Epidemiological Picture Research Articles

Effects of Cnidoscolus Quercifolius Pohl leaves extracts on glucemia reduction in diabetic mice / Efeitos das folhas de Cnidoscolus Quercifolius Pohl sobre a redução da glucemia em ratos diabéticos

Obesity, metabolic syndrome and diabetes are epidemic chronic situations in industrialized countries that are associated with the reduction of life quality and increase of patients’ mortality. Before the serious epidemiological picture and the impact that the diabetes causes in the society, the use of different therapeutic interventions is priority in the scientific community. Thus, the goal of this work valued the hypoglycemic effect of the aqueous and methanolic extracts of the leaves of Cnidoscolus quercifolius Pohl (faveleira). The phytochemical analysis demonstrated the carbolic acids presence, flavonols, xanthone, catechin, triterpenoids, tannin and coumarins in both extracts and the liquid chromatography of high efficiency revealed the presence of the gallic acid; a powerful metabolite antioxidant. The Diabetes was induced in mice Swiss with alloxan that they did not present mortality when treated with 100, 200 mg / kg of methanolic extract and 100, 200 and 400 mg / kg of aqueous extract for 30 days. Histopathological analysis of the animal’s organs (kidney, pancreas, liver) did not reveal architectural alteration. All the diabetic animals submmited to the extracts presented a higher reduction on the blood sugar level percentage than the ones which were undergone to the standard drug. It is important to highlight that the blood sugar level - of the diabetic animals undergone to 400 mg / kg of weight of the aqueous extract - presented glycemic reduction of 39,81 % after 30 days of treatment. These results are very promising because they show great potential for the use of this typical Brazilian Caatinga plant as an alternative therapeutic option to slow down or reduce the risk of hyperglycemia and oxidative stress in diabetic patients.

Revisiting Porcine Circovirus Disease Diagnostic Criteria in the Current Porcine Circovirus 2 Epidemiological Context.

Current knowledge on porcine circovirus diseases (PCVD) caused by Porcine circovirus 2 (PCV-2) includes the subclinical infection (PCV-2-SI), systemic (PCV-2-SD) and reproductive (PCV-2-RD) diseases, and porcine dermatitis and nephropathy syndrome (PDNS). Criteria to establish the diagnosis of these conditions have not changed over the years; thus, the triad composed by clinical signs, lesions and viral detection in lesions are still the hallmark for PCV-2-SD and PCV-2-RD. In contrast, PCV-2-SI diagnosis is not usually performed since this condition is perceived to be controlled by default through vaccination. PDNS is diagnosed by gross and histopathological findings, and PCV-2 detection is not recognized as a diagnostic criterion. Molecular biology methods as a proxy for PCVD diagnoses have been extensively used in the last decade, although these techniques should be mainly considered as monitoring tools rather than diagnostic ones. What has changed over the years is the epidemiological picture of PCV-2 through the massive use of vaccination, which allowed the decrease in infectious pressure paralleled with a decrease in overall herd immunity. Consequently, the need for establishing the diagnosis of PCVD has increased lately, especially in cases with a PCV-2-SD-like condition despite vaccination. Therefore, the objective of the present review is to update the current knowledge on diagnostic criteria for PCVDs and to contextualize the interest of using molecular biology methods in the overall picture of these diseases within variable epidemiological scenarios of PCV-2 infection.

Tick borne relapsing fever - a systematic review and analysis of the literature.

