Epidemiological Information Research Articles

Leptospira infection and carrier survey on rats from wet market areas in Kuala Lumpur, Malaysia.

Leptospirosis is an important zoonotic infection that has caused significant mortality and morbidity worldwide. This disease is endemic in Malaysia and as a developing tropical country, leptospirosis is concerning as it threatens Malaysian public health and the country's economic sectors. However, there is limited information on leptospirosis in Malaysia, especially regarding leptospiral seroepidemiology among carriers in Malaysia. Therefore, more epidemiological information on the source of the disease and reservoir are needed for better disease control and source intervention. The objectives of this study are to gather information on Leptospira infection and the carrier status of rats captured from selected wet markets of Kuala Lumpur metropolitan city in Malaysia. Live rat trappings were performed in four major wet markets in Kuala Lumpur, namely, Pudu, Chow Kit, Datuk Keramat, and Petaling Street. Animal samplings were performed for 12 months in 2017, where blood and kidney samples were collected and tested for anti-leptospiral antibodies via Microscopic Agglutination Test (MAT) and pathogenic Leptospira screening via Polymerase Chain Reaction (PCR) amplification offlaB gene. MAT showed that 34.7% (n = 50/144) of the captured rats were positive for anti-leptospiral antibody of which the most prominent serovar was Malaya followed by a local strain, IMR LEP 175. In parallel, 50 rats were also positive for pathogenic Leptospira DNA. This study showed that there are persistent Leptospira infections among rats in Kuala Lumpur wet markets and these rats are important reservoir hosts for the bacteria.

Clients' knowledge and satisfaction with outpatient pharmacy services and associated factors at Felege Hiwot comprehensive specialized hospital, Ethiopia: A cross-sectional study.

This study aimed to assess patient knowledge and satisfaction and associated factors with outpatient pharmacy service at Felege Hiwot comprehensive specialized hospital. An institution-based cross-sectional study was conducted at Felege Hiwot comprehensive specialized hospital on patients getting outpatient Pharmacy service from 01 March 2022 to 30 May 2022. The study participants were selected by simple random sampling method. Patients' knowledge and satisfaction with pharmacy service was measured by a structured questionnaire and Data were collected, cleared, and coded, then entered into EPI Info (Epidemiological information. version 7.1.5.2) and analyzed using SPSS (version 25). The overall knowledge result of the respondents showed that only 13.3% of individuals have good drug knowledge and 72.01% of respondents were satisfied with the outpatient pharmacy service. Following up on the multivariate analysis of service modality patients by credit (AOR: 5.50 (1.71-17.74), who are with the occupation of merchants (AOR: 0.09 (0.01-0.83)) and labeling (AOR: 3.13 (1.58-6.20) had an association with drug knowledge. Multivariate analysis showed that waiting time, dispensing time and privacy had an association with satisfaction. When we consider waiting time; respondents with 3-6 min, 6.1-9 min and >9 min waiting times are 0.06 times, 0.02 times, and 0.01 less likely satisfied compared with respondents having waiting time <3 min. It shows that as the patient stays without getting serviced for a long time, satisfaction decreases. Overall, around three-fourths of the respondents were satisfied with the outpatient pharmacy services which is approaching the national satisfaction assessment result. Respondents were strongly satisfied with Dose, route, frequency, and duration. However, they were strongly dissatisfied with the name of the drug. After the multivariate analysis privacy, waiting time, and dispensing time had an association with patient satisfaction.

Women with pelvic organ prolapse and fibulin-5 rs12589592 polymorphism.

This study aims to access the frequency of single-nucleotide polymorphism rs12589592 (G>A) of the fibulin-5 gene in a Brazilian population with pelvic organ prolapse. This was a case-control study, with menopausal women divided into two groups and classified using the pelvic organ prolapse quantification system: pelvic organ prolapse group: pelvic organ prolapse quantification system stages III and IV and Control group: pelvic organ prolapse quantification system stages I and 0. We collected epidemiologic and baseline health information and performed genotyping of rs12589592 from the fibulin-5 gene using a restriction fragment length polymorphism (polymerase chain reaction-restriction fragment length polymorphism) strategy, based on the distinction of sequences from alleles G and A by the restriction enzyme DdeI. For the pelvic organ prolapse group and control, 111 and 180 women were recruited, respectively. The rs12589592 (G>A) polymorphism analysis showed 141 GG homozygotes (pelvic organ prolapse group: 53 [47.7%] and Control: 88 [49.2%] p=0.850); and 149 AA+GA: (pelvic organ prolapse group: 58 [52.3%]; Control: 91 [50.8%]; p=0.904). The distribution of genotypes did not follow the Hardy-Weinberg equilibrium conditions. There was no difference between groups regarding genotypes (rs12589592 G>A) frequency; however, the population characteristics prevent the analysis of the association between the genotype and the occurrence of prolapse.

