Extrinsic Risk Research Articles

Anterior knee pain and its extrinsic risk factors among runners in under-resourced communities in Ekurhuleni, Gauteng, South Africa

Background: Various factors predispose athletes with Anterior Knee Pain (AKP) making a holistic assessment & rehabilitation inevitable. Due to minimal rehabilitation services in under-resourced communities, runners are likely to report poorer health outcomes compared to other communities. Objective: The purpose was to report on the prevalence and determine extrinsic risk factors for AKP among runners in under-resourced communities. Materials & Methods: This was a cross-sectional study which included a population of 347 runners. Convenience sampling was used to recruit 183 participants aged between 13 and 55 with no history of knee surgery, traumatic or degenerative knee conditions. Questionnaires were used to collect data on AKP prevalence, and extrinsic risk factors. The SPSS (version 25) was used to analyse the data. Data were presented as frequencies and percentages and the results from chi-square and logistic regression tests. Results: Forty percent (40%) of participants presented with AKP, particularly males (n=106, 58%), youth (n=94, 51%) and participants with 3–5 years of running experience (n=57, 31%). Anterior knee pain was associated with age (X2=6.484, p=0.039) and running experience (X2=8.39, p=0.04). The following extrinsic risk factors contributed to AKP significantly: training load (p=0.04, Odds ratio [OR]=1.23); warm-up (p=0.04, OR=1.23); shoe condition (p=0.04, OR=0.14) and running surface (p=0.05, OR=1.2). Discussion & conclusions: A substantial presence of AKP and its extrinsic risk factors were found among participants. These outcomes suggest that extrinsic risk factors should also be considered when managing AKP among runners.
 Keywords: Patellofemoral pain, external risk factors, athletes, poor resourced communities.

Environmental and Other Extrinsic Risk Factors Contributing to the Pathogenesis of Cutaneous T Cell Lymphoma (CTCL).

The applications of disease cluster investigations in medicine have developed rather rapidly in recent decades. Analyzing the epidemiology of non-random aggregation of patients with a particular disease fostered identification of environmental and external exposures as disease triggers and promoters. Observation of patient clusters and their association with nearby exposures, such as Dr. John Snow's astute mapping analysis in the mid-1800's, which revealed proximity of cholera patients in London to a contaminated water pump infected with Vibrio cholerae, have paved the way for the field of epidemiology. This approach enabled the identification of triggers for many human diseases including infections and cancers. Cutaneous T-cell lymphomas (CTCL) represent a group of non-Hodgkin lymphomas that primarily affect the skin. The detailed pathogenesis by which CTCL develops remains largely unknown. Notably, non-random clustering of CTCL patients was reported in several areas worldwide and this rare malignancy was also described to affect multiple members of the same family. These observations indicate that external factors are possibly implicated in promoting CTCL lymphomagenesis. Here, we review the epidemiology of CTCL worldwide and the clinical characteristics of CTCL patients, as revealed by global epidemiological data. Further, we review the known risk factors including sex, age, race as well as environmental, infectious, iatrogenic and other exposures, that are implicated in CTCL lymphomagenesis and discuss conceivable mechanisms by which these factors may trigger this malignancy.

Prevalence and Associated Factors of Injuries Related to Running: A Study among Runners in Sri Lanka

Running is one of the popular sports worldwide and it is the sport of choice for many in Sri Lanka because of its convenience, health benefits and economical nature. However, the potential for running injuries also has been well documented in the world literature. But unfortunately, at present there is no database available on running injuries among Sri Lankan runners. Aim of this study is to generate scientific details on running injuries among runners in Sri Lanka. A cross sectional study was performed among 256 runners (133 short distance runners and 123 long distance runners) in Sri Lanka who perform at provincial and national level competitions. The prevalence of any form of injury was 50.39% (129 injured athletes among 256 participants), while a total of 143 injuries sustained among 256 runners with the prevalence rate of 55.85%. The prevalence of any form of injury among short distance runners was 46.61% and among long distance runners was 54.47%. The body region showing the highest injury prevalence was the Knee joint (22.38%) in both short and long distance runners. Hamstring (18.18%), lower back (13.99%), ankle (13.29%) and calf (11.19%) were the other common sites of injuries. Abnormal Q angle, flat foot and history of previous injuries were found as associated intrinsic risk factors, while not engaging in stretching exercises by holding a stretch >20 seconds, training at hard intensity and sudden alterations in training pattern were found as associated extrinsic risk factors for injuries in runners. Age, body mass index, leg length discrepancy, training time per week and running shoes were found to have no association with the occurrence of injuries in runners. The findings of this study revealed that injury rate is high and suggests that effective preventive strategies are needed to reduce the injury rate in runners in Sri Lanka.