Tick borne relapsing fever (TBRF) is a zoonosis caused by various Borrelia species transmitted to humans by both soft-bodied and (more recently recognized) hard-bodied ticks. In recent years, molecular diagnostic techniques have allowed to extend our knowledge on the global epidemiological picture of this neglected disease. Nevertheless, due to the patchy occurrence of the disease and the lack of large clinical studies, the knowledge on several clinical aspects of the disease remains limited. In order to shed light on some of these aspects, we have systematically reviewed the literature on TBRF and summarized the existing data on epidemiology and clinical aspects of the disease. Publications were identified by using a predefined search strategy on electronic databases and a subsequent review of the reference lists of the obtained publications. All publications reporting patients with a confirmed diagnosis of TBRF published in English, French, Italian, German, and Hungarian were included. Maps showing the epidemiogeographic mosaic of the different TBRF Borrelia species were compiled and data on clinical aspects of TBRF were analysed.The epidemiogeographic mosaic of TBRF is complex and still continues to evolve. Ticks harbouring TBRF Borrelia have been reported worldwide, with the exception of Antarctica and Australia. Although only molecular diagnostic methods allow for species identification, microscopy remains the diagnostic gold standard in most clinical settings. The most suggestive symptom in TBRF is the eponymous relapsing fever (present in 100% of the cases). Thrombocytopenia is the most suggestive laboratory finding in TBRF. Neurological complications are frequent in TBRF. Treatment is with beta-lactams, tetracyclines or macrolids. The risk of Jarisch-Herxheimer reaction (JHR) appears to be lower in TBRF (19.3%) compared to louse-borne relapsing fever (LBRF) (55.8%). The overall case fatality rate of TBRF (6.5%) and LBRF (4–10.2%) appears to not differ. Unlike LBRF, where perinatal fatalities are primarily attributable to abortion, TBRF-related perinatal fatalities appear to primarily affect newborns.

Preliminary Data on the Occurrence of Anisakis spp. in European Hake (Merluccius merluccius) Caught Off the Portuguese Coast and on Reports of Human Anisakiosis in Portugal.

Parasitic nematodes of the genus Anisakis are among the most important biological hazards associated with seafood. A survey of Anisakis spp. in European hake (Merluccius merluccius) was undertaken as this species is a staple of the Portuguese diet. Moreover, a literature review of cases of anisakiosis reported from Portugal, a country with one of the highest levels of fish consumption in the world, was also carried out. Seventy-five European hake caught in the Atlantic Ocean off the northern coast of Portugal were analyzed to determine the infection levels and site distribution of Anisakis spp. Isolated nematode larvae were identified to species level by molecular analysis. Two sets of samples were collected. Firstly, a total of 46 Anisakis spp. L3 larvae were collected with a prevalence of 76.7% (95% CI 61.5–91.8%) and intensity (mean ± SD, range) of 2.0 ± 1.2 (1–5). Most larvae were found on the liver (45.7%) and on the gonads (32.6%), but none in the muscle. The molecular analysis showed the presence of both A. simplex s.s. (70%) and A. pegreffii (30%). For the second sample, analyzed using the UV-Press method, a total of 473 Anisakis spp. were found, with a prevalence of 95.6% (95% CI 89.5–100.0%), intensity (mean ± SD, range) of 11.3 ± 9.7 (1–41), density of 0.05 ± 0.04 (0–0.16) worms/muscle weight in g, and density of 0.54 ± 0.50 (0–2.53) worms/viscera weight in g. Surprisingly, only three very recent cases of human anisakiosis in Portugal have been reported in the literature. Data from this study contribute towards an updating of the existing epidemiological picture in an area characterized by very high seafood consumption and changing eating habits.

Genetic variation analysis of the sigma B protein gene of novel duck reovirus in southeastern China from 2011 to 2020

The novel duck reovirus (NDRV) disease first appeared in China in 2011. Infected ducks may be of various ages and breeds. Sigma B protein, which is the key component of NDRV's outer capsid, may trigger group-specific neutralizing antibodies linked to NDRV infection, pathogenicity, and immune defense. The sigma B protein gene of fourteen NDRV field strains was amplified by RT-PCR and cloned into the pMD-18 T vector for sequencing to examine the genetic variation in sigma B proteins of NDRVs in southeastern China between 2011 and 2020. The sigma B protein gene of the fourteen NDRV southeastern strains included in this analysis had 96.3 %–99.8 % nucleotide, and 96.2 %–99.7 % deduced amino acid sequence homology. Phylogenetic analysis revealed that the fourteen southeastern strains belonged to a well-supported lineage that included NDRV and Muscovy duck reovirus (MDRV) strains. However, Avian reovirus (ARV) formed a distinct genetic lineage in the gene tree. The sigma B protein gene sequences of NDRV strains found in southeastern China are substantially conserved, according to these findings. There is no significant geographical difference between NDRV southeastern strains and DRV strains in other regions of China. Our findings will add to the molecular epidemiological picture of NDRV strain spread in southeastern China between 2011 and 2020, laying the groundwork for potential in-depth research on vaccine collection and comprehensive prevention.

