Department Of Epidemiology Research Articles

Salmonellosis outbreak associated with the consumption of food at a wedding in an urban restaurant in Kazakhstan: a retrospective cohort study.

From June 13-16, 2022, a regional epidemiological department in Kazakhstan reported an increase in acute gastroenteritis cases among people who consumed food from a wedding at a restaurant. An investigation was initiated to determine factors associated with acute intestinal infection and prevent further illness. The investigation team conducted a retrospective cohort study among people who consumed event food. Participants were classified as a case if they were acutely ill with diarrhea, vomiting, fever, vomiting, or weakness from June 13-18. We interviewed people to collect information on demographics, symptoms, and food exposures at the event. We calculated food-specific attack rates and estimated adjusted relative risks (aRR) using multivariable Poisson regression, which was adjusted for sex, age, and foods consumed. Patient stool and gastric lavage samples, leftover food, and restaurant environmental samples were collected for bacterial culture and chemical analysis. Of the 138 participants, 66 became ill; the attack rate was 48%. The most reported symptoms were diarrhea (92%), abdominal pain (91%), and fever (89%). Symptom onset occurred between 6h and 4 days after the event (median = 1day). Overall, 50 (76%) cases were hospitalized; no deaths were reported. In bivariable analysis, a greater proportion of cases than non-cases ate honey cake (89% vs. 13%, p < 0.01), and 45% of cases ate leftovers compared with 11% of non-cases (p < 0.01). In multivariable analysis, honey cake was the only risk factor associated with illness (aRR = 7.8, 95% confidence interval = 3.5-20.1, p < 0.01). Honey cakes, which use raw eggs in cream layers, had been stored at room temperature for three days before the event. Salmonella enterica serovar Enteriditis (S. Enteritidis) was isolated from all patient stool samples (49/49, 100%) and honey cake samples (2/2, 100%). Staphylococcus aureus was detected in 92% (35/38) of patient gastric lavage samples. S. Enteritidis was this outbreak's most probable etiological agent based on clinical manifestations and isolation from participant and honey cake samples. The improper storage of cakes containing raw eggs was a key contributing factor. Leftover event food was discarded, and the restaurant was closed for disinfection. Future outbreaks could be prevented by increased food safety awareness.

A model for predicting confirmed leptospirosis cases in Sri Lanka

Leptospirosis is a significant health issue in Sri Lanka, but current studies have only examined some districts using time series analysis. There is no comprehensive leptospirosis prediction model for the entire country. This study aims to develop a model to predict leptospirosis distribution across Sri Lanka. We collected reported leptospirosis cases in all districts from 2011 to 2022 from the Epidemiology Department. We tested the normality of the data using the Shapiro-Wilk test. Also, we evaluated various models, including linear regression, exponential regression, polynomial regression, Autoregressive Integrated Moving Average (ARIMA) time series, generalised additive models (parametric), Cox proportional hazards regression model (semi-parametric), and median-based linear model (non-parametric). The best-fitting model was selected based on the minimum Akaike information criterion (AIC) and Bayesian Information Criteria (BIC), and its accuracy was verified using the Root Mean Square Error (RMSE). We found that the ARIMA model was the best-fitting model for Galle, Mullaitivu, Batticaloa, and Puttalam. The exponential regression model was the best-fitting model for Kalmunai, while the polynomial regression model was the best-fitting model for Matale and Jaffna. The generalised additive model was the best-fitting model for Gampaha, Hambantota, Matara, Mannar, Vavuniya, Trincomalee, Anuradhapura, Badulla, Monaragala, and Ratnapura. In contrast, the median-based linear model was the best-fitting model for Colombo, Kalutara, Kandy, Nuwara Eliya, Kilinochchi, Ampara, Kurunegala, Polonnaruwa, and Kegalle. The fitted models were then used to forecast leptospirosis incidents in Sri Lanka from 2024 to 2026. For future research, we recommend Bayesian hierarchical models to identify high-risk clusters of leptospirosis in Sri Lanka.

Lefser: Implementation of metagenomic biomarker discovery tool, LEfSe, in R.

