Incidence Of Fever Research Articles

Review Article on Typhoid Fever

Typhoid fever is primarily found in impoverished countries with inadequate sanitation on a global scale. In the United States, the incidence of typhoid fever has been steadily decreasing since 1900 due to improvements in sanitation and effective antibiotic treatments. While typhoid fever is widespread, 80% of cases occur in the Americas, the Caribbean, Oceania, Bangladesh, China, India, Indonesia, Laos, and Nepal. Each year, approximately 200,000 individuals succumb to typhoid fever, and 21.6 million people are infected with the disease. When treated, the chance of death is 0.2% and there are rarely long-term symptoms. Untreated typhoid fever can lead to fatality and persist for multiple weeks. Lasting complications may involve central nervous system damage. 54 percent of reported typhoid fever cases in the United States between 1999 and 2006 included. One can receive fluids and electrolytes via a vein. For the treatment of typhoid fever, the patient can receive an antibiotic and, in rare circumstances, steroid medications. When prescribed antibiotics, most patients start feeling better after two days, and fatalities are rare. Typhoid cases are generally treated with specific antibiotics such ciprofloxacin, ampicillin, or chloramphenicol. Important public health measures include proper water purification, proper waste disposal, and safeguarding the food supply from contamination. Typhoid carriers should not be permitted to handle food in any capacity. If treatment is not received, patients may have a fever for weeks or months, and up to 20% of them may pass away from infection-related problems. The hospital setting is where those with infections are treated.

Global burden, trends, and inequalities for typhoid and paratyphoid fever among children younger than 15years over the past 30years.

Typhoid and paratyphoid fever, collectively known as enteric fever, are systemic infections caused by Salmonella enterica and are highly prevalent in children. We aimed to describe the global burden, trends, and inequalities of enteric fever among children under 15years from 1990 to 2019 based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019). In this secondary analysis of GBD 2019, we extracted data for incident cases, deaths, disability-adjusted life-years (DALYs) as measures of enteric fever burden. We estimated the average annual percentage changes (AAPC) in enteric fever incidence, mortality, and DALYs rate to quantify trends over time. Cross-country inequalities in enteric fever incidence were measured using the slope index of inequality and concentration index. In 2019, the global cases of typhoid and paratyphoid were 4 833 282 and 1 793 172, respectively, both lower than those in 1990. On secondary analysis, paratyphoid incidence decreased at a faster rate than typhoid from 1990 to 2009, whereas the incidence of paratyphoid (AAPC = -3.78, 95% CI: -4.07, -3.49) declined slower than that of typhoid (AAPC = -4.32, 95% CI: -4.50, -4.13) from 2010-2019 (P < 0.05) at the global level. The incidence burden of enteric fever increased in Australasia (AAPC = 1.28, 95% CI: 0.77, 1.78) and Western Europe (AAPC = 0.77, 95% CI: 0.44, 1.11). Death and DALYs burden in low socio-demographic index (SDI) region showed an stable trend. A significant reduction in SDI-related inequality occurred, with the concentration index falling from -0.31 in 1990 to -0.22 in 2019. The global disease burden of enteric fever and the magnitude of inequalities across countries have declined since 1990, but low SDI countries remain a region of concern. Travellers from Oceania and Western Europe to endemic regions should be particularly aware of the risk of enteric fever.

Outcome differences of emergency cesarean delivery in the delivery room versus the operating room: A study based on propensity score matching.