COVID-19 Vaccine-Related Myocarditis: A Descriptive Study of 40 Case Reports.

After the surging rise in the Coronavirus disease 2019 (COVID-19) pandemic, the Food and Drug Administration (FDA) approved emergency approval of vaccinations to prevent life-threatening complications of COVID-19 infection. These vaccines are BNT162b2, mRNA-1273. Later, the FDA also approved JNJ-78436735. COVID-19 vaccination does not have major side effects, but there are some concerning adverse events reported right after vaccination. Myocarditis is one of them. Based on our analysis of 40 case reports, we are presenting the epidemiology and clinical picture of myocarditis related to the COVID-19 vaccine.Based on our analysis, we found that the majority of cases were seen in males with 90% predominance, and these cases were seen in the age group of 29.13 years old (mean, SD of 14.39 years). In 65% of cases, patients took the BNT162b2 vaccine; 30% of cases were reported with the mRNA-1273 vaccine; and 5% of cases with JNJ-78436735. Of all the cases, 80% of them are reported after the second dose of the vaccine with either Moderna or Pfizer.The characteristics of COVID-19 vaccine-related myocarditis were analyzed in this study. We identified several findings, ranging from age, gender, type of vaccination, presentation of symptoms, and diagnosis modality. This depicts the picture of COVID-19 vaccine-related myocarditis and what physicians should expect when dealing with the disease. Our analysis showed that more cases were reported after receiving the BNT162b2 vaccine compared to mRNA-1273 and JNJ-78436735 vaccines. Further research needs to be conducted to analyze the underlying cause of this association.

Obesity as an Important Marker of the COVID-19 Pandemic.

Introduction: In December 2019, the emergence of the new coronavirus disease 2019 (COVID-19) began in Wuhan, China. Thereafter, the disease has been spreading rapidly across the world, with about 300 million registered cases worldwide, and the numbers are also exponentially increasing in India, with about 34 million registered cases by the end of 2021. Among the comorbidities, obesity may increase the risk of hospitalization due to COVID-19 infection as it is related to immune system dysfunction. Since the epidemiological picture of COVID-19 is changing very rapidly. Therefore, it is very important to discuss the pattern of clinical manifestation and association with comorbidities. Hence, we have conducted this observational study in one of the tertiary care centers in North India. Methods and Materials: We conducted a hospital-based prospective observational study in dedicated COVID-19 wards and ICU of a tertiary care center in North India with a sample size of 400 positive patients (males: 260, females: 140). We divided the patients in this study into three different age groups (less than 40 years, 40-60 years, and more than 60 years). The patients with age ≤ 18 years and BMI 18.5 kg/m2 were excluded from the study. Results: Out of these 400 patients, 55 (13.8%) developed severe COVID-19. There was a fewer number of patients who developed severe COVID-19 in the normal and over-weight group. Moreover, obese patients progressed to more severe cases (34.5%). This also shows that after adjusting for age, compared to the normal-weight group, those who were overweight had a 1.48-fold chance of developing severe COVID-19 (OR 1.48, P 0.0455), while those who were obese had a 1.73-fold chance of developing the disease (ORs 1.73, P 5 0.0652). Regarding gender distribution, the association appeared to be stronger in men than in women. After similar adjustment, the ORs for overweight and obese patients compared to normal-weight patients were 1.39 (p 0.5870) and 3.55 (p 0.0113) in females and 1.36 (0.5115) and 6.19 (0.0001) in males, respectively. Conclusion: Our study shows that obese patients with a BMI of greater than or equal to 27.5 are at higher risk of developing COVID-19 severity, especially in the male population. Moreover, severity may be related to other comorbid conditions. However, in our study, patients with chronic obstructive pulmonary disease (COPD) and GI/liver diseases were less obese, and severity was relatively low. So, the conclusion is that obese male patients with comorbidities are more likely to develop severe COVID-19 infection.