LEfSe is a widely used Python package and Galaxy module for metagenomic biomarker discovery and visualization, utilizing the Kruskal-Wallis test, Wilcoxon Rank-Sum test, and Linear Discriminant Analysis. R/Bioconductor provides a large collection of tools for metagenomic data analysis but has lacked an implementation of this widely-used algorithm, hindering benchmarking against other tools and incorporation into R workflows. We present the lefser package to provide comparable functionality within the R/Bioconductor ecosystem of statistical analysis tools, with improvements to the original algorithm for performance, accuracy, and reproducibility. We benchmark the performance of lefser against the original algorithm using human and mouse metagenomic datasets. Our software, lefser, is distributed through the Bioconductor project (https://www.bioconductor.org/packages/release/bioc/html/lefser.html), and all the source code is available in the GitHub repository https://github.com/waldronlab/lefser. Institute for Implementation Science in Population Health, Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY, United States. E-mail: Sehyun.Oh@sph.cuny.edu (S.O.). Supplementary data are available at Bioinformatics online.

Injury epidemiology and emergency department length of stay in trauma hospital in Addis Ababa, Ethiopia.

Injuries are a major cause of health problems in low- and middle-income countries than in high-income nations. This study aimed to describe injuries and identify factors associated with the emergency department (ED) length of stay (LoS). This study was conducted at the Addis Ababa Burn, Emergency, and Trauma (AaBET) hospital in Addis Ababa, Ethiopia. All injured patients who visited the ED between April 1, 2021, and March 30, 2022, were included in the study. Data were collected through a retrospective medical record review. Descriptive statistics were used to present the data and a multivariable binary logistic regression model was used to assess factors associated with LoS in the ED. A total of 6991 (86.8%) injured patients were studied out of 8055 patients who visited the ED. The majority of the patients were male, 5184 (74.2%), and aged between 18-44 years, 4368 (62.4%). The most common mechanism of injury was road traffic accidents, 2693 (38.5%), followed by falls, 1523 (21.8%). The most commonly reported injured body parts were the head (2179, 31.2%). Of the total injured patients, 101 (1.8%) died. The LoS in the ED was greater than 24 hours for 24.4% (95% CI: 23.3-25.5) of the injured patients, with a mean duration of 2.51 (SD = 5.18) days. Factors significantly associated with a prolonged LoS (>24 hours) in the ED included being residing in outside Addis Ababa in Oromia [AOR: 1.61, 95% CI (1.38-1.88)], Amhara [AOR: 1.56, 95% CI (1.14-2.14)] and other [AOR: 3.93, 95% CI (2.73-5.64)], male [AOR: 1.30, 95% CI (1.09-1.54)], aged 60 years or older [AOR: 1.38, 95% CI (1.03-1.85)]; sustaining injuries from road traffic accident [AOR: 2.43, 95% CI (1.19-4.94)], being triaged to orange [AOR: 3.03, 95% CI (2.40-3.83)] and red zones [AOR:3.37, 95% CI (2.65-4.28)]; having fracture injuries [AOR: 1.95, (1.34-2.83)]; and experiencing contusions and crushing injuries [AOR: 2.63 (1.57-4.42)]. Injuries are the major share of cases among ED patients at AaBET hospital. Patients were staying in the ED for longer than the recommended 24 hours by the Ethiopian health system. Intervention measures focusing on injury prevention are necessary to reduce the patient burden on the hospital and strengthen the hospital's capacity to reduce prolonged LoS.

Emergency Medical Services and Police Utilization for Pediatric Mental and Behavioral Health Concerns Within a Large Hospital System.

This study aimed to compare emergency medical services (EMS) and police utilization trends, epidemiology, and emergency department (ED) outcomes between pediatric patients with mental or behavioral health (MBH) emergencies and those with non-MBH concerns transported to a large children's hospital system. This was a retrospective cohort study of patients aged 5 to 18 years transported via EMS and police to two EDs affiliated with a children's hospital from January 2012 through December 2020. Data were abstracted from electronic hospital records. Encounters for MBH emergencies were identified using diagnostic codes and chief complaints. Trends of EMS and police transports of patients with MBH emergencies were examined. Patient demographics and ED outcomes were compared between children presenting with MBH emergencies and those with non-MBH concerns. During the 9-year study period, out of 40,663 transports to the EDs, 36,137 (89%) arrived via EMS, and 4,526 (11%) arrived via police. A total of 10,250 (28.4%) EMS transports were for MBH emergencies. The volume of patients transported by EMS for MBH emergencies increased by 1.4% per year (P < 0.01) with no significant change in total EMS patient volumes. Patients with MBH emergencies transported by EMS were more likely to be older, female, of White race, and publicly insured; require restraint in the ED; and be admitted (P < 0.001). Of police transports, 4153 (91.8%) were for MBH emergencies, with no statistical change in the proportion of police transports that were for MBH emergencies. Police-transported MBH patients compared to non-MBH police-transported patients were more likely to be younger, female, and of White race (P < 0.001); 8.7% required mechanical/physical restraints in ED, 6.7% required pharmacologic restraint medications in ED, and 53% were admitted. The proportion of pediatric transports for MBH emergencies by EMS is rising and comprises the majority of police transports. Distinct from non-MBH pediatric patients transported, MBH patients necessitate significant ED resources, including ED-administered restraints and admission, highlighting their unique burden on the prehospital and ED systems.