This study sought to compare the risks and outcomes associated with category I cesarean section procedures performed in the delivery room versus those performed in the operating room. The analysis included 126 singleton pregnant women who underwent inpatient delivery at the Second People's Hospital of Nanning between January 2021 and May 2024. Following propensity score matching, 21 cases were in the delivery room group, and 105 cases were in the operating room group. Parameters under investigation encompassed decision-to-delivery interval, incision-to-delivery interval, surgical duration, intraoperative blood loss, postoperative antibiotic duration, postoperative hospital stay length, postoperative fever incidence, adverse neonatal outcomes, and blood routine parameters. The decision-to-delivery interval was significantly shorter in the delivery room group than in the operating room group. Conversely, the delivery room group exhibited longer surgical durations, higher blood loss, prolonged postoperative antibiotic usage, extended hospital stays, and elevated white blood cell counts with statistical significance (p < 0.05). Nevertheless, no notable variations were observed between the groups in maternal and neonatal outcome indicators, such as adverse neonatal outcomes and postoperative fever rates. The outcomes suggest that the delivery room group showed increased risks compared with the operating room group, potentially indicating heightened vulnerabilities to bleeding and infection. Hence, it is advisable for patients to undergo surgery in the operating room unless the delivery room is equipped with sterile surgical facilities or in cases of urgent necessity.

Effectiveness of Eupatorium Perfoliatum 30C in Preventing Dengue Fever-A Prospective, Community-Based, Open Label, Parallel Cohort Study in Delhi, India.

The study was undertaken to evaluate the protective effect of Eupatorium perfoliatum (EP) 30C on the incidence of dengue fever. This study was designed as a prospective, open label, parallel cohort study. Participants were enrolled in two medicine cohort (MC) communities and one control cohort (CC) community. Participants in MC who were more than 5 years of age received four medicated globules and those aged between 1 and 5 years received two medicated globules of EP 30C once a week for 10 weeks. Participants in CC received no medical intervention. Both cohorts received information and educational material regarding dengue. The primary outcome was incidence of dengue cases based on laboratory confirmation or the clinical definition of dengue as per the case definition notified by the National Vector-Borne Disease Control Program, Government of India, during the 14 weeks of intervention and observation. The analysis included 20,607 participants residing in three slums of Delhi, of which MC and CC included 15,298 and 5,309 participants respectively. The overall protective effect of EP 30C in MC against probable/laboratory-confirmed dengue was 59.59% (95% confidence interval [CI], 50.74 to 66.85, p = 0.0001). The overall protective effect of EP 30C against laboratory-confirmed dengue was 72.78% (95% CI, 54.45 to 83.74, p = 0.0001): 26 cases per 15,298 (0.13 per 1,000 person-weeks) in MC versus 33 cases per 5,309 (0.46 per 1,000 person-weeks) in CC. The use of EP 30C was associated with some protection against probable and laboratory-confirmed dengue.

Real world comparison of filgrastim to filgrastim-sndz in patients with chemotherapy-induced neutropenia.

There exists some apprehension by prescribers, healthcare providers, and other stakeholders regarding the real-world safety and effectiveness of biosimilars. While some of the apprehension is likely due to clinician knowledge gaps in the biosimilarity exercise, additional data (including those generated from the real-world) regarding safety and efficacy could reduce a clinician's perception of biosimilar uncertainty and can potentially increase biosimilar acceptance and uptake. The published literature is lacking regarding the real-world impact on healthcare costs and clinical outcomes when a single healthcare institution converts from filgrastim to filgrastim-sndz as its short-acting Granulocyte Colony Stimulating Factor (GCSF), especially within diverse populations and indications not explicitly studied through the registration trials. Specifically, both filgrastim and filgrastim-sndz possess FDA-approved indications within patients with hematologic malignancies receiving high-dose chemotherapy and in those undergoing bone marrow transplantation. As a biosimilar to filgrastim, the FDA did not require prospective, randomized controlled trials to obtain these indications for filgrastim-sndz. The purpose of this study is to describe real-world healthcare resource costs, utilization patterns, and clinical outcomes in patients with hematologic malignancies who received filgrastim-sndz or filgrastim to support neutrophil recovery following chemotherapy (i.e., induction or consolidation) or a bone marrow transplant (BMT) at Yale New Haven Hospital (YNHH). A total of 148 patients were identified and met the following criteria: at least 18 years old, Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2, absence of fever or infection, newly diagnosed acute myeloid leukemia or newly post-bone marrow transplant and received filgrastim-sndz (Zarxio®) or reference filgrastim (Neupogen®). Healthcare resource utilization outcomes were compared between biosimilar and reference filgrastim using descriptive statistics. There were no major differences between either cohort, including duration of hospitalization, the number of overall emergency room visits and additional hospital admissions with a primary diagnosis of febrile neutropenia or neutropenia within 30 days post-discharge from initial hospital admission, time to neutrophil recovery following GCSF support, and the incidence and duration of both fever and febrile neutropenia. The total cost based on treatment of all patients in each arm differed significantly with filgrastim-sndz being the most cost-effective choice. filgrastim-sndz significantly reduced healthcare utilization costs compared to reference filgrastim with similar effect on absolute neutrophil count, incidence of fever, and febrile neutropenia.