The Cases of COVID-19 and Measles Co-Infection in Children

Relevance. The rapid spread of new pathogens inevitably leads to the occurrence of joint circulation with already known infectious agents, leading to the development of mixed infections. The simultaneous circulation of the pandemic coronavirus SARS-CoV-2 with a highly contagious measles virus leads to the development of mixed infections in people who have not been sick or vaccinated against measles. Aims. Review cases of co-infection with measles and COVID-19 in Moscow. Material and methods. A retrospective study of cases of measles and COVID-19 co-infection in three children with a description of the epidemiological and clinical picture of the disease. Results. In all observed children, the manifestation of the disease was typical for measles, the diagnosis of COVID-19 was established based on a laboratory study carried out in a hospital, which gave reason to count. That the infection with SARSCoV-2 occurred after the infection of children with measles. Conclusions. Different incubation periods can lead to several options for the development of co-infection. The similarity of clinical symptoms at the onset of the disease does not allow excluding a certain infection clinically, without laboratory verification.

Особенности раннего подключения речевого процессора у пациентов после кохлеарной имплантации

Hearing loss affects the entire course of a child’s development, especially if it occurred at an early age. At the same time, features of auditory, cognitive, and emotional-personal development are noted. Hearing loss limits social activity, communication, and psychoemotional comfort. The widespread spread of the disease presents a serious problem for public health. In the context of the spread of the new coronavirus infection COVID-19, the epidemiological picture in different regions and within them may change; in this regard, there are certain difficulties with hospitalization of patients, which are associated with an increased risk of morbidity and the collection of all the necessary analyses. To solve this problem, an early connection is used without patients being discharged from the hospital after surgery. Cochlear implantation followed by early intensive rehabilitation can allow patients to master speech, language, and social skills as soon as possible, which can be successfully used during a critical period when children master speech. The purpose of this article is to identify and compare the perceived advantages of early connection of the cochlear implantation system processor: early start of settings, allowing the child to have physical hearing, on the basis of which spontaneous oral speech will form naturally.

Epidemiological profile of congenital and gestational syphilis cases in the State of Piauí, Brazil

This study aimed to identify the epidemiological profile of congenital syphilis in pregnant women residing in the State of Piauí from 2007 to 2017. An ecological epidemiological study was carried out between January and February 2019 in the Notifiable Diseases Information System and the Live Births Information System. The incidence of congenital syphilis increased during the period studied (2007 to 2017), with an emphasis in the “Entre Rios” Health Region. Regarding neonates, they were predominantly diagnosed with up to 6 days of life (94.5%), males (49.9%), mixed race/color (66.4%), recent syphilis (82.8%), and evolved to live (91.9%). Pregnant women are aged between 20 and 39 years (69.9%), brown color (70.5%), low schooling (28.9%), underwent prenatal care (85.4%), received diagnosis during prenatal care (46.6%), did not undergo a treponemal test (46.2%), the non-treponemal test was reactive (86.8%), had a primary form of the disease (30.5%), and partners without treatment (60.8%). It is necessary to improve surveillance and prenatal care actions that result in the planning and adoption of interventions in order to change this epidemiological picture.

Perfil epidemiológico dos casos de sífilis congênita e gestacional no Estado do Piauí, Brasil

This study aimed to identify the epidemiological profile of congenital syphilis in pregnant women residing in the State of Piauí from 2007 to 2017. An ecological epidemiological study was carried out between January and February 2019 in the Notifiable Diseases Information System and the Live Births Information System. The incidence of congenital syphilis increased during the period studied (2007 to 2017), with an emphasis in the “Entre Rios” Health Region. Regarding neonates, they were predominantly diagnosed with up to 6 days of life (94.5%), males (49.9%), mixed race/color (66.4%), recent syphilis (82.8%), and evolved to live (91.9%). Pregnant women are aged between 20 and 39 years (69.9%), brown color (70.5%), low schooling (28.9%), underwent prenatal care (85.4%), received diagnosis during prenatal care (46.6%), did not undergo a treponemal test (46.2%), the non-treponemal test was reactive (86.8%), had a primary form of the disease (30.5%), and partners without treatment (60.8%). It is necessary to improve surveillance and prenatal care actions that result in the planning and adoption of interventions in order to change this epidemiological picture.

Dispersion routes of the main vectors of human malaria in the Americas: Genetic evidence from the mitochondrial COI gene.