Breast cancer risk factors

Background: To assess the level of awareness of risk factors of breast carcinoma among women of reproductive age group (15-45 years). Methods: In this descriptive cross sectional study 100 female patients, presented in Gynaecology and Obstetrics OPD’s for their regular antenatal checkup or some gynecological issues, were included. They were not cases of any breast disease or carcinoma breast. Attendants accompanying patients, subject presenting with sign and symptoms suggestive of any breast disease and women with any patient of carcinoma breast in immediate family were excluded. Patient’s awareness was assessed by formal interview in which intrinsic, extrinsic risk factors and common myths regarding breast cancer were interpreted among women of reproductive age group. Based on the correctness of the responses of the study participants, to operationalize their knowledge into a quantitative indicator, a scoring system was devised. Result: Awareness about carcinoma breast varies with 46.66% had adequate knowledge. Almost 50% patients had some awareness regarding risk factors of breast CA with familial predisposition (31.5%), increasing age (19%), breast feeding influence (22.5%), obesity (36.7%) and smoking (44.4 %).The mean score of the knowledge in the sample was -0.54 (+ 5.21), the lowest being -12 and highest attained was +8.Statistically significant association of formal education with knowledge was determined (p=0.009). Conclusion: Majority of participants had limited knowledge about risk factors of breast cancer.

Variations in plantar pressure and balance in HIV-infected children in antiretroviral therapy

Balance disorders have been poorly investigated and somewhat neglected in people infected with the human immunodeficiency virus, especially in children, whose have intrinsic and extrinsic risk factors that may compromise the balance. To evaluate the foot plantar pressures and the balance in children with acquired immunodeficiency. We recruited 53 children aged between 6 and 15 years: 33 healthy children, and 20 children with positive serology for the human immunodeficiency virus. A physical examination included anthropometric, reflexes, tactile sensitivity of the foot and orthopedic evaluation. We also collected data of them using Pediatric Equilibrium Scale, baropodometry, and stabilometry. We considered significance level of 0.05 for statistics. Both groups were aged-, sex-matched and similar body mass index and scores of the Pediatric Equilibrium Scale. Three infected children had altered tactile sensitivity, and none had orthopedic or reflex alteration. Infected children had higher mean plantar pressure in the hindfoot than of the control group (p = 0.02). There was higher maximum plantar pressure in the hindfoot of the infected children than of the controls (p = 0.04). Controls had lower maximum plantar pressure in the forefoot than the infected children (p = 0.04). Infected children had larger displacement of the center of pressure (p = 0.006), larger mean velocity of displacement (p = 0.006), and longer duration between successive peaks of displacement than the controls (p = 0.02). Children living with the human immunodeficiency virus discharges great plantar pressures in the hindfoot and to present balance disturbances in the absence of neurological symptomatology.

Lesão por pressão: análise de prontuários e notificações do evento adverso

Introduction: The movement for patient safety seems increasingly globalized. Thus, strategies to leverage patient safety are necessary for this asset to be consolidated in the healthcare dynamics of health organizations. Objective: Evaluate in parallel the records of reports on pressure injuries with reports of adverse events in a public university hospital. Method: Descriptive study, from a documentary source. It was developed with patient records and reports of pressure injury in the Intensive Care Unit for adults and neurology and orthopedics unit of a hospital in Parana. Variables of clinical and demographic characterization of the sample were extracted; intrinsic and extrinsic risk factors for pressure injury, in addition to comparative incidence in documentary records in medical records and reports. Descriptive statistical analysis was performed. Results: A total of 658 medical records were analyzed, predominantly of men (62.0%), hospitalized in the non-critical sector (69.7%). It was found 91 (13.8%) records of incidence of pressure-related injuries in the medical records. Several intrinsic and extrinsic risk factors were raised. There were three reports of the adverse event in the same period, revealing that 96.7% of the injuries identified in the medical records were not properly reported. Conclusions: There is a clear discrepancy between the incidence of pressure injury observed in medical records and reports of adverse events.