Responses to "A Review of the Book 'Minamata Disease and the Responsibility of Medical Authorities'"

Drs. Futatsuka, Eto, and Uchino expressed their opinions in the Journal of the Japanese Society for Hygiene in the form of a review of my book, "Minamata Disease and the Responsibility of Medicine." (The reviewers translated it as "Responsibility of Medical Authorities," but for my purposes in writing this book, I believe it should be translated as "Responsibility of Medicine.") The nine major comments of the three reviewers described in this book review were reviewed from the basic perspective of toxicology, epidemiology, and neuroscience. This book review is fraught with either medical, logical, or ethical problems in all the nine points as follows: (1) the inadequate way in which exposure and health hazards are considered from the toxicological perspective, (2) problems in interpreting epidemiological information, (3) the failure to consider recent achievements in methylmercury toxicosis studies, (4) presenting the reviewers' own theories without regard to the content of my book while calling it a "book review," (5) presenting and criticizing what Takaoka does not claim as if he does, and (6) making claims that are inconsistent with the three reviewers' own views. The problems with this book review will become even clearer when you read "Minamata Disease and the Responsibility of Medicine" itself.

Mortalidade perinatal: análise de necropsias médico-legais no período de 2018 a 2022

OBJECTIVES: characterize the sociodemographic profile of the study population; analyze the cause of death described in the report; identify the events that contributed to the death; evaluate the quality of the completion of the Death Certificate (DC) and verify the prenatal follow-up of these children. METHODS: cross-sectional study, using secondary data from necropsy reports performed at the Criciúma and Tubarãos Death Verification Services. Individuals with death between 22 weeks of gestation and the sixth day of life were included, excluding those with more than 50% of the report without completion. The information present in the DC, necropsy reports and complementary tests were evaluated. RESULTS: a total of 212 necropsy reports were evaluated. Among these, 51,4% corresponded to females and 87,7% were caucasians. The majority (85.5%) of the cases analyzed were fetal deaths, with complications of the placenta, umbilical cord and membranes (ICD P02) being the main cause with 73,1% of the cases. There was a lack of completion of intermediate causes in 84,4%, and significant conditions that contributed to death in 98,5% of the reports. Regarding prenatal care, 89.6% underwent follow-up. CONCLUSION: it is emphasized that perinatal mortality is a crucial indicator for prenatal evaluation and factors related to mother and pregnancy. This is because it will be through epidemiological information related to it that public resources will be distributed, in order to reduce the diseases and improve health indicators.

Re-telling the story of aminoglycoside ototoxicity: tales from sub-Saharan Africa.