In America, of the 44 species of Anopheles, nine are main vectors of malaria and, of these, genetic information exists for seven. Hence, this study sought to know the gene flow and diversity of the seven principal vectors of malaria at the Americas level. For the seven species and the sequences of the mitochondrial cytochrome c oxidase I (COI) gene obtained from the GenBank and Bold System, genetic analyzes of populations and genetic structure were performed and haplotype networks and phylogenetic trees were obtained. For the seven species, 1440 sequences were analyzed and 519 haplotypes were detected. The Hd and π values were higher within a continental context than by countries. Neutrality tests indicated positive and negative values with most of these being significant (p < 0.05). Phylogenetic analyses for all the species recovered three clades with no geographic pattern among them. Studies suggest that native species of Anopheles from the Americas have greater haplotype diversity and low genetic differentiation due to the lack of physical barriers to impede gene flow among these populations. Moreover, all the species are interconnected by roadways. This scenario complicates the epidemiological picture of malaria in the Americas.

Mental health status of married women during COVID-19 pandemic in Bangladesh: A cross-sectional study

AimThe uncontrolled spread of COVID-19 has demanded unparalleled measures, from the imposition of quarantine to the declaration as a public health emergency of international concern. COVID-19 poses a severe threat to our day-to-day life as well as physical and mental health. This study explores mental health status among married women that remain understudied in Bangladesh during the COVID-19 pandemic. MethodologyA cross-sectional study was conducted among 597 married women via face-to-face interview, maintaining all safety protocols. A semi-structured questionnaire was assembled that included socio-demographics and the DASS-21 scale. Descriptive analysis and logistic regression were performed to examine the associations between variables. ResultAlmost 35% of the respondents had stress, 20% had anxiety, and 44% had depression ranging from mild to extremely severe. Metropolitan city inhabitants, being housewives, higher educational status, number of children, financial condition, comorbidities, family members assistance in household activities, relocation during COVID-19, social media use, concern about family, infected family members, tendency to get COVID-19 updates had been found significant in multivariable and univariate regression analysis with depression, anxiety, and stress. ConclusionIn this study, we found high rates of stress, anxiety, and depression among the study participants. These findings provide us with an epidemiological picture of the mental health status of our target population that could be a key benchmark for identifying high-risk groups and developing policies as well. Results could also be used to formulate psychological interventions that might be helpful during the COVID-19 period and later.

High incidence of acute Q fever among incarcerated people in Cayenne, French Guiana.

ABSTRACTQ fever is a major public health problem in French Guiana. In recent years, a considerable number of cases has been reported in French Guiana’s penitentiary center. The main objective of this study was to describe the epidemiology of these cases. A retrospective study was conducted at the prison to identify cases of acute Q fever in people incarcerated between 2010 and 2021. During the study period, 16 patients were diagnosed with acute Q fever. The positivity rate varied between 13 and 57%. The annual incidence rate in 2019, 2020 and 2021 was 269 (95% CI: 0-640) 1,120 (95% CI: 290-1950) and 1,931 (95% CI: 60-3810) per 100,000 person-years, respectively. While several vertebrate species have already been shown to play an important role in the transmission of Coxiella burnetii, the full epidemiology picture in the tropics is far from clear, and the prison context, with its controlled environment, could help provide answers.

ASSESSMENT OF PERIODONTAL STATUS AMONG SUGAR FACTORY WORKERS

Introduction: Wellbeing is of fundamental significance in this day and age. Show of sickness free dentition is a respectable test, however tragically not many stay in this unblemished condition of wellbeing. Oral wellbeing being an essential part of general wellbeing status, plays a part in the improvement of personal satisfaction. Hence, the current status of dental sicknesses in the agricultural nations is clearly unfit to change their epidemiological picture. This paper assess periodontal status among sugar factory workers of karad taluka of Maharashtra, using community periodontal index (CPI).&#x0D; Aim: An epidemiological study to assess periodontal status among sugar factory workers of karad taluka using community periodontal index.&#x0D; Results: The results obtained were analyzed statistically. It was seen that of the total population under study, 22.93% (score 1 i.e. 269 subjects) had bleeding on probing, 39.64% (score 2 i.e. 465 subjects) had calculus or other plaque retentive factors, 37.43% ( score 3 i.e. 439 subjects ) had a pocket of 4-5mm. 14.32% (score 0 i.e. 168 subjects) had a loss of attachment of 0-3mm according to CPI index calculations and 85.67% (score 1i.e. 1005 subjects) had a loss of attachment of more than 3 mm.&#x0D; Conclusion: The following conclusions were drawn from the present study Subjects above the age of 35 years have more chances of occurrence of periodontal disease than the subjects below the age of 35 years. As age increases the prevalence of periodontal disease also increases. With increase in level of education and better socioeconomic status the level of periodontal disease decreased.