Prevalence and risk factors of health care–associated infections in a limited resources country: A cross-sectional study

The aim of this study was to determine the prevalence of health care-associated infections (HAI) in our university hospitals (UH) and to delineate the risk factors associated with HAI. We conducted a cross-sectional study in the 2 UH of Sfax, Tunisia on July 2017, including all patients hospitalized for at least 48 hours. It was a 1-day pass per department and a 1-week prevalence survey per UH. Of 752 patients eligible for the study, the total number of HAI was 82, representing an overall prevalence of HAI of 10.9%. Respiratory tract infections were the most prevalent HAI (36.6%). In multivariate analysis, intrinsic risk factors independently associated with HAI were immune-suppression (adjusted odds ratio (AOR) = 2.8; P < .001), diabetes (AOR = 2.2; P = .008), and malnutrition (AOR = 2.2; P = .019). Extrinsic risk factors were endotracheal intubation (AOR = 17; P = .01), transfer to another department (AOR = 9; P = .019), parental feeding (AOR = 7.2; P = .014), tobacco use (AOR = 6.3; P = .004), as well as surgical wound class contaminated or dirty (AOR = 6.3; P = .002), and peripheral venous catheter(AOR = 4.7; P = .006). Our study highlighted the magnitude of the HAI problem threatening the quality of care in Southern Tunisia. A wise identification of HAI risk factors may help health care workers to ascertain the avoidability of these infections.

Risk factors for bovine mastitis with the isolation and identification of Streptococcus agalactiae from farms in and around Haramaya district, eastern Ethiopia

A cross-sectional study was carried out to determine the prevalence and risk factors of bovine mastitis caused by Streptococcus agalactiae from farms in and around Haramaya district, eastern Ethiopia. A total of 384 lactating cows were selected from small-, medium-, and large-scale production systems. California mastitis test (CMT) was used for screening subclinical mastitis. Out of the total animals examined, 63.02% (n = 242) had mastitis, where 6.77% (n = 26) and 56.25% (n = 216) were clinical and subclinical mastitis respectively. The quarter-level prevalence was 29.04% (n = 446), from which the clinical form was 6.38% (n = 98) and the subclinical was 22.66% (n = 348), and the rest quarters were blind 3.32% (n = 51). Milk samples from clinical as well as CMT positive quarters were cultured for isolation of S. agalactiae, where 10.3% (n = 46) resulted in growth of the bacterium. The prevalence of mastitis was found to be statistically significant among the age groups (p = 0.002), breed (p = 0.000), and parity (p = 0.000). Similar findings were found to the extrinsic risk factors considered; as production type (p = 0.010), teat injury (p = 0.02), and type of floor (p = 0.000). The study confirmed the importance of S. agalactiae as the cause of contagious mastitis and also identified the associated risk factors in the study farms and hence warrants serious attention.

Activity modification in heat: critical assessment of guidelines across athletic, occupational, and military settings in the USA.

Exertional heat illness (EHI) risk is a serious concern among athletes, laborers, and warfighters. US Governing organizations have established various activity modification guidelines (AMGs) and other risk mitigation plans to help ensure the health and safety of their workers. The extent of metabolic heat production and heat gain that ensue from their work are the core reasons for EHI in the aforementioned population. Therefore, the major focus of AMGs in all settings is to modulate the work intensity and duration with additional modification in adjustable extrinsic risk factors (e.g., clothing, equipment) and intrinsic risk factors (e.g., heat acclimatization, fitness, hydration status). Future studies should continue to integrate more physiological (e.g., valid body fluid balance, internal body temperature) and biometeorological factors (e.g., cumulative heat stress) to the existing heat risk assessment models to reduce the assumptions and limitations in them. Future interagency collaboration to advance heat mitigation plans among physically active population is desired to maximize the existing resources and data to facilitate advancement in AMGs for environmental heat.

Are MMP3, MMP8 and TIMP2 gene variants associated with anterior cruciate ligament rupture susceptibility?