Aminoglycosides, such as Streptomycin, are cheap, potent antibiotics widely used Sub-Saharan Africa. However, aminoglycosides are the commonest cause of ototoxicity. The limited prospective epidemiological studies on aminoglycoside ototoxicity from Sub-Saharan Africa motivated this study to provide epidemiological information on Streptomycin-induced ototoxicity, identify risk factors and predictors of ototoxicity. A longitudinal study of 153 adults receiving Streptomycin-based anti-tuberculous drugs was done. All participants underwent extended frequency audiometry and had normal hearing thresholds at baseline. Hearing thresholds were assessed weekly for 2 months, then monthly for the subsequent 6 months. Ototoxicity was determined using the ASHA criteria. Descriptive statistics were used to analyze socio-demographic variables. Ototoxicity incidence rate was calculated, and Kaplan-Meier estimate used to determine cumulative probability of ototoxicity. Chi-square test was done to determine parameters associated with ototoxicity and Cox regression models were used to choose the predictors of ototoxicity. Age of participants was 41.43 ± 12.66 years, with a male-to-female ratio of 1:0.6. Ototoxicity was found in 34.6% of the participants, giving an incidence of 17.26 per 1,000-person-week. The mean onset time to ototoxicity was 28.0 ± 0.47 weeks. By 28th week, risk of developing ototoxicity for respondents below 40 years of age was 0.29, and for those above 40 years was 0.77. At the end of the follow-up period, the overall probability of developing ototoxicity in the study population was 0.74. A significant difference in onset of ototoxicity was found between the age groups: the longest onset was seen in <40 years, followed by 40-49 years, and shortest onset in ≥50 years. Hazard of ototoxicity was significantly higher in participants aged ≥50 years compared to participants aged ≤40 years (HR = 3.76, 95% CI = 1.84-7.65). The probability of ototoxicity at 40 g, 60 g and 80 g cumulative dose of Streptomycin was 0.08, 0.43 and 2.34, respectively. Age and cumulative dose were significant predictors of ototoxicity. The mean onset time to Streptomycin-induced ototoxicity was 28 weeks after commencement of therapy. Age and cumulative dose can reliably predict the onset of Streptomycin-induced ototoxicity. Medium to long term monitoring of hearing is advised for patients on aminoglycoside therapy.

Characterisation of pathogenic Leptospira in invasive raccoons (Procyon lotor) in northeast and southwest France.

Leptospirosis is a widespread zoonosis caused by bacteria of the genus Leptospira. Although crucial to mitigate the disease risk, basic epidemiological information is lacking, such as the identities of Leptospira maintenance hosts. The raccoon (Procyon lotor), an alien invasive species in France, could pose a public health risk if it carries pathogenic Leptospira. We investigated the rate and type (selective vs. unselective) of Leptospira carriage in the two main raccoon populations in France. Out of the 141 raccoons collected, seven (5%) tested quantitative PCR positive, targeting lfb1 gene, based on kidney, lung, and urine samples. Phylogenetic analysis revealed the presence of three different L. interrogans clusters. The results suggest that raccoons were more likely accidental hosts and made only a limited contribution to Leptospira maintenance.

Measuring the knowledge and attitudes of physicians towards patients with HIV/AIDS: study of Anatolian group

PurposeThis paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked.Design/methodology/approachThe survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title.FindingsA total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively.Originality/valueIn this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.

Predicting the spread of SARS-CoV-2 variants: An artificial intelligence enabled early detection.

During more than 3 years since its emergence, SARS-CoV-2 has shown great ability to mutate rapidly into diverse variants, some of which turned out to be very infectious and have spread throughout the world causing waves of infections. At this point, many countries have already experienced up to six waves of infections. Extensive academic work has focused on the development of models to predict the pandemic trajectory based on epidemiological data, but none has focused on predicting variant-specific spread. Moreover, important scientific literature analyzes the genetic evolution of SARS-CoV-2 variants and how it might functionally affect their infectivity. However, genetic attributes have not yet been incorporated into existing epidemiological modeling that aims to capture infection trajectory. Thus, this study leverages variant-specific genetic characteristics together with epidemiological information to systematically predict the future spread trajectory of newly detected variants. The study describes the analysis of 9.0 million SARS-CoV-2 genetic sequences in 30 countries and identifies temporal characteristic patterns of SARS-CoV-2 variants that caused significant infection waves. Using this descriptive analysis, a machine-learning-enabled risk assessment model has been developed to predict, as early as 1 week after their first detection, which variants are likely to constitute the new wave of infections in the following 3 months. The model's out-of-sample area under the curve (AUC) is 86.3% for predictions after 1 week and 90.8% for predictions after 2 weeks. The methodology described in this paper could contribute more broadly to the development of improved predictive models for variants of other infectious viruses.

First Canadian report of transmission of fluconazole-resistant Candida parapsilosis within two hospital networks confirmed by genomic analysis.