Clinical characteristics and outcomes of COVID-19 in pediatric patients with rheumatic diseases.

This study investigates the clinical characteristics and outcomes of pediatric patients with rheumatic diseases infected with COVID-19 in China. We conducted a retrospective analysis of pediatric patients with rheumatic diseases who contracted COVID-19. Data were collected via a comprehensive questionnaire with a 14-day follow-up. Multivariable logistic regression was used to assess severe outcomes, and network analyses evaluated symptom correlations. A total of 1070 cases were collected. Fever (88.05%) and cough (62.75%) were the most common symptoms. Cough, nasal congestion, and runny nose exhibited a stronger correlation with each other. A higher incidence of fever reduced the incidence of two single symptoms (nasal congestion [r = -0.833], runny nose [r = -0.762]). Vaccinated children showed a shorter time to negative COVID-19 conversion (7.21 days vs. 7.63 days, p < 0.05) and lower hospitalization rates (p = 0.025). Prolonged symptom duration was associated with older age (OR: 1.07 [1.04-1.11]; p < 0.001) and systemic lupus erythematosus (OR: 1.47 [1.01-2.12]; p = 0.046). Pediatric patients with rheumatic diseases exhibited a wide range of clinical symptoms after COVID-19 infection. The infection generally did not lead to severe outcomes in this study. COVID-19 vaccination was associated with reduced hospitalization risk and expediting the time to negativity for virus. This manuscript demonstrates a comprehensive analysis of the clinical characteristics and outcomes of COVID-19 infection in pediatric patients with rheumatic diseases in China. It provides critical insights into the specific challenges faced by this vulnerable population and offers practical recommendations for improving patient management during periods of increased infectious risk.

Strategic Infectious Diseases in Beef Cattle in Balongpanggang during 2023

Strategic infectious animal diseases have a great impact on the national economy as they may cause great economic loss, public anxiety, and high mortality. In Indonesia, among the diseases considered as strategic infectious animal diseases is foot and mouth disease (FMD). This study reported the incidence of strategic infectious animal diseases in Balongpanggang district during 2023. Throughout 2023, FMD only accounted for 4% of the total diseases of the year and was the only strategic infectious animal disease reported that year. Meanwhile, bovine ephemeral fever (BEF) incidence reached 57% (876/1546) of the total diseases in beef cattle in 2023. In addition to BEF, official veterinary services reported a total case of 1546 throughout 2023 that comprises; diarrhea (99), limping (24), helminthiasis (91), ectoparasite (11), hematochezia (3), wound (3), mastitis (4), allergy (1), dystocia (28), vaginal prolapse (11), dermatitis (45), enteritis (27), tympani (11), scabiosis (122), arthritis (67), ophthalmic problem (11), endometritis (1), uterine retention (13), indigestion (2), pneumonia (21), hypoglycemia (5), abscess (21), ovariohysterectomy (1), orchitis (1), intoxication (1), and papilloma (1). In conclusion, the only strategic infectious animal disease reported in 2023 in Balongpanggang was FMD with the incidence as high as 3% as compared to the non-strategic infectious animal diseases, BEF, which reached 54% of the total cases during 2023.

Assessment of the Influence of Climatic Factors on the Incidence of Crimean Hemorrhagic Fever: a Comprehensive Analysis of Data for Russia, Kazakhstan, Turkey and Iran between 1999 and 2022

Assessment of the Influence of Climatic Factors on the Incidence of Crimean Hemorrhagic Fever: a Comprehensive Analysis of Data for Russia, Kazakhstan, Turkey and Iran between 1999 and 2022

Familial Mediterranean Fever in Pregnancy.