ObjectivesAnterior cruciate ligament rupture (ACLR) is a common and severe knee injury which typically occurs as a result of sports participation, primarily via a non-contact mechanism. A number of extrinsic and intrinsic risk factors, including genetics, have been identified thus far. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteases (TIMPs) play a crucial role in extracellular matrix remodeling of ligaments and therefore the genes encoding MMPs and TIMPs are plausible candidates for investigation with ACL rupture risk. DesignA case-control genetic association study was conducted on 229 (158 male) individuals with surgically diagnosed primary ACLR, ruptured through non-contact mechanisms and 192 (107 male) apparently healthy participants (CON) without any history of ACLR. All participants were physically active, unrelated, self-reported Caucasians. MethodsAll participants were genotyped for four single nucleotide polymorphisms (SNP): MMP3 (rs591058C/T, rs679620 G/A), MMP8 (rs11225395C/T), and TIMP2 (rs4789932 G/A) using standard PCR assays. Gene-gene interactions were inferred. Single-locus association analysis was conducted using the Chi-square test. SNP-SNP interaction effects were analysed using multifactor dimensionality reduction (MDR) method. ResultsGenotype frequencies did not significantly differ between cases and controls, however, the MMP3 rs679620 G and rs591058C alleles were significantly overrepresented in cases compared to controls (p=0.021, OR=1.38, 95% CI: 1.05–1.81). ConclusionsThese results support the hypothesis that genetic variation within MMP3 contributes to inter-individual susceptibility to non-contact ACLR. However, these results need to be explored further in larger, independent sample sets.

RISK FACTORS ASSOCIATED WITH NOSOCOMIAL PNEUMONIA IN ADULT PATIENTS

Objective: The objective of this article is to carry out a systematic review of several scientific publicationsabout the risk factors associated with nosocomial pneumonia in adult patients. Methods: The review was conducted through the electronic search of various scientific articles related to the subject. The PEO question was used: Is there an association between risk factors and the development of nosocomial pneumonia in adult patients? The search sources were PubMed and Scielo. The key words were: "nosocomial pneumonia", "hospital - acquired pneumonia" in combination with "risk factors"; "Nosocomial pneumonia", "intrahospital pneumonia" together with "risk factors". Articles published from January 1, 2014 to December 10, 2018 were selected. Results: Of the 101 articles found, 77 were discarded because they did not comply with our inclusion and exclusion criteria, leaving 24 articles for this review. The significant risk factors for NN were: Age (OR = 1.742, p = 0.000), consciousness disorder (HR: 2.0, P &lt;0.005), CKD (OR: 2.194, P &lt;0.002), COPD (OR: 3.52; p = 0.001), emergency tracheal intubation (OR 1.511, P &lt;0.024) and mechanical ventilation (HR: 8.2, P &lt;0.005), etc. Conclusion: Various intrinsic and extrinsic risk factors are associated with the acquisition of nosocomial pneumonia in adult patients: Age, consciousness disorder, CKD, COPD, endotracheal intubation, mechanical ventilation and other factors. &nbsp; DOI 10.25176/RFMH.v19.n1.1796

Critical review of incidence and etiology of ankle sprain and stress fracture in basketball

Basketball is the most engaging game to take place in any community. It involves high-intensity physical activities that require changing direction continuously, along with high-load actions. To make this sport safer, it is essential to understand the causes of injuries during games. Furthermore, understanding the intrinsic, extrinsic, biomechanical, psychological, and physiological risk factors, it is also crucial to be aware of the incidence and prevalence of associated injuries. Such knowledge will facilitate the development of new prevention techniques and methods that will help prevent extensive sports injuries and make sports safer.

Extrinsic Risk Factors for Women Breast Cancer in Gaza Strip, Palestine: Associations and Interactions in a Case-Control Study

Background: Worldwide, breast cancer (BC) is the most frequently diagnosed neoplastic disease in women around menopause that is the leading cause of DALYs, because it causes a significant reduction of these women’s ability to function normally in everyday life. Methods: The present hospital-based case-control study was carried out between January and August 2018 using a structured questionnaire on 105 breast cancer women and 210 controls who are clinically free from breast cancer. Data about the study cases were collected in the oncology day-care clinics of the two main hospitals in Gaza strip “Al-Shifa and European Gaza hospitals”. Univariate logistic regression and multivariate logistic regression analyses were employed to identify the significant factors associated with BC. Results: Multivariate logistic regression analyses with adjustment for all confounders revealed that woman with BMI more than or equal 30 kg/m2 are under risk of getting BC 2.9 times greater than those having BMI less than 29 kg/m2 (AOR = 2.895; 95% CI: 1.305 - 6.423). Analysis of risk according to reaching menopause showed that the estimated AOR was greater among those reached menopause (3.137, 95% CI 1.824 - 5.395) than among those that did not reach menopause. The risk of developing BC in the case of a history of incidence of BC in the family was more than two times higher (AOR = 2.632, 95% CI 1.528 - 4.535) than in case of the history of a free family of BC. Conclusion: In this context, the above-mentioned risk factors must be taken into consideration in BC management processes in the Gaza strip.

Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit: Risk factors and key preventive measures for eradication in record time

IntroductionIn November 2014, an extended-spectrum beta-lactamase producing Klebsiella pneumoniae outbreak was detected in the neonatal intensive care unit of a tertiary care hospital. ObjectiveOur aim was to determine the clinical, epidemiological and microbiological characteristics of the outbreak, to analyse the identified risk factors and to describe the preventive and control measures implemented for its eradication. MethodsWe conducted a case-control study. We performed univariate and bivariate analyses, defining statistical significance as a P-value of less than 0.05. The implemented preventive and control measures were aimed at establishing the magnitude of the outbreak, effective communication, the evaluation of health care processes and education on patient safety. Clinical samples were collected for molecular and phenotypic characterisation. FindingsThe sample consisted of 51 newborns, of who 17 were cases and the remaining 34 controls. The distribution of cases by birth weight was: 2 cases (11.8%) greater than 2500g, 4 cases (23.5%) between 1500 and 2500g, 5 cases (29.4%) between 1000 and 1500g, and 5 cases (29.4%) less than 1000g. In one case, the birth weight was not documented in the health record. The following risk factors for colonisation or infection were statistically significant in our study: presence of a central venous catheter (OR, 5.0 [95% CI, 1.4–17.8]; P=.016); parenteral nutrition (OR, 6.8 [95% CI, 1.8–25.7]; P=.006); urinary catheterization (OR, 5.9 [95% CI, 1.2–30.0]; P=.028) and birth weight (P=.035). We found statistically significant differences in the mean total length of stay in hospital (P=.004) and length of stay in the NICU (P=.002). All 17 cases presented antimicrobial resistance with presence of extended-spectrum beta-lactamase type CTX-M-14. ConclusionWorkplace interventions focused on patient safety need to be reinforced, especially those concerning practices with the potential to increase the extrinsic risk of colonisation or infection by extended-spectrum beta-lactamase-producing K. pneumoniae in the NICU, such as the insertion, care and maintenance of central venous catheter, parenteral nutrition and urinary catheterization.

The beginning of the end: A qualitative study of falls among HIV+ individuals.

Falls are an important concern for individuals living with HIV (HIV+). The purpose of this study was to understand perceptions of HIV+ individuals who had fallen regarding what caused their falls, prevention strategies that they used, and the impact of falls on their lives. Qualitative Description was the approach best suited to our study. We conducted in-depth interviews with 21 HIV+ individuals aged 47 to 71 years who had fallen within the past two years and who received care in a primary care/HIV clinic. Participants identified causes of falls as intrinsic (HIV, opportunistic infections, antiretroviral therapy, substance use, polypharmacy) or extrinsic (icy sidewalks, wet floors). Among those who felt that their falls could be prevented, prevention strategies included physical therapy and avoiding extrinsic fall risk factors. Some participants, however, felt that their falls could not be prevented. While some participants responded adaptively to falls, for many, the experience of falling was connected with deep feelings of loss and suffering. For these individuals, falls were understood to be “the beginning of the end” and a source of social isolation, changing family roles, diminished sense of self, and stigma.

Root Cause Analysis of Falls Occurred and Presenting Fall Prevention Strategies Using Nominal Group Technique

Background: Patients’ fall is considered as a challenge to patient safety, which entails not only prolonged hospital stays and higher costs, however, it may also result in injuries and even death. Objectives: This study aimed to identify attributed root causes and to develop preventive strategies. Methods: The present study is a multiphase qualitative study in which all fall incidents were studied deploying a root cause analysis process in accordance with the modified NPSA protocol in an educational hospital within a 9-month period. The contribution and association of risk factors attributed to each fall incident were analyzed using descriptive and analytical statistics. Finally, a nominal group technique was used, with specialist and holding three separate rounds, for determining preventive strategies of falling in health care facilities. Results: Out of a total of 110 fall incidents, 657 root causes were identified. Three groups of attributed causes, including patient, task, and education factors were found to have a greater share in the patient falling. Based on the identified root causes, fall prevention interventions were selected by members as specialized panels, who rated the solutions in several sessions. Ultimately, interventions agreed less than 70% were removed, and other potential preventive interventions were implemented in the form of a hospital-based trial. Conclusions: We found that a fall is the result of intrinsic and extrinsic risk factors. The first step in preventing falls is proper assessment of the patient in terms of clinical condition. Evaluation of the environment of the hospital is also essential to identify problems as well as developing amendment programs. Due to missing data on falls reported by nurses, it seems unwise to solely rely on the submitted reports.