Candida parapsilosis is a common cause of non-albicans candidemia. It can be transmitted in healthcare settings resulting in serious healthcare-associated infections and can develop drug resistance to commonly used antifungal agents. Following a significant increase in the percentage of fluconazole (FLU)-nonsusceptible isolates from sterile site specimens of patients in two Ontario acute care hospital networks, we used whole genome sequence (WGS) analysis to retrospectively investigate the genetic relatedness of isolates and to assess potential in-hospital spread. Phylogenomic analysis was conducted on all 19 FLU-resistant and seven susceptible-dose dependent (SDD) isolates from the two hospital networks, as well as 13 FLU susceptible C. parapsilosis isolates from the same facilities and 20 isolates from patients not related to the investigation. Twenty-five of 26 FLU-nonsusceptible isolates (resistant or SDD) and two susceptible isolates from the two hospital networks formed a phylogenomic cluster that was highly similar genetically and distinct from other isolates. The results suggest the presence of a persistent strain of FLU-nonsusceptible C. parapsilosis causing infections over a 5.5-year period. Results from WGS were largely comparable to microsatellite typing. Twenty-seven of 28 cluster isolates had a K143R substitution in lanosterol 14-α-demethylase (ERG11) associated with azole resistance. As the first report of a healthcare-associated outbreak of FLU-nonsusceptible C. parapsilosis in Canada, this study underscores the importance of monitoring local antimicrobial resistance trends and demonstrates the value of WGS analysis to detect and characterize clusters and outbreaks. Timely access to genomic epidemiological information can inform targeted infection control measures.

Clinical profile, management and risk factors for seizure-related burn injuries among patients with epilepsy in southwest China

ObjectiveThe epidemiological information associated with seizure-related burn injuries is lacking in China. Therefore, this study aims to analyze the clinical profile, management, outcome, and risk factors of burns that are directly caused by seizures among epileptic patients, and identify the epidemiological characteristics to develop effective preventive strategies. MethodsThis study was conducted between January 2002 and December 2022 in a large Chinese burn center. Data including clinical profile, wound treatment, and outcome were analyzed. A multiple linear regression was used to screen the risk factors for the length of hospital stay (LOS), and a multiple logistic regression was used to screen the contributory factors for the amputation. ResultsA total of 184 burn patients (55.98 % females) were enrolled, with a 0.78 % incidence rate during the study period. The mean age of the patients was 36.16 years (SD: 17.93). Patients aged 20–29 were the most affected age groups (23.37 %). Most burns were caused by flame, accounting for 60.33 % (111/184) of all cases. In total, 76.09 % of the 184 patients underwent at least one operation, and 35 patients (19.02 %) still required amputation during the study period. Burn sites (hands) had the greatest impact on amputation (OR = 3.799), followed by flame burns (OR = 3.723). The mean LOS/TBSA was 6.90 ± 8.53 d, and a larger TBSA, full-thickness burns, and a higher number of operations were identified as the risk factors for a longer LOS. There was one death among the 184 patients, with a mortality rate of 0.54 %. ConclusionThis study demonstrates that burn injuries are extremely harmful to individuals with epilepsy in China because they are at high risk of amputation and disability. Effective healthcare education and preventive programs that focus on lifestyle modifications and seizure control should be implemented to reduce the burn incidence in these populations.

Record Linkage for Malaria Deaths Data Recovery and Surveillance in Brazil.

The objective is to describe the results and the methodological processes of record linkage for matching deaths and malaria cases. A descriptive cross-sectional study was conducted with probabilistic record linkage of death and malaria cases data in Brazil from 2011 to 2020 using death records from the Mortality Information System (SIM) and epidemiological data from the Notifiable Diseases Information System (Sinan) and Epidemiological Surveillance Information Systems for malaria (Sivep-Malaria). Three matching keys were used: patient's name, date of birth, and mother's name, with an analysis of cosine and Levenshtein dissimilarity measures. A total of 490 malaria deaths were recorded in Brazil between 2011 and 2020. The record linkage resulted in the pairing of 216 deaths (44.0%). Pairings where all three matching keys were identical accounted for 30.1% of the total matched deaths, 39.4% of the matched deaths had two identical variables, and 30.5% had only one of the three key variables identical. The distribution of the variables of the matched deaths (216) was similar to the distribution of all recorded deaths (490). Out of the 216 matched deaths, 80 (37.0%) had poorly specified causes of death in the SIM. The record linkage allowed for the detailing of the data with additional information from other epidemiological systems. Record linkage enables data linkage between information systems that lack interoperability and is an extremely useful tool for refining health situation analyses and improving malaria death surveillance in Brazil.