Territorialização das políticas públicas em territórios vulneráveis de Londrina/Paraná/Brasil

This research aims to reflect on the scope of public health, epidemiology and social assistance policies in vulnerable territories in the North Zone of Londrina-PR, represented by the vulnerable territories (favelas) called Aparecidinha and Flores do Campo, in 2023, based on the work of CRAS Norte A and Norte B, the Department of Epidemiology and Health Information (DEPIS) and the municipal Health Department. This is a qualitative study, based on a survey of secondary information (scientific literature and official documents). It was found that health, epidemiology and care have faced challenges such as: guaranteeing the management of policies in accordance with the law, maintaining the efficiency of the services provided and tackling complex social problems in the face of the reality experienced by the population. The conclusion is that the social context in the areas of socio-economic vulnerability and lack of ownership of urban land in the North Zone of Londrina makes it very difficult to conduct and implement public policies that are essential for the quality of life of families, particularly those that fall under the Department of Epidemiology and Health Information (DEPIS).

Intestinal Parasites and Hematological Parameters in Children Living in Ambatoboeny District, Madagascar.

Madagascar is one of the poorest countries in the world. The country's extreme weather conditions, poor sanitation, and weak economy facilitate the spread of parasitic diseases. Infections with intestinal parasites are particularly dangerous for children because they can cause malnutrition and anemia, which, in turn, have a negative effect on children's cognitive functions and physical development. The aim of the present study was to analyze the prevalence of intestinal parasites and to assess hematological parameters in a group of children living in northern Madagascar. The screening was conducted in May 2024 in the Clinique Medicale Beyzym in Manerinerina, the Ambatoboeny district. It involved a sample of 208 children aged 0-17 years. Single stool samples were collected from all study participants. The samples were fixed in SAF fixative and then transported from Africa to Europe for further diagnostics at the Department of Epidemiology and Tropical Medicine, the Military Institute of Medicine-the National Research Institute in Poland. First, the samples were analyzed by light microscopy methods using three different diagnostic techniques (direct smear, decantation with distilled water, and the Fülleborn method). Next, they were tested by molecular biology methods (real-time PCR). Blood samples for the assessment of hematological parameters were collected at the healthcare center in Madagascar. The prevalence of intestinal parasites in the study sample was 61.5%. Helminths were found in 15.2% of the investigated children, and Giardia intestinalis (20.5%) was found to be the most prevalent parasite in the study population. Most infections were caused by potentially pathogenic stramenopila Blastocystis spp. (32.0%). Mean Hb, HCT, MCV, MCH, and MCHC levels in the study participants were below normal values. However, no correlation was found between the presence of a parasitic infection and low hematological parameters, which are a clinical sign of anemia. High rates of infections with intestinal parasites in children living in northern Madagascar support the necessity to introduce long-term preventive measures, which would limit the spread of parasitic diseases in the Malagasy population. Low hematological parameters in non-infected children may be indicative of persistent malnutrition or infection with other parasites, e.g., malaria or schistosomiasis.

