged 1 to 5 years, while more common in males than females. 1,617 out of 2,000 clinical collection of samples were tested positive for enterovirus. Among them, 614 were identified as CVA16, 45 were enterovirus A71 (EV A17), and 958 were other enterovirus serotypes. All 41 CVA16 strains belonged to the Bla and B1b genotypes. Homology analysis showed that 41 CVA16 isolates shared 83.2%–100% nucleotide and 93.7%–100% amino acid similarity among themselves. The results of this study update molecular epidemiology of CVA16 and provide a reference for HFMD prevention and control.

Can we use meat inspection data for animal health and welfare surveillance?

Ante- and post-mortem inspections at abattoir were originally introduced to provide assurance that animal carcasses were fit for human consumption. However, findings at meat inspection can also represent a valuable source of information for animal health and welfare surveillance. Yet, before making secondary use of meat inspection data, it is important to assess that the same post-mortem findings get registered in a consistent way among official meat inspectors across abattoirs, so that the results are as much independent as possible from the abattoir where the inspection is performed. The most frequent findings at official meat inspections of pigs and beef cattle in Sweden were evaluated by means of variance partitioning to quantify the amount of variation in the probabilities of these findings due to abattoir and farm levels. Seven years of data (2012-2018) from 19 abattoirs were included in the study. The results showed that there was a very low variation between abattoirs for presence of liver parasites and abscesses, moderately low variation for pneumonia and greatest variation for injuries and nonspecific findings (e.g., other lesions). This general pattern of variation was similar for both species and implies that some post-mortem findings are consistently detected and so are a valuable source of epidemiological information for surveillance purposes. However, for those findings associated with higher variation, calibration and training activities of meat inspection staff are necessary to enable correct conclusions about the occurrence of pathological findings and for producers to experience an equivalent likelihood of deduction in payment (independent of abattoir).

Genomic Surveillance of Salmonella from the Comunitat Valenciana (Spain).

Salmonella enterica subspecies enterica is one of the most important foodborne pathogens and the causative agent of salmonellosis, which affects both humans and animals producing numerous infections every year. The study and understanding of its epidemiology are key to monitoring and controlling these bacteria. With the development of whole-genome sequencing (WGS) technologies, surveillance based on traditional serotyping and phenotypic tests of resistance is being replaced by genomic surveillance. To introduce WGS as a routine methodology for the surveillance of food-borne Salmonella in the region, we applied this technology to analyze a set of 141 S. enterica isolates obtained from various food sources between 2010 and 2017 in the Comunitat Valenciana (Spain). For this, we performed an evaluation of the most relevant Salmonella typing methods, serotyping and sequence typing, using both traditional and in silico approaches. We extended the use of WGS to detect antimicrobial resistance determinants and predicted minimum inhibitory concentrations (MICs). Finally, to understand possible contaminant sources in this region and their relationship to antimicrobial resistance (AMR), we performed cluster detection combining single-nucleotide polymorphism (SNP) pairwise distances and phylogenetic and epidemiological data. The results of in silico serotyping with WGS data were highly congruent with those of serological analyses (98.5% concordance). Multi-locus sequence typing (MLST) profiles obtained with WGS information were also highly congruent with the sequence type (ST) assignment based on Sanger sequencing (91.9% coincidence). In silico identification of antimicrobial resistance determinants and minimum inhibitory concentrations revealed a high number of resistance genes and possible resistant isolates. A combined phylogenetic and epidemiological analysis with complete genome sequences revealed relationships among isolates indicative of possible common sources for isolates with separate sampling in time and space that had not been detected from epidemiological information. As a result, we demonstrate the usefulness of WGS and in silico methods to obtain an improved characterization of S. enterica enterica isolates, allowing better surveillance of the pathogen in food products and in potential environmental and clinical samples of related interest.

Insights from Mendelian randomization and genetic correlation analyses into the relationship between endometriosis and its comorbidities.