Community Science Strategies Reveal Distributional Patterns of Treponeme-Associated Hoof Disease in Washington Elk (Cervus canadensis)

Treponeme-associated hoof disease (TAHD) is an emerging disease of conservation concern in elk (Cervus canadensis) in the Northwest USA. Elk with TAHD exhibit characteristic hoof lesions that are often accompanied by lameness and limping. The gold standard approach traditionally used for infectious disease surveillance is laboratory confirmation, which for TAHD is a histologic examination of abnormal elk hooves submitted by wildlife agencies. Diagnostic evaluation affords certainty in confirming TAHD; however, these examinations are also labor and resource intensive, and therefore, not conducive to the collection of sufficient data for epidemiologic investigations. In response, two community science (CS) surveillance strategies have been implemented in Washington State: public observations of limping elk from a web-based reporting tool and hunter reports of hoof abnormalities on harvested elk. Surveillance using CS strategies can be implemented widely and may be useful for describing broad distributional patterns of TAHD, despite their unknown relationship to laboratory-confirmed cases. We described and compared the spatial–temporal distribution of TAHD in western Washington game management units (GMU) using the two CS strategies to assess congruences and discrepancies between observed patterns. We used spatial scan statistics to identify possible core-affected and newly emerging areas at the GMU level. Lastly, we contrasted CS observations against confirmed case data to examine possible delays in TAHD detection and co-occurrence among surveillance strategies. We found public observations of limping elk often predated TAHD confirmations in GMUs by several years, while hunter-reported abnormalities predated confirmations in GMUs by several months. High co-occurrence between the presence of apparent and confirmed cases under different surveillance strategies further supports the use of CS sources. This study capitalizes on wide-reaching CS data to provide new and complementary epidemiological information that can help guide future surveillance, management, and research efforts for this novel elk hoof disease.

A data-driven epidemic model with human mobility and vaccination protection for COVID-19 prediction

Epidemiological models allow for quantifying the dynamic characteristics of large-scale outbreaks. However, capturing detailed and accurate epidemiological information often requires consideration of multiple kinetic mechanisms and parameters. Due to the uncertainty of pandemic evolution, such as pathogen variation, host immune response and changes in mitigation strategies, the parameter evaluation and state prediction of complex epidemiological models are challenging. Here, we develop a data-driven epidemic model with a generalized SEIR mechanistic structure that includes new compartments, human mobility and vaccination protection. To address the issue of model complexity, we embed the epidemiological model dynamics into physics-informed neural networks (PINN), taking the observed series of time instances as direct input of the network to simultaneously infer unknown parameters and unobserved dynamics of the underlying model. Using actual data during the COVID-19 outbreak in Australia, Israel, and Switzerland, our model framework demonstrates satisfactory performance in multi-step ahead predictions compared to several benchmark models. Moreover, our model infers time-varying parameters such as transmission rates, hospitalization ratios, and effective reproduction numbers, as well as calculates the latent period and asymptomatic infection count, which are typically unreported in public data. Finally, we employ the proposed data-driven model to analyze the impact of different mitigation strategies on COVID-19.

Magnitude and Associated Factors of Suicidal Ideation and Attempts among High School Adolescents of Jimma Town, Ethiopia.