Assessment of the economic benefit of smoking cessation in cancer patients

Introduction. In 2021, the results of the first large-scale prospective cohort study were published showing the negative impact of post-diagnosis smoking on the prognosis of non-small cell lung cancer (I-IIIа). The purpose of the study is to assess the possible benefits of postdiagnosis smoking cessation of patients with non-small cell lung cancer (NSLC) stage I–IIIa to both the health care system society as a whole. Materials and methods. A mathematical model (calculator) has been developed to calculate the economic benefits of smoking cessation among patients with a confirmed diagnosis of NSCLC (I–IIIa). The calculator uses indicators characterizing the postdiagnosis smoking status of patients with stage I–IIIa NSCLC, the probability of disease progression and survival in the groups of those who continue to smoke and those who quit smoking. These data were obtained from the prospective epidemiologic study performed in the department of clinical epidemiology, N. N. Blokhin NMRC of oncology in cooperation with the IARC. The calculator takes into account the average cost of treating patients with late-stage NSCLC (IIIb-IV stage) in 2020–2022, which is calculated based on an analysis of the medical records of patients who were treated in the Department of Medical Cancer Therapy No. 3 of the of the Federal State Budgetary Institution «N. N. Blokhin National Medical Research Center of Oncology» (Head K. K. Laktionov), statistical data on incidence and mortality from NSCLC in Russia, the Gross Domestic Product (GDP) per capita indicator, and the MINEC Forecast of socio-economic development of the Russian Federation for 2023, 2024 and 2025. Results. Stopping smoking after diagnosis of NSCLC stage I–IIIa results in cost savings due to a reduced likelihood of relapses and an increased number of patients who avoid relapses when quitting smoking. Taking into account the fact that the average cost of treatment for patients with stage IIIb–IV NSCLC is 4,000,000 rubles, savings on treatment due to a decrease in the likelihood of relapses and as a result of an increase in the number of relapse-free patients who quit smoking amounted to 3,321 million rubles. and 9,251 million rubles, respectively, per year. Thus, the total cost savings on treatment will amount to 12,588 million rubles or slightly more than 2.3 million rubles per patient who quit smoking. The second source of saving is maintaining the economically active potential of some patients diagnosed with stage I–IIIa NSCLC, due to increased progression free survival as a result of smoking cessation аmounts to 3 304 million rubles per year in terms of per capita GDP. If 100 % of patients with stage I–IIIa NLCLC hypothetically quit smoking, the potential budget savings could reach a significantly greater value of 29,480 million rubles per year. The economic benefit to society in the total metric of per capita GDP, obtained as a result of increased survival and possible preservation of labor activity, could exceed 14 billion rubles over a 5-year period. Conclusion. Smoking cessation in cancer patients is accompanied not only by clinical benefits, i. e. it reduces mortality and improves survival rates, but also by economic benefits for the healthcare system and the country as a whole.

Intestinal parasitic infections in Ukrainian war refugee children living in Poland

Introduction: The armed aggression of the Russian Federation against Ukraine in February 2022 forced millions of Ukrainian citizens to flee their country and seek refuge mainly in the European Union. Many of them found shelter in Poland. There are now over one million Ukrainian war refugees living in Poland, including 500,000 children. The attention of Polish medical services has been recently drawn to the previously unknown epidemiological status of infectious and invasive diseases in the paediatric population of Ukrainian refugees. The aim of this study was to assess the prevalence of intestinal parasitic infections in the group of Ukrainian children living in Poland. Materials and methods: The study involved performing parasitological examination of stool samples collected in May 2023 from 37 Ukrainian refugee children aged 3–7 years, who were living in Szczecin (Poland) and were attending a preschool set up to address the needs of the local Ukrainian community. Stool samples were tested by light microscopy using three different methods (direct smear, decantation, flotation) at the Department of Epidemiology and Tropical Medicine at the Military Institute of Medicine – National Research Institute. Results: Intestinal parasites were detected in 3 out of 37 children (8.1% of the study group; there was one case of infection with Ascaris lumbricoides and two cases of infection with Blastocystis spp.). The infected children’s parents or guardians did not observe any diarrhoeas or other gastrointestinal symptoms within 6 months prior to the examination. Conclusions: The presence of intestinal parasites among Ukrainian war refugee children living in Poland justifies the screening for parasitic diseases in this population. The obtained results will allow to take appropriate preventive and therapeutic actions.

The role of standardized quality systems in the management of a healthcare provider

Review Article, Pol J Public Health, Vol. 134 (2024): 69-72 Daria Żuraw, Paulina Oleksa, Mateusz Sobczyk, Kacper Jasiński, Mikołaj Porzak, Alicja Sodolska, Monika Żybowska, Anna Rzewuska-Fijałkowska Student Scientific Association at the Chair and Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, Poland DOI_disc_logo 10.12923/2083-4829/2024-0015 © 2024 Author(s). This is an open access article distributed under the Creative Commons Attribution-NonComercial-No Derivs licence (http://creativecommons.org/licenses/by-nc-nd/3.0/) Abstract Since the 1940s, the healthcare sector in Poland has been in constant evolution and requires constant improvement in the quality of services provided and customer-patient satisfaction. To facilitate quality management, systems dedicated to healthcare entities have been developed over the years, and others have been adapted to medical facilities. These methods are based on efficient, planned, repeatable, documented procedures based on current medical knowledge. The key is to choose the right system, tailored to the way the entity operates. A quality management system defines: organizational structure, available resources, procedures and processes to be implemented, the way information and documents communicate and flow, and the responsibility for quality assurance care and compliance. Creating awareness and a pro-quality attitude in the field of medical services makes it possible to learn about instruments and solutions aimed directly at healthcare provider, as well as those that can be adapted and subsequently implemented. Keywords: ISO standards, accreditation standards, total quality management, adverse events, medical mistake, management.