Dengue 2 serotype and yellow fever coinfection

Case PresentationArboviruses primarily consist of RNA, which favours greater genetic plasticity, with a higher frequency of mutations that allow the virus to adapt to different hosts. The initial symptomatology is nonspecific, in that the patient can present fever, myalgia, arthralgia, rash and headache. This makes a clinical diagnosis using laboratory tests difficult and time-consuming. In Brazil, the main arboviruses involved in epidemics belong to the family Flaviviridae. The patient in this case is from the municipality of São Bernardo do Campo, an area endemic for arboviruses. He presented symptoms of fever, myalgia and headache.ResultsThe multiplex assay for arboviruses detected genetic material from the dengue 2 and yellow fever viruses.ConclusionThis result confirms the importance of molecular tests showing high sensitivity and specificity that can assist clinical diagnosis, particularly in endemic areas during periods of outbreak for other arboviruses, like the epidemiological picture in Brazil in 2018, when significant co-circulation of dengue virus and yellow fever virus occurred. The presence of co-circulating arboviruses increases the chance of coinfection and demonstrates the importance of differential diagnosis.

Exploring temporal trends and risk factors for resistance in Escherichia coli-causing bacteraemia in England between 2013 and 2018: an ecological study.

Escherichia coli are Gram-negative bacteria associated with an increasing burden of antimicrobial resistance (AMR) in England. To create a comprehensive epidemiological picture of E. coli bacteraemia resistance trends and risk factors in England by linking national microbiology data sources and performing a longitudinal analysis of rates. A retrospective observational study was conducted on all national records for antimicrobial susceptibility testing on E. coli bacteraemia in England from 1 January 2013 to 31 December 2018 from the UK Health Security Agency (UKHSA) and the BSAC Resistance Surveillance Programme (BSAC-RSP). Trends in AMR and MDR were estimated using iterative sequential regression. Logistic regression analyses were performed on UKHSA data to estimate the relationship between risk factors and AMR or MDR in E. coli bacteraemia isolates. An increase in resistance rates was observed in community- and hospital-onset bacteraemia for third-generation cephalosporins, co-amoxiclav, gentamicin and ciprofloxacin. Among community-acquired cases, and after adjustment for other factors, patients aged >65 years were more likely to be infected by E. coli isolates resistant to at least one of 11 antibiotics than those aged 18-64 years (OR: 1.21, 95% CI: 1.18-1.25; P < 0.05). In hospital-onset cases, E. coli isolates from those aged 1-17 years were more likely to be resistant than those aged 18-64 years (OR: 1.33, 95% CI: 1.02-1.73; P < 0.05). Antibiotic resistance rates in E. coli-causing bacteraemia increased between 2013 and 2018 in England for key antimicrobial agents. Findings of this study have implications for guiding future policies on a prescribing of antimicrobial agents, for specific patient populations in particular.

Scabies in Spain? A comprehensive epidemiological picture.

IntroductionScabies is a neglected disease stablished worldwide with a fairy well determined incidence. In high-income countries, it often causes outbreaks affecting the residents and staff of institutions and long-term facilities, usually hard to detect and control due to the difficult diagnosis and notification delay. This study aim at characterizing the affected population, geographical distribution, and evolution of scabies in Spain from 1997–2019 as well as to describe the main environments of transmission using different data sources.MethodsWe carried out a nationwide retrospective study using four databases, which record data from different perspectives: hospital admissions, patients attended at primary healthcare services, outbreaks, and occupational diseases. We described the main characteristics from each database and calculated annual incidences in order to evaluate temporal and geographical patterns. We also analyzed outbreaks and occupational settings to characterize the main transmission foci and applied Joinpoint regression models to detect trend changes.ResultsThe elderly was the most frequent collective among the hospital admitted patients and notified cases in outbreaks, while children and young adults were the most affected according to primary care databases. The majority of the outbreaks occurred in homes and nursing homes; however, the facilities with more cases per outbreak were military barracks, healthcare settings and nursing homes. Most occupational cases occurred also in healthcare and social services settings, being healthcare workers the most common affected professional group. We detected a decreasing trend in scabies admissions from 1997 to 2014 (annual percentage change -APC- = -11.2%) and an increasing trend from 2014 to 2017 (APC = 23.6%). Wide geographical differences were observed depending on the database explored.DiscussionAn increasing trend in scabies admissions was observed in Spain since 2014, probably due to cutbacks in social services and healthcare in addition to worsen of living conditions as a result of the 2008 economic crisis, among other reasons. The main transmission foci were healthcare and social settings. Measures including enhancing epidemic studies and national registries, reinforcing clinical diagnosis and early detection of cases, hygiene improvements and training of the staff and wide implementation of scabies treatment (considering mass drug administration in institutions outbreaks) should be considered to reduce the impact of scabies among most vulnerable groups in Spain.