Studies show that suicidal ideation and attempt are major predictors of suicide. Flourishing technologies such cyber bullying, increased local and global events, like pandemics, wars, and effects of climate change exacerbate vulnerability of adolescents to mental health problems. Thus, timely epidemiological information is important for evidence-based practices. Therefore, the aim of this study was to assess the magnitude and associated factors of suicidal ideation and suicidal attempt among school adolescents. A school-based cross-sectional study was conducted in June 2022 on randomly selected 1144 school adolescents using multistage sampling technique. Data were collected using a self-administered questionnaire. Then, data were cleaned, entered into Epi-data V.3.1 and analyzed using SPSS version 26. Multivariable logistic regression was done to identify predictors of suicidal ideation and suicidal attempt among adolescents. Adjusted odds ratio and confidence interval (CI) were respectively used to measure statistical associations and their statistical significance. The prevalence of lifetime suicidal ideation and attempt were 22.5%, and 13.3%, respectively, while 12-month suicidal ideation and attempt were found to be 14.6% and 10%, respectively. Being female, disappointment in school results, family history of suicide attempt, current alcohol intake, anxiety, and chronic medical condition were significantly associated with both suicidal ideation and attempt while cyber bullying was significantly associated with suicidal ideation only. Unsupportive home environment plus behavioral and medical conditions predispose school adolescents to suicidal ideation and attempt. The Ministry of Education and school administrations should facilitate favorable environment that enhance mental health awareness and protection of school adolescents. Building better parent-child relationship and parental discretion on the use of mobile phones can mitigate suicidal ideation and attempt.

Stress Response Pattern of Heart Rate Variability in Patients with Functional Somatic Syndromes.

Functional somatic syndromes (FSSs) represent a clinically important group of disorders that are often stress-related. Their autonomic pathophysiology, including reduced heart rate variability (HRV), has been reported. However, the response pattern to mental stress and recovery in FSSs remains unclear. Thus, we aimed to clarify the pattern of autonomic stress response and recovery to mental arithmetic stress in patients with FSS compared to that in healthy controls. This cross-sectional study included 79 patients with FSS who visited the Department of Psychosomatic Medicine at a university hospital in Japan and 39 healthy controls. Following a mood questionnaire and obtaining epidemiologic information, HRV was measured during three periods (5 min each): relaxation baseline resting, stress (mental arithmetic task), and post-stress recovery period. The HRV analysis included inter-beat interval, low frequency power, and high frequency power. Compared to healthy controls, patients with FSS exhibited significantly higher scores on the mood questionnaire, prolonged duration of illness, and decreased functionality in daily activities. While the healthy control group showed a pronounced stress response pattern with a significant decrease in vagal HRV and recovery, the FSS group showed a "flat" vagal stress response pattern, and the HRV in the FSS group was lower at relaxation baseline, remained low during the stress, and did not change post stress. Patients with severe FSS exhibit an altered stress response pattern. Our results could provide significant clues for the diagnosis and treatment of such patients, as well as useful insights into the relationship between stress and illness.

A Serological Survey and Risk Factors of Respiratory Syncytial Virus in Goats in Different Locations in Al-Najaf, Iraq

Bovine respiratory syncytial virus (BRSV) is one of the most common causes of respiratory illness in goats globally, resulting in major financial losses. The goal of this Survey was to determine the incidence of Bovine Respiratory Syncytial virus in Al-Najaf goats and the risk factors for this disease. Between December 2021 and November 2022 For this study, 200 goats of various ages and breeds from Al Kufa, Qadisiyia, Hayderia, and Abbasyia in Al-Najaf, Iraq, were tested. The animals’ epidemiological information was recorded. An indirect Elisa test kit was used to establish the disease’s incidence. The incidence of BRSV in goats was 44.5%, and it was substantially higher in Goats aged more than one-year (50.4%). The incidence of BRSV in male and female goats did not vary significantly. Compared to samples taken during the other seasons, those collected in the winter had a significantly higher BRSV incidence. There was a significantly difference in disease infection rate (P≤0.05) among mixed goats compared with others that were not mixed with other specious. The results revealed that the imported animals had a significantly higher prevalence than the native goats. In Conclusion: Bovine Respiratory Syncytial Virus is predominant in goats from the Al-Najaf province and risk factors such as animal age, herd size, origin, and the herd’s geographical location are related to an increased occurrence of the disease in this region. Routine vaccination plans must be assumed to decrease the incidence of BRSV in goats.

Antimicrobial susceptibility and serotype distribution of Streptococcus pneumoniae isolates among children in Suzhou, China.