Though the incidence of familial Mediterranean fever (FMF) in pregnancy is rare, understanding the etiology and symptomatology of FMF is essential for obstetric treatment of patients with FMF. Familial Mediterranean fever is a hereditary periodic fever syndrome that has unique obstetric considerations. Familial Mediterranean fever is typically characterized by recurrent episodes of high-grade fevers, pleuritis/pericarditis, and arthritis lasting 1-3 days with complete recovery seen in between episodes. Familial Mediterranean fever is seen worldwide, but particularly in patients of Mediterranean descent. Its incidence varies across ethnicities. This article provides a comprehensive review of existing literature. It is well established that colchicine is safe and effective to use during pregnancy in patients with FMF to control and prevent flares. Although most pregnancies progress without negative outcomes, FMF has been shown in the literature to be associated with preterm birth and premature rupture of membranes. Its impact on increasing the rate of fetal growth restriction and hypertensive disorders is less understood. Additionally, FMF flares may be suppressed in pregnancy, whereas other sources report that flares are similar to those outside of pregnancy in terms of frequency, type of symptoms, and severity. Breastfeeding is safe in patients with FMF who are taking colchicine. Genetic counseling can be offered to patients with FMF, but in utero diagnostic testing is generally not pursued solely for the indication of FMF diagnosis in the fetus. Further investigation of the impact of FMF on pregnancy is needed for advancing our understanding of the condition and optimizing care for pregnant individuals with FMF.

Epidemiological changes of scarlet fever before, during and after the COVID-19 pandemic in Chongqing, China: a 19-year surveillance and prediction study

BackgroundThis study aimed to investigate the epidemiological changes in scarlet fever before, during and after the COVID-19 pandemic (2005–2023) and predict the incidence of the disease in 2024 and 2025 in Chongqing Municipality, Southwest China.MethodsDescriptive analysis was used to summarize the characteristics of the scarlet fever epidemic. Spatial autocorrelation analysis was utilized to explore the distribution pattern of the disease, and the seasonal autoregressive integrated moving average (SARIMA) model was constructed to predict its incidence in 2024 and 2025.ResultsBetween 2005 and 2023, 9,593 scarlet fever cases were reported in Chongqing, which resulted in an annual average incidence of 1.6694 per 100,000 people. Children aged 3–7 were the primary victims of this disease, with the highest average incidence found among children aged 6 (5.0002 per 100,000 people). Kindergarten children were the dominant infected population, accounting for as much as 54.32% of cases, followed by students (34.09%). The incidence for the male was 1.51 times greater than that for the female. The monthly distribution of the incidence showed a bimodal pattern, with one peak occurring between April and June and another in November or December. The spatial autocorrelation analysis revealed that scarlet fever cases were markedly clustered; the areas with higher incidence were mainly concentrated in Chongqing’s urban areas and its adjacent districts, and gradually spreading to remote areas after 2020. The incidence of scarlet fever increased by 106.54% and 39.33% in the post-upsurge period (2015–2019) and the dynamic zero-COVID period (2020–2022), respectively, compared to the pre-upsurge period (2005–2014) (P < 0.001). During the dynamic zero-COVID period, the incidence of scarlet fever decreased by 68.61%, 25.66%, and 10.59% (P < 0.001) in 2020, 2021, and 2022, respectively, compared to the predicted incidence. In 2023, after the dynamic zero-COVID period, the reported cases decreased to 1.5168 per 100,000 people unexpectedly instead of increasing. The cases of scarlet fever are predicted to increase in 2024 (675 cases) and 2025 (705 cases).ConclusionsChildren aged 3–7 years are the most affected population, particularly males, and kindergartens and primary schools serving as transmission hotspots. It is predicted that the high incidence of scarlet fever in Chongqing will persist in 2024 and 2025, and the outer districts (counties) beyond urban zone would bear the brunt of the impact. Therefore, imminent public health planning and resource allocation should be focused within those areas.