Zarażenia pasożytami jelitowymi u dzieci ukraińskich − uchodźców wojennych mieszkających w Warszawie

Introduction and objectiveThe war and the humanitarian crisis in Ukraine have resulted in a mass migration of millions of Ukrainians into the EU countries. According to the data obtained from Statistics Poland, a governmental agency collecting and publishing the country’s statistical data, the number of Ukrainian children currently living in Poland is approximately 500,000. The massive influx of immigrants into Poland poses a considerable challenge to the national health care sector. The aim of this study was to assess the prevalence of intestinal parasitic infections among Ukrainian child war refugees living in Warsaw.Material and methodsThe study involved a total of 25 Ukrainian children, patients of the Clinic of Paediatrics, Nephrology and Paediatric Allergology at the Military Institute of Medicine – National Research Institute in Warsaw. Parasitological diagnostic work-up was carried out in October 2023 at the Department of Epidemiology and Tropical Medicine, the Military Institute of Medicine – National Research Institute in Gdynia. Stool tests for the presence of intestinal parasites were conducted by light microscopy using three different methods (direct smear in Lugol’s solution, decantation with distilled water, Fülleborn’s flotation).ResultsA total of 20% of the children studied (5/25) were found to be infected with potentially pathogenic stramenopile &lt;i&gt;Blastocystis&lt;/i&gt; spp. In addition, two of the children were also infected with non-pathogenic &lt;i&gt;Endolimax&lt;/i&gt; nana and &lt;i&gt;Entamoeba&lt;/i&gt; coli protozoa. There were no infections with nematodes, cestodes or trematodes among the study participants.ConclusionsThe confirmation of potentially pathogenic &lt;i&gt;Blastocystis&lt;/i&gt; spp. in stool samples collected from Ukrainian children, war refugees living in Warsaw, justifies the necessity to re-introduce a large-scale routine screening for intestinal parasites in the paediatric population in Poland.

Metformin – the old drug with new therapeutic possibilities

Original Article, Pol J Public Health, Vol. 134 (2024): 47-51 Paulina Oleksa, Kacper Jasiński, Daria Żuraw, Mateusz Sobczyk, Monika Żybowska, Anna Rzewuska-Fijałkowska, Karolina Haczkur-Pawłowska, Piotr Więsyk Students’ Scientific Society at the Department of Epidemiology and Clinical Research Methodology, Medical University of Lublin, Poland Introduction. Metformin is an oral antidiabetic drug from the biguanide group, popularly referred as an aspirin of the 21st century. The therapeutic targets of metformin are expanding. It is characterized by antineoplastic, immunoregulatory, anti-aging and neuroprotective properties. We aimed to evaluate the pleiotropic effects of metformin, taking into account its different mechanisms, efficacy and safety in contemporary public health challenges. Material and methods. We conducted the literature review from 2014 to 2024 using the PubMed and Google Scholar. Results. Metformin, depending on the cancer and its stage, enhances the cancer treatment effects, prevents the drug resistance, lengthens overall time of survival, reduces the risk of recurrence. In the Parkinson’s disease, Alzheimer’s disease and depression metformin can even increase the risk of their occurrence, especially in high doses. Such doses predispose to the cobalamin deficiency, affecting the functioning of the nervous system. Metformin was effective in seizure control of epilepsy. It has positive impact on the course of some autoimmunological diseases. Among diabetics treatment, outcomes of COVID-19 and tuberculosis could be improved by metformin. Conclusions. Metformin is pluripotential drug. Possibilities of adjuvant metformin therapy are very promising, but it cannot be recommended as standard treatment. This issue requires further investigation, preferentially randomized controlled trials on the bigger research samples. Keywords: metformin and therapy, metformin and treatment, metformin and advances.