Streptococcus pneumoniae (SP) is responsible for pneumococcal diseases with severe morbidity and mortality. High rates of drug resistance constitute serious public health concerns. Vaccination has proven to be an effective means of reducing disease burden. Epidemiological information of antibiotic susceptibilities and serotype distribution will be of great help to the management of pneumococcal infections. This study reported the serotype distribution and antibiotic resistance pattern of SP in hospitalized children in Suzhou during the years 2017-2018. The aim is to reduce pneumococcal resistance and guide vaccination. The clinical data of hospitalized children with SP were collected and analyzed. A total of 2,446 strains of SP were isolated from these patients. Serotypes were determined using the Quellung reaction. Antibiotic resistance was tested using the E-test diffusion method. The non-susceptible rates of the isolates to penicillin, amoxicillin, and cefotaxime were 9.5%, 27.7%, and 27.2%, respectively. And 97.6% of SP isolates showed multidrug-resistant (MDR). The most common resistance pattern of non-invasive isolates was macrolides + sulfamethoxazole + clindamycin + tetracycline. The major serotypes of this resistance pattern were 6A, 23F, 6B, 19F, 15B. The most extensive resistance pattern of invasive isolates was macrolides + β-lactams + sulfamethoxazole + clindamycin + tetracycline. The most common serotypes of the pattern were 19F, 19A, 6B, 23F, 6A. The most common serotypes were 19F (28.6%), 6B (11.9), 23F (11.2%), 6A (10.6%), and 19A (9.1%). In the isolates with MDR, the first five most common serotypes were 19F, non-vaccine serotype (NVT), 6B, 6A and 23F. Strains belonging to different serotypes exhibited distinct antimicrobial resistance patterns and were found to be associated with different diseases. The coverage rates of pneumococcal conjugate vaccine (PCV)7 and PCV13 in all isolates reached 60.4% (310/513) and 80.9% (415/513), respectively. The main serotypes of SP in Suzhou were 19F, 6B, 23F, 6A, and 19A. The use of PCV13 is beneficial to children in Suzhou.

COVID-19 surveillance in educational institution as an early detection in subpopulation

Since the first time it was discovered in 2019, COVID-19 has been the major threat to public health. Surveillance is considered to be one of the main pillars in dealing with the pandemic as it enhances the efforts of prevention and control of COVID-19. This study aimed to develop COVID-19 surveillance system at Universitas Airlangga that play a great importance in detecting and monitoring of COVID-19 status among its academias. This study refers to system approach which include system analysis and system design. System analysis was conducted by describing it into its components, namely input, process, and output. The results from system analysis are then utilized to the system design. The surveillance system collects and analyzes data which resulted to epidemiological information and recommendation. The result from the monitoring then utilized as an effort to enhance the coordination for epidemic preparedness in the institution. This study concludes that the COVID-19 surveillance system model in this institution monitors the COVID-19 status and associated risk factors of the sub-population within the institution. The information generated is used by decision-makers for early detection and monitoring of COVID-19 status.

Smoking history and breast cancer risk by pathological subtype: MCC-Spain study.

The role of cigarette smoking on breast cancer risk remains controversial, due to its dual carcinogenic-antiestrogenic action. In the population-based multi-case-control study (MCC-Spain), we collected epidemiological and clinical information for 1733 breast cancer cases and 1903 controls, including smoking exposure. The association with breast cancer, overall, by pathological subtype and menopausal status, was assessed using logistic and multinomial regression models. Smokers had higher risk of premenopausal breast cancer, particularly if they had smoked ≥30 years (AOR=1.75; 95% CI: 1.04-2.94), although most estimates did not achieve statistical significance. In contrast, among postmenopausal women, smoking was associated with lower risk of breast cancer, mainly in overweight and obese women. The strongest risk reductions were observed among postmenopausal women who had stopped smoking ≥10 years before cancer diagnosis, particularly for HER2+ tumors (AOR=0.28; 95% CI: 0.11-0.68); p for heterogeneity = 0.040). Also, those who had smoked <10 pack-years (AOR=0.68; 95% CI: 0.47-0.98) or 10-25 pack-years (AOR=0.62; 95% CI: 0.42-0.92) during their lifetime were at a reduced risk of all breast cancer subtypes (p for heterogeneity: 0.405 and 0.475, respectively); however, women who had smoked more than 25 pack-years showed no reduced risk. Menopausal status plays a key role in the relationship between tobacco and breast cancer for all cancer subtypes. While smoking seems to increase the risk in premenopausal woman, it might be associated to lower risk of breast cancer among postmenopausal women with excess weight.