Risk factors for the development of idiopathic pulmonary fibrosis: A review.

Idiopathic pulmonary fibrosis (IPF) is an invariably progressive disease. Current treatment options simply slow disease progression and better therapeutic options are needed. We aimed to review emerging literature on risk factors associated with the development of IPF. There is increasing data to support the role of intrinsic risk factors (e.g. genetics, aging, sex, lung microbiome), co-morbidities (e.g. gastroesophageal reflux, obstructive sleep apnea, diabetes mellitus, herpes virus infection), and extrinsic risk factors (e.g. cigarette smoking, environmental exposures, air pollution) in IPF development. These risk factors may independently increase susceptibility for IPF or act in a synergistic fashion to contribute to increased risk for disease development. Various risk factors have been identified in IPF development that fit within the current paradigm of disease pathogenesis. Further investigation in to these risk factors may help us better understand the pathophysiology of IPF and may guide future therapeutic interventions.

Epidemiology of injuries among Italian footballers: the role of the playing field

BackgroundFootball has a higher injury rate compared with other team sports such as rugby, in terms of two main categories: intrinsic (individual) and extrinsic (environmental) factors. The playing field is...

A Preliminary Study on Injury Risk Factors of Perak Athletes

The objective of this study is to identify the injury risk factors of Perak male and female athletes who participating in contact and non-contact sports, meanwhile to suggest preventive strategies to all the sports personnel. The research design chosen was retrospective descriptive epidemiological study. The data from this study is examined based on intrinsic risk factors (Self Induce and Attire) and extrinsic risk factors (Third Party, Environment and Equipment). The descriptive statistics was utilized to analyze the research variables. The data collected for self status in self induce factor, finding revealed that body composition (51.1%) as highest risk followed by body status to play (41.7%), self-attitude (5.8%) and age difference (1.4%). Whereby, for factor of attire, more injuries occurred due to not wearing appropriate protective gear (47.5%) compared to inappropriate footwear (34.5%) and inappropriate clothing (18.0%). The extrinsic factors of third party that lead to injuries were mostly due to opponent (89.2%), contrary to referee (10.8%) and none from audiences. There was no injury reported due to playing equipment. This study finding revealed that playing surface was reported highest (75.5%) in environment factors followed by weather (24.5%). In the nutshell, injury rates can be reduced by identifying the injury risk factors and thus the life span of high performance athletes will be prolonged.

Associated risk factors influencing ovine Eimeria infections in southern Spain

Eimeria infections are common in sheep industry worldwide nonetheless very little is known on infection dynamics and associated risk factors influencing the outcome of clinical ovine coccidiosis. The aim of the present work was to analyse intrinsic (e. g. host age) and extrinsic (flock size, farm size and animal density) risk factors influencing dynamics of Eimeria spp. infections in sheep farms of the semi-arid region of Murcia in southern Spain. Overall, 64 ovine flocks in Murcia were surveyed and a total of 396 faecal samples were collected between May and July 2015. Flotation and McMaster techniques were performed for parasitological investigation. Excreted oocysts were identified on the basis of morphological as well as morphometric characteristics. In all analysed samples Eimeria spp. oocysts (100%) were found and 11 different Eimeria species were identified. Most prevalent species was E. ovinoidalis (97%) followed by E. parva/E.pallida (97%), E. weybridgensis (90.9%) and E. crandallis (89.4%), respectively. Concomitant infections with more than one Eimeria species were observed in all analysed samples. Analysis of intrinsic/extrinsic risk factor revealed age, herd/farm size and animal density to be the main factors significantly influencing Eimeria oocysts per gram of faeces counts (OPG) and overall prevalence of Eimeria spp. infections in sheep.