Infection Epidemiology of Dengue Virus and Its Impacts on Liver Enzymes

Background: Dengue fever is a mosquito-borne viral disease that has emerged as a significant public health concern in Kolkata, with a substantial burden on the healthcare system. Also, this disease shows and additional impact on liver. Objective: To investigate the epidemiological trends of dengue fever in Kolkata and its effect on liver function. Methods: A retrospective study was conducted using data from [Ashok Laboratory] in Kolkata. Patients diagnosed with dengue fever between [July, 2023 to June, 2024] were included. Demographic, clinical, and laboratory data were analyzed. Results: A total of [6132] patients were included. The majority were [10-30] years old, and [males]. The incidence of dengue fever was highest during [monsoon season]. The data shows that SGPT/ALT and SGOT/AST value is very high on the dengue positive individuals and total bilirubin value is also high on dengue positive individuals. Conclusion: This study highlights the significant impact of dengue fever on liver function in Kolkata. The findings suggest that early detection and management of dengue-induced hepatic dysfunction are crucial to prevent severe complications. Public health measures should focus on vector control, timely diagnosis, and appropriate treatment to mitigate the burden of dengue fever in Kolkata.

Formation of a Credible Methodological Framework for Epidemiological Forecasting of the Incidence of Hemorrhagic Fever with Renal Syndrome Using Machine Learning Techniques

Formation of a Credible Methodological Framework for Epidemiological Forecasting of the Incidence of Hemorrhagic Fever with Renal Syndrome Using Machine Learning Techniques

Incidence of Typhoid Fever Infection among Febrile Patients attending FUDMA Clinic

Typhoid fever remains a public health concern in Nigeria, with its incidence poising substantial challenges to health care systems. Widal agglutination test is largely the only used diagnostic test method for the laboratory diagnosis of Typhoid infection which has been proven to be neither sensitive nor specific. This paper delves into the incidence, contributory factors as well as sensitivity and specificity of commonly used diagnostic tests of typhoid fever infection among febrile patients attending the FUDMA Clinic. A total of 55 Blood and stool samples were analyzed using standard procedures for slide agglutination test (Widal) and stool culture, before culturing, the samples were first inoculated in an enrichment medium (Selenite-F broth). After 4 hours of pre-enrichment, the samples were inoculated into Salmonella Shigella Agar and Mackonkey agar, while catalase, TSI, citrate utilization test, Indole test, and urease tests served to identify the organism biochemically. Socio-demographic data revealed that 55 Participants, 52.8% were males, 72.7% were students and 80% were singles. Slide agglutination test recorded a 90.9% incidence rate, stool culture had an incidence rate of 18.18%. Among the age groups that enrolled in this study, a 44.1% incidence rate was recorded among the age Group 20-26 years. Stool culture was to found have performed better diagnostically with a sensitivity of 60% as well as a specificity of 40%. Conclusively, A high Incidence of typhoid fever was observed in this study. This Therefore suggests that there is an urgent need for improved personal hygiene and more accessibility to potable drinking water.

Environmental surveillance for Salmonella Typhi in rivers and wastewater from an informal sewage network in Blantyre, Malawi.

Environmental surveillance for Salmonella Typhi may provide information on the community-level dynamics of typhoid fever in resource poor regions experiencing high disease burden. Many knowledge gaps concerning the feasibility of ES remain, especially in areas lacking formal sewage systems. We implemented protocols for S. Typhi ES, including site selection and catchment population estimation, sample concentration and testing using qPCR for S. Typhi specific gene targets. Between May 2021 and May 2022, we collected grab samples and Moore swabs from 43 sites in Blantyre, Malawi. Catchment characteristics, water quality, and human faecal contamination (qPCR for Bacteroides HF183) were also recorded. Their association with S. Typhi detection was investigated using a logistic mixed-effects regression analysis. Prevalence of S. Typhi in ES samples was 2.1% (1.1-4.0%) and 3.9% (1.9-7.9%) for grab and Moore swab samples, respectively. HF183 was associated S. Typhi positivity, with a unit increase in log genome copies/microlitre increasing the odds of detection of S. Typhi by 1.56 (95% CI: 1.29-1.89) and 1.33 (1.10-1.61) in Moore swabs and grab samples, respectively. The location and timing of S. Typhi detection through ES was not associated with the incidence of typhoid fever reported in associated catchment populations. During this period of relatively low typhoid fever incidence, wastewater surveillance continued to detect S. Typhi in human sewage and wastewater suggesting that ES using natural river systems can be a sensitive indicator of transmission.