Towards a sustainable training on epidemiology and public health in Tamil Nadu, South India: a narrative review

Aiming to improve public health, with the science of epidemiology, Tamil Nadu Dr. MGR Medical University established the department of epidemiology in February 1997 and began its two year Master's degree program in Epidemiology and Public Health. A core mission of the department is to provide high quality education in epidemiology, translate epidemiologic research findings into clinical practice, and advance epidemiology research. In order to ensure that epidemiological research and practice continue to be of high quality, we aim to establish principles, activities, and successful outcomes of graduates contributing to the reduction of disease burden in human populations through research, education, and service. The description of courses was based on internal discussions and reviewing documents. The central components of the courses were divided into input, process and outcomes. A total of 55 students were enrolled in epidemiology from 2001-2004 and 75 in public health from 2017-2024 with Faculty-to-student ratio ranging from 4 to 5. Learning methods include lectures, technology-based learning, and group and individual instruction. In the field, students spend 75% of their time in state/central government institutions, and are required to submit a field report upon completion. There are 250 publications, 200 projects, 30 abstracts and 7 chapters, graduates working under state health departments of India, ICMR institutes, and pursuing additional degrees at John Hopkins and universities of France. With our guiding principles of think big, go far, learn together, and inspire change our goal is to provide evidence of sustainable epidemiological training.

Gender and the h-index in epidemiology

Gender-Based differences in h-indices across fields, including psychology, social work, and the biomedical sciences have been reported. These differences are persistent across all faculty ranks, including assistant, associate, and full professors, but may be larger for early career and senior faculty. Even with these known biases, the h-index remains a widely used metric of the productivity and impact of research scientists and university faculty. Recently, several studies have drawn attention to the potential for a widening gender gap in academic metrics given the ways in which gendered roles, and thus research productivity, were inequitably impacted by the COVID-19 pandemic. We describe the association between gender and h-index among a sample of tenured faculty from epidemiology departments in Schools and Programs of Public Health. Gender explained 1.2% of the variance in h-indices; after adjustment for professional age, gender explained only 0.1% of the variance. There was also crossover interaction for professional age and gender, with women having lower h-indices in early career yet overtaking males later. If h-indices are utilized as metrics for promotion and tenure, or as criteria for appointments to leadership or other roles, gender bias will continue to limit early- and mid-career women’s inclusion and advancement.

Impact of the organ-system integrated curriculum on the research productivity of a Philippine government medical school: An ARIMA-based bibliometric analysis

The organ-system integrated (OSI) curriculum was pioneered in the country by the U.P. College of Medicine (UPCM) in 2004. Data on its impact on research productivity was lacking. This study aims to describe the trends in research productivity of UPCM in a time series and the impact of OSI implementation on publication trends. Relevant electronic databases (PubMed, Scopus, and WPRIM) were searched from the earliest indexed record until December 2023. The auto-regressive integrated moving average (ARIMA) time series analysis was used to compare the actual and predicted trends during the OSI implementation using the pre-OSI trend. A total of 2,705 articles were included. Acta Medica Philippina is the journal with the highest number of publications (n = 420, 20.24%). Although there is a considerable rise in the number of publications utilizing evidence synthesis and qualitative design, observational studies remain as the most common design (n = 293, 2021-2023 period). The leading clinical departments are Neurosciences and Medicine. The departments of Biochemistry and Clinical Epidemiology take the lead among basic sciences departments. Despite the glaring uptrend in publications concurrent with OSI implementation, the actual trend is not significantly different from the predicted trend (LR chi2(1) = 0.37; Prob &gt; chi2 = 0.5432). The OSI curriculum did not significantly change the trend of productivity. Medical curriculum designers should revisit strategies dedicated for research competencies. It is imperative to include activities for qualitative and mixed-methods designs. Future studies should consider relevant critical events in the time series forecasting models and the scientific outputs in the grey literature.

Heroic history of the Institute of Epidemiology and Microbiology (1941–1945) and the main achievements of the present time