Identifying Plasmodium falciparum transmission patterns through parasite prevalence and entomological inoculation rate

Monitoring malaria transmission is a critical component of efforts to achieve targets for elimination and eradication. Two commonly monitored metrics of transmission intensity are parasite prevalence (PR) and the entomological inoculation rate (EIR). Comparing the spatial and temporal variations in the PR and EIR of a given geographical region and modelling the relationship between the two metrics may provide a fuller picture of the malaria epidemiology of the region to inform control activities. Using geostatistical methods, we compare the spatial and temporal patterns of Plasmodium falciparum EIR and PR using data collected over 38 months in a rural area of Malawi. We then quantify the relationship between EIR and PR by using empirical and mechanistic statistical models. Hotspots identified through the EIR and PR partly overlapped during high transmission seasons but not during low transmission seasons. The estimated relationship showed a 1-month delayed effect of EIR on PR such that at lower levels of EIR, increases in EIR are associated with rapid rise in PR, whereas at higher levels of EIR, changes in EIR do not translate into notable changes in PR. Our study emphasises the need for integrated malaria control strategies that combine vector and human host managements monitored by both entomological and parasitaemia indices. This work was supported by Stichting Dioraphte grant number 13050800.

Relation between Epstein-Barr virus infection and Multiple Sclerosis

Abstract Background Multiple sclerosis (MS) is an immune mediated inflammatory disease that attacks myelinated axons in the central nervous system (CNS), destroying the myelin and the axon in variable degrees. The aetiology and pathogenesis of MS is complex and multifactorial, involving many interlacing mechanisms. Many theories had considered viral infections as a possible cause of MS. One of these viruses is Epstein-Barr virus (EBV), a herpes virus belonging to the family herpesviridae. There is obvious similarity between EBV and MS regarding their epidemiological pictures, and it was observed that most MS patients had a history of infectious mononucleosis (IM) a few years before onset. The relation between EBV and MS may give hope for development of biomarkers for prediction of disease development, early diagnosis, prediction of prognosis, curing or even preventing MS through an anti EBV vaccine or antiviral therapies. Objectives This study aims to analyze the association between EBV infection and multiple sclerosis. Subjects and Methods This is a case control study carried in the MS outpatient clinic at Ain Shams University Hospitals during the period from April 2019 till November 2019. Subjects included in this study were classified into two groups. The first group included 30 patients diagnosed as having MS, on the basis of their MRI finding, clinical presentation and according to revised Mc Donald criteria 2017. The patient group included 11 males and 19 females, their age ranged from 18 to 48 years. The second group included 30 age and sex matched healthy controls without any neurological or medical diseases. The control group included 11 males and 19 females, their age ranged from 18 to 48 years. Both groups were tested quantitatively for immunoglobulin G against Epstein Barr viral capsid antigen (VCA) using the enzyme linked immunosorbent assay technique (ELISA). Results All patients with MS (100%) were positive for EBV VCA IgG, whereas (93.33%) of controls were positive. In the MS group, the EBV VCA IgG mean level was (161± 66.32) U/ml compared with (78.53±47.63) U/ml in controls. The difference in serum level of EBV VCA IgG between both groups was statistically highly significant (P = &amp;lt; 0.001). Conclusion There were higher levels of EBV VCA IgG in the serum of MS patients compared to healthy controls. This finding postulates a relation between EBV infection and MS and its role in the pathogenesis of MS.