Analyzing and Forecasting Dengue Fever Incidence in Thailand: A Comprehensive Study for Public Health Preparedness

Analyzing and Forecasting Dengue Fever Incidence in Thailand: A Comprehensive Study for Public Health Preparedness

Neonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis.

To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis. We searched PubMed, Embase, and Cochrane Central in May 2023. The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models. We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine. non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment. CRD42023421814.

Effect of zoledronic acid and pamidronate on renal function.

There is limited data on the effect bisphosphonates have on renal function and the use of bisphosphonates in patients with baseline renal dysfunction. The purpose of this study was to determine the incidence of acute kidney injury (AKI) in patients after receiving zoledronic acid or pamidronate. A retrospective cohort analysis was conducted of patients who received one dose of a bisphosphonate, either zoledronic acid or pamidronate. The primary objective of this study was to determine the incidence of AKI after bisphosphonate administration. Baseline characteristics were compared, and unadjusted analyses of primary and secondary outcomes were completed using Pearson's chi-square or Fisher's exact test for categorical data and Mann-Whitney U test for continuous data. There was no difference found in AKI incidence between zoledronic acid and pamidronate (17.1% vs. 15.0%; p = 1.00). Additionally, there was no difference found in AKI incidence between patients with baseline renal dysfunction and those without, (25.0% vs. 15.0%; p = 0.322). There were no differences observed in either corrected calcium within seven days or serum creatinine (SCr) within 30 days returning to baseline after administration, nor were there differences in fever or hypophosphatemia incidences. Bisphosphonates may be used to treat hypercalcemia of malignancy in patients with and without renal dysfunction. AKI may occur post infusion; however, long-term effects on renal function are infrequent when hydrating patients prior to administration and adhering to the manufacturer's recommended infusion rate.

Outcome of Pediatric Patients With Sickle Cell Anemia Admitted With Fever: A Retrospective Single-Center Study.

Pediatric patients with sickle cell anemia (SCA) are known to have an increased susceptibility to infections, leading to a higher incidence of fever among this population. However, there is limited literature specifically focusing on the outcomes of pediatric SCA patients presenting to the emergency department (ED) or hospital with a primary diagnosis of fever. The objective of this retrospective single-center study was to compare the characteristics of fever and associated symptoms among pediatric patients with SCA, and to investigate the risk factors associated with patients' outcomes and mortality in this specific population. The study was conducted at the King Salman Medical City, Maternity and Children's Hospital, Medina, Saudi Arabia, during the period from 2017 to 2022. All pediatric SCA patients under the age of 14, who presented to the ED of the hospital during the study period with a primary diagnosis of fever, were included. The study collected and analyzed clinical, laboratory, treatment, complications, and outcome data of the patients using appropriate statistical methods, including logistic regression. A total of 57 children were included in the analysis. The mean age of the patients was 7.1 ± 4.3 years, with 26 males (45.6%) and 31 females (54.4%). Among the cases, 8 (14%) exhibited fever along with gastrointestinal symptoms, 18 (31.6%) presented with musculoskeletal symptoms, 5 (8.8%) showed neurological symptoms, and approximately half of the cases (45.6%) displayed respiratory symptoms along with fever. Logistic regression analysis identified several significant factors associated with complications in this sample, including a very low level of hemoglobin (Hb) (<7 g/dL) with an odds ratio (OR) of 14.5 (95% CI=1.03-222.3), ICU admission with OR of 14 (95% CI=1.03-186.8), and a hospital stay duration of more than 10 days (OR=11.5; 95% CI=1.10-121.3). Additionally, fever associated with neurological symptoms, neutrophilia, history of splenectomy, and male sex showed positive associations with complications among the studied patients, although not significant. This study provides valuable insights into the characteristics and outcomes of febrile pediatric patients with SCA. The findings highlight the importance of early recognition and management of fever in this vulnerable population, particularly when certain risk factors are present.