The aim of this article was to show the labor valour during the Great Patriotic War of the employees of the first research institute in Irkutsk, which began its history in 1912, as well as their success of the present time. The oldest scientific institution in the Irkutsk region was originally created on the initiative of the Siberian Medical Society as a laboratory and was transformed into the Chemical and Bacteriological Institute in 1918, and in 1930 it became the Institute of Epidemiology and Microbiology of the People’s Commissariat of Public Health of Russia.By the beginning of the Great Patriotic War, the institute had an epidemiological department and a microbiological laboratory that carried out epidemiological surveillance and diagnosis of a wide range of infections in Siberia. During the war years, the manufacturing sector with the production of vaccines and serums acquired particular importance. By the end of the war, 285 employees worked at the institute, 32 of them had higher education. During the war years, the production of vaccines against typhoid, paratyphoid, dysentery, diphtheria, tuberculosis, and smallpox was significantly increased. Serums against tetanus and measles, and a dysentery bacteriophage were produced. At the same time, research projects and thesis works were carried out. The employees of the institute received national and departmental awards, commendations, honorary distinctions, and rewards for their scientific work and production excellence.Currently, the institute continues the glorious traditions of the past and demonstrates truly heroic efforts in the development of virology and microbiology, working in priority areas of medical and biological science. Of course, the works of scientists of the present time will be appreciated only by descendants, as is now happening with the assessment of the work of the Institute of Epidemiology and Microbiology during the Great Patriotic War.

Modelling the Time-varying Transmission of Wild Poliovirus in Pakistan

Aims/Objectives: The efforts to eradicate the wild poliovirus since 1988 have successfully reduced its global prevalence by 99%. However, as of 2024, Pakistan and Afghanistan remain the only two endemic countries facing the virus transmission. This study employs a transmission dynamic model to understand the persistence of wild poliovirus type 1 (WPV1) in Pakistan. Study Design: An ordinary differential equations-based deterministic type of mathematical model was developed. Place and Duration of Study: Department of Epidemiology and Public Health and Institute of Microbiology, University of Agriculture Faisalabad, March 2023 to August 2023. Methodology: We included the number of reported polio cases and the proportion of missed children by supplementary immunization activities (SIAs) across the country from 2017-2022. The model considered both human-human and environment-human virus transmission through sewage contamination and these are represented by time-dependent transmission rate parameters. The parameter estimation was done by model fitting to the reported data of WPV1 cases. The model simulations then predicted the future polio infections in Pakistan. Results: Our analysis identified that the asymptomatic infectious population missed by the SIAs is the major contributor to disease persistence in the country. Moreover, the environment can contribute to virus transmission in areas with poor WASH infrastructure and under-immunized populations. The estimated basic reproduction number through the next-generation matrix method was 1.61 while the estimated effective reproduction number was 0.12. The model showed a better predictive ability than constant transmission rate models. The numerical simulations considering the reduction in the virus-shedding rate by the asymptomatic population resulted in an 85% reduction in future polio cases in Pakistan. Conclusion: The results suggest that endemic virus transmission will continue subject to the current higher vaccination coverage across the country. The model can be further utilized to guide eradication efforts for targeted allocation of preemptive measures.

Listeriosis in Poland in 2012-2021.

The aim of the study is to present and evaluate the epidemiological situation of listeriosis in Poland in the years 2012-2021. The analysis material consisted of data from individual epidemiological case reports on listeriosis submitted to the Department of Epidemiology of Infectious Diseases and Surveillance of the NIPH NIH - NRI by state sanitaryepidemiological stations in the form of paper questionnaires (2012-2019) and in the electronic form through the EpiBaza system (2020 and 2021), as well as aggregated data from the bulletin "Infectious Diseases and Poisoning in Poland". Between 2012 and 2021, a total of 896 cases of listeriosis were registred in Poland. The median incidence was 0.23 per 100,000 population, which was an increase by 52.2% compared to the previous 5-year period (2007-2011). Every year, more than 90% of cases were hospitalized. The highest percentage of patients were in the age group >60 years old (65.5%). From 2012 to 2019 (in the years when information on cases was collected on a paper form), a total of 275 deaths of patients from listeriosis were recorded (38.4% of all reported cases). According to data from the EpiBaza system, in 2020 and 2021 there were 5 (8.33%) and 25 (20.83%) deaths due to listeriosis. A total of 92.1% of patients with listeriosis had significant predisposing factors for the occurrence of this disease, most of which were associated with neoplasia and heart disease and were present in half of all cases. As part of routine surveillance, no epidemic outbreak associated with Listeria monocytogenes infection was reported in Poland in the years 2012-2021.A total number of 49 pregnant women with listeriosis were reported during described period. Between 2012 and 2021, 37 cases of congenital listeriosis were reported. The median of incidence was 1.07/100 thousand live births, a decrease of 26% compared to the previous 5-year period (2007-2011). Of all congenital infections in newborns, 12 deaths (32.43%) were reported. The epidemiology of listeriosis is changing both in the EU/EEA countries and in Poland: the incidence is increasing and the distribution of cases in different age groups is changing, affecting primarily the elderly, especially those with predisposing diseases. Although 2020 tere was a decrease in the number of cases at EU level, possibly related to the COVID-19 pandemic, the overall trend of listeriosis cases isincreasing. The clinical condition has a significant impact on the course of L. monocytogenes infection: in healthy people, infection is usually asymptomatic. The disease primarily affects immunocompromised people. In contrast, infection of pregnant women can lead to premature birth, miscarriage, meningitis and neonatal sepsis with mortality rate of 20-30%. The growing trend in listeriosis is alarming and requires greater attention in terms of prevention and control of the disease.