Endometriosis remains a poorly understood disease, despite its high prevalence and debilitating symptoms. The overlap in symptoms and the increased risk of multiple other traits in women with endometriosis is becoming increasingly apparent through epidemiological data. Genetic studies offer a method of investigating these comorbid relationships through the assessment of causal relationships with Mendelian randomization (MR), as well as identification of shared genetic variants and genes involved across traits. This has the capacity to identify risk factors for endometriosis as well as provide insight into the aetiology of disease. We aim to review the current literature assessing the relationship between endometriosis and other traits using genomic data, primarily through the methods of MR and genetic correlation. We critically examine the limitations of these studies in accordance with the assumptions of the utilized methods. The PubMed database was used to search for peer-reviewed original research articles using the terms 'Mendelian randomization endometriosis' and '"genetic correlation" endometriosis'. Additionally, a Google Scholar search using the terms '"endometriosis" "mendelian randomization" "genetic correlation"' was performed. All relevant publications (n = 21) published up until 7 October 2022 were included in this review. Upon compilation of all traits with published MR and/or genetic correlation with endometriosis, additional epidemiological and genetic information on their comorbidity with endometriosis was sourced by searching for the trait in conjunction with 'endometriosis' on Google Scholar. The association between endometriosis and multiple pain, gynaecological, cancer, inflammatory, gastrointestinal, psychological, and anthropometric traits has been assessed using MR analysis and genetic correlation analysis. Genetic correlation analyses provide evidence that genetic factors contributing to endometriosis are shared with multiple traits: migraine, uterine fibroids, subtypes of ovarian cancer, melanoma, asthma, gastro-oesophageal reflux disease, gastritis/duodenitis, and depression, suggesting the involvement of multiple biological mechanisms in endometriosis. The assessment of causality with MR has revealed several potential causes (e.g. depression) and outcomes (e.g. ovarian cancer and uterine fibroids) of a genetic predisposition to endometriosis; however, interpretation of these results requires consideration of potential violations of the MR assumptions. Genomic studies have demonstrated that there is a molecular basis for the co-occurrence of endometriosis with other traits. Dissection of this overlap has identified shared genes and pathways, which provide insight into the biology of endometriosis. Thoughtful MR studies are necessary to ascertain causality of the comorbidities of endometriosis. Given the significant diagnostic delay of endometriosis of 7-11 years, determining risk factors is necessary to aid diagnosis and reduce the disease burden. Identification of traits for which endometriosis is a risk factor is important for holistic treatment and counselling of the patient. The use of genomic data to disentangle the overlap of endometriosis with other traits has provided insights into the aetiology of endometriosis.

Outbreak of Cholera in Ghana: A Systematic Review from 2010 to 2020

Background: Cholera affects several hundred thousand individuals worldwide each year. According to estimates, more than 20 million individuals in Ghana are at danger of contracting the illness. However, research from Asia and other continents continues to be a major source of information for understanding cholera epidemiology in Africa, particularly in its coastal nations. The purpose of the study was to evaluate Ghana's cholera epidemics each year.&#x0D; Methods: A thorough analysis of articles that have been published on cholera outbreaks worldwide and in Ghana. A thorough search was done in the databases of Science Direct, PubMed, and Google Scholar to retrieve and to review research works published on cholera.&#x0D; Results: Findings suggest cholera has been a significant public health issue for Ghana every year since the first case was reported in 1970. Greater Accra is the area with the most cholera cases each year, with Accra being the district with the most cases. Greater Accra alone reported 58.5% of all cholera cases in Ghana from 1998 to 2017. However, the least affected regions in Ghana are the Upper West, Northern, Upper East, and Volta region. The cause of these cholera outbreaks is subpar sanitation and contaminated water. Annual cholera outbreaks occur in Ghana, where more attention is needed. Multiple deaths have been caused by these epidemics.&#x0D; Conclusion: Improved sanitation and provision of adequate clean drinking water can help curb the incidence of cholera and its devastating effects on individuals and the country as a whole.