A Poisson regression approach for assessing morbidity risk and determinants among under five children in Nigeria

In this paper, we have provided more insights on the relationship between under five morbidity in Nigeria and some background characteristics using a Poisson regression model and the most recent 2018 NDHS data on Acute Respiratory Infection (ARI), diarrhoea and fever. Some of our results are that children 36-47 months old have the highest risk of ARI [OR=1.45; CI (1.31,1.60)] while children less than 6 months old have the lowest risk of ARI [OR=0.14; CI (0.11,0.17)]. The prevalence of diarrhoea is generally high among children under 48-59 months old but highest among children 6-11 months old [OR=4.34; CI (3.69,5.09)]. Compared to children 48-59 months old, children in all other age categories except 24-34 months old have a high risk of fever [OR=0.95; CI (0.73,1.24)]. ARI is more prevalent among female children [OR=8.88; CI (8.02,9.82)] while diarrhoea [OR=21.75; (19.10,24.76)] and fever [OR=4.78; CI (4.31,5.32)] are more prevalent among male children. Children in urban areas are more likely to suffer ARI [OR=9.49; CI (8.31,10.85)] while children in rural areas are more likely to suffer both diarrhoea [OR=21.75; CI (19.10,24.76)] and fever [OR=4.90; CI (4.26,5.63)]. Children in the South-South have the highest risk of ARI [OR=4.03; CI (3.65,4.454)] while children in the North Central have the lowest risk of ARI [OR=1.55; CI (1.38,1.74)] and highest risk of diarrhoea [OR=3.34; CI (2.30,5.11)]. Children in the Northeast have the highest risk of fever [OR=1.30; CI (1.14,1.48)]. In the Northcentral region, Kogi state has the highest prevalence of fever [OR=2.27; CI (1.62,3.17)], while Benue state has the lowest [OR=0.35; CI (0.20,0.60)]. Children in Abuja state face similar risks of fever and diarrhoea [OR=0.84; CI (0.55,1.27)], with the risk of diarrhoea in Abuja being comparable to that in Plateau state [OR=1.57; CI (0.92,2.70)]. Nasarawa state records the highest incidence of diarrhoea in the Northcentral [OR=5.12; CI (3.03,8.65)], whereas Kogi state reports the lowest [OR=0.29; CI (0.16,0.53)]. In the Northeast, Borno state has the highest rate of fever [OR=3.28; CI (2.80,3.84)], and Bauchi state the lowest [OR=0.38; CI (0.29,0.50)]. In Adamawa state, the risks of fever and diarrhoea are nearly equivalent [OR=1.17; CI (0.97,1.41)], and the risk of fever there is similar to that in Taraba state [OR=0.92; CI (0.75,1.12)]. Diarrhoea is most prevalent in Yobe state [OR=3.17; CI (2.37,4.23)] and least prevalent in Borno state [OR=0.26; CI (0.20,0.33)]. In the Northwest, the risk of fever is similarly high in Zamfara and Kebbi states [OR=1.04; CI (0.93,1.17)], with Kastina state showing the lowest risk [OR=0.39; CI (0.34,0.46)]. Children in Zamfara state experience notably different risks of fever and diarrhoea [OR=0.07; CI (0.05,0.10)]. Kaduna state reports the highest incidence of diarrhoea [OR=21.88; CI (15.54,30.82)], while Kano state has the lowest [OR=2.50; CI (1.73,3.63)]. In the Southeast, Imo state leads in fever incidence [OR=8.20; CI (5.61,11.98)], while Anambra state has the lowest [OR=0.40; CI (0.21,0.78)]. In Abia state, the risk of fever is comparable to that in Enugu state [OR=1.03; CI (0.63,1.71)], but the risks of fever and diarrhoea in Abia differ significantly [OR=2.67; CI (1.75,4.06)]. Abia state also has the highest diarrhoea rate in the Southeast [OR=2.67; CI (1.75,4.06)], with Ebonyi state having the lowest [OR=0.05; CI (0.03,0.09)]. In the South-South region, Bayelsa and Edo states have similar risks of fever [OR=1.28; CI (0.84,1.95)], with Akwa Ibom state reporting the highest fever rate [OR=4.62; CI (3.27,6.52)] and Delta state the lowest [OR=0.08; CI (0.02,0.25)]. Children in Bayelsa state face distinctly different risks of fever and diarrhoea [OR=0.56; CI (0.34,0.95)]. Rivers state shows the highest incidence of diarrhoea in the South-South [OR=10.50; CI (4.78,23.06)], while Akwa Ibom state has the lowest [OR=0.30; CI (0.15,0.57)]. In the Southwest, Lagos and Osun states have similar risks of fever [OR=1.00; CI (0.59,1.69)], with Ogun state experiencing the highest incidence [OR=3.47; CI (2.28,5.28)] and Oyo state the lowest [OR=0.18; CI (0.07,0.46)]. In Lagos state, the risks of fever and diarrhoea are comparable [OR=0.96; CI (0.57,1.64)], and the risk of diarrhoea is similar to those in Ekiti, Ogun, and Ondo states. Oyo state has the highest diarrhoea rate in the Southwest [OR=10.99; CI (3.81,31.67)], with Ogun state reporting the lowest [OR=0.77; CI (0.42,1.42)]. Children of mothers with more than secondary education are significantly less likely to suffer ARI [OR=0.35; CI (0.29,0.42)], whereas children of mothers without any education run a higher risk of diarrhoea [OR=2.12; CI (1.89,2.38)] and fever [OR=2.61; CI (2.34,2.91)]. Our analysis also indicated that household wealth quintile is a significant determinant of morbidity. The results in this paper could help the government and non-governmental agencies to focus and target intervention programs for ARI, diarrhoea and fever on the most vulnerable and risky under five groups and populations in Nigeria.