Zarażenia pasożytami jelitowymi u polskich żołnierzy rozmieszczonych w Kosowie

Introduction and objectiveSoldiers of the Polish Military Contingents currently stationed in foreign countries serve under difficult environmental conditions. Military service abroad is associated with the risk of importing infectious pathogens back to soldiers’ home country. The aim of the study was to assess the current prevalence of infections caused by intestinal parasites in soldiers from the Polish Military Contingent Kosovo serving as part of the Kosovo Force operation in the Balkans.Material and methodsParasitological diagnostics was carried out in June 2023 in a group of 221 soldiers from the Polish Military Contingents Kosovo stationed in several military camps across the country. Each participant was asked to provide three stool samples collected at 2–3-day intervals. Faecal examinations were performed using three different light microscopy testing methods (direct smear, decantation, flotation) at the Department of Epidemiology and Tropical Medicine at the Military Institute of Medicine – National Research Institute.ResultsIntestinal parasites, all of protozoan aetiology, were found in 28 out of 221 Polish soldiers taking part in the Kosovo Force operation in Kosovo included in the study (0.9% participants were infected with &lt;i&gt;Giardia intestinalis&lt;/i&gt; and 11.7% with potentially pathogenic parasites, &lt;i&gt;Blastocystis&lt;/i&gt; spp. and &lt;i&gt;Dientamoeba fragilis&lt;/i&gt;). There were no infections with nematodes, cestodes or trematodes among the study participants. No correlation was found between the detection of a parasitic infection and the presence of diarrhoea or other gastrointestinal symptoms within six months prior to the study. The analysis demonstrated that infections with protozoa were most often found in soldiers aged 35–45 years old. As for the military ranks, the rate of infections in each corps (privates, non-commissioned officers, and officers) was similar.ConclusionsCases of intestinal parasitic infections in soldiers from the Polish Military Contingent Kosovo could be associated with the effects of environmental conditions (poor standards of sanitation in the areas of deployment) and failure to comply with disease prevention principles (food and feed hygiene).

Trends of COVID-19 mortality and hospitalization rates in southern states of the United States, 2020-2023

ackground and Objectives: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has emerged as one of the most profound global health crises of the 21st century. In the United States, the impact of COVID-19 has been severe, with notable disparities observed in the Southern region. This study aims to evaluate trends in COVID-19 mortality and hospitalization rates in southern states over the course of 2020 to 2023 by presenting a comprehensive analysis of trends in COVID-19 outcomes within Southern states. Methods: Data for the study was collected from the COVID-19 Data Tracker, a resource provided by the Centers for Disease Control and Prevention (CDC). Stratification techniques were employed to categorize the sample into subgroups of Southern states (Arkansas, Alabama, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas, and Virginia). Joinpoint regression models were used to calculate Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC). Results: Results showed a downward trend in both age adjusted APC and AAPC COVID-19 hospitalization rates and an upward trend in mortality rates for all southern states between 2020 to 2023. Only 3 out of the 12 states have age adjusted mortality rates that are lower than the national age adjusted mortality rate for COVID-19 (286.4 deaths per 100,000). COVID-19 vaccine coverage in 12 southern states is 61.8% - 91.3%. Conclusion:The study contributes to a deeper understanding of the evolving dynamics of COVID-19 pandemic within the southern U.S. states. The information would be a valuable guidance for public health strategies, resource allocation, and policymaking aimed at addressing this ongoing crisis. July 2024; Vol. 18(2):001. DOI: https://doi.org/10.55010/imcjms.18.013 *Correspondence: Bever-Leigh Holden, Jackson State University, Department of Epidemiology and Biostatistics, Jackson, Mississippi, USA, Email:bever-leigh.i.holden@students.jsums.edu; beverleighholden@yahoo.com