Feasibility and safety of endoscopic full-thickness resection for submucosal tumors in the upper gastrointestinal tract, including predominantly extraluminal submucosal tumors (with video).

Endoscopic full-thickness resection (EFTR) for submucosal tumors (SMTs) has been technically challenging. This retrospective study aimed to evaluate the feasibility, safety, and efficacy of EFTR for upper gastrointestinal (GI) SMTs, including extraluminal lesions. We retrospectively investigated 232 patients with SMTs who underwent EFTR from January 2014 to August 2023. Clinicopathologic characteristics, procedure-related parameters, adverse events (AEs), and follow-up outcomes were assessed in all patients. The en-bloc resection and en-bloc with R0 resection rates were 98.7% and 96.1%, respectively. The average endoscopic tumor size measured 17.2 ± 8.7 mm, ranging from 6 to 50 mm. The resection time and suture time were 49.0 ± 19.4 min and 22.5 ± 11.6 min, respectively. In all, 39 lesions (16.8%) exhibited predominantly extraluminal growth. Gastrointestinal stromal tumors (GISTs) were the predominant pathology, accounting for 78.4% of the cases. Twenty-one patients (9.1%) encountered complications, including pneumothorax (1/232, 0.43%), hydrothorax (1/232, 0.43%), localized peritonitis (3/232, 1.29%), and fever (16/232, 6.9%). Although the incidence of postoperative fever was notably higher in the predominantly extraluminal group (7/39, 17.9%) compared to the predominantly intraluminal group (9/193, 4.7%, P = 0.008), there were no significant differences in outcomes of the EFTR procedure. No instances of recurrence were observed during the mean follow-up period of 3.7 ± 2.3 years. EFTR was found to be feasible, safe, and effective for resecting upper GI SMTs, including lesions with predominantly extraluminal growth. Further validation in a prospective study is warranted.