Socio-epidemiological Factors Research Articles

Epidemiological Correlates of Substance Abuse Among In-Facility Clients of De-addiction and Rehabilitation Centres of District Dehradun: A Cross-Sectional Study.

Background The increasing production, distribution, promotion, and availability of substances contemporaneous with the changing values of society have resulted in rising substance abuse as an emerging public health concern in India. A prevalence of 32-37% has been reported for substance abuse in various studies conducted in Uttarakhand but there is a dearth of data on socio-epidemiological factors affecting substance abuse. Materials & methods A facility-based observational cross-sectional study was conducted in selected de-addiction and rehabilitation centers of district Dehradun. Data were collected using multistage systematic random sampling from clients admitted to the facility. Results The mean age of in-facility participants was 28 ± 8 years and most of them started taking drugs after the age of 18 years. The most common substance of abuse was alcohol (61.7%) followed by tobacco smoking (15.6%). Both 'peer pressure' and 'curiosity' play a major role in predisposition to substance use. Further, we found that age (p=0.002), and level of education (p <0.001) were important determinants for substance abuse. At the same time, among other factors, the influence of occupation notably did not have a statistically significant association. Conclusion Sensitization and capacity building of both providers and the community is integral to effective strategizing for the prevention and control of substance abuse. Regional studies including the current study can be of help in framing drug policies and management guidelines including prioritizing the importance of the establishment of de-addiction and rehabilitation centers at the district level.

The Techniques of Retrograde Uretrocystography at the Radiology Department of the “Point G” University Hospital Center

Introduction: Retrograde urethrocystography (UCR) is a radiographic examination allowing to make visible the urethra and the bladder by direct retrograde opacification with a water-soluble iodinated contrast product. The aim of our work was to evaluate the epidemiological profile of the techniques of the UCR in the radiology department of the CHU point G. Methodology: This was a prospective and descriptive study concerning all elderly subjects addressed for UCR in the CHU HPG. A televised remote-controlled table was used with saline and contrast product (omnipaque). The parameters studied were socio-epidemiological factors. Results: We had collected 19 patients for UCR, i.e. 1.47% of cases. 100% of the UCR examinations performed were male. The age group ≥ 50 years was the most frequently encountered with 36.84% of cases. Workers were the most represented profession with 47.36% of cases followed by farmers (21.05% of cases) and the military (15.78% of cases). The majority of UCR examinations came from the urology department of the CHU point “G” with 2.47% of cases. Dysuria was frequently encountered among the examinations with 47.36% of cases followed by trauma in 21.05% of cases). Conclusion: A good mastery of UCR techniques by all imaging technicians would be necessary for better management.

Skin and Soft Tissue Infections due to Aeromonas spp.: An Emerging Pathogen

Introduction: Aeromonas spp., the emerging human pathogens, can cause various diseases like gastrointestinal infections, Skin and Soft-Tissue Infections (SSTIs), respiratory tract infections, urinary tract infection, hepatobiliary tract infection, blood stream infections etc. Aeromonas consists of important pathogenic species like Aeromonas hydrophila being the most common one followed by A.sobria, A.veroni, A.caviae and A.salmonicida. SSTIs due to Aeromonads are most often associated with preexisting ulcer, traumatic wound and exposure to water. Aim: The present study was carried out to analyse socioepidemiological factors, clinical features, risk factors and antibiotic resistance potential of Aeromonas spp., SSTIs. Materials and Methods: In this prospective study, all Gramnegative fermenting motile isolates which are positive for oxidase, H2 S production, indole reaction, lysine decarboxylase were further identified by Vitek 2 compact system (Biomerieux, France). The study period was 2 years. Results: A total of 39 patients with Aeromonas spp., SSTIs were identified during the period from 2020 to 2022. Majority of patients hailed from urban areas, were in middle age group and were farmers. A.hydrophila (n=24, 62%) was the predominant isolate. Majority of the infections were superinfection of wound (n=16, 41%) and chronic non healing ulcer (n=13, 33.3%). A total of 33.3% of infections were polymicrobial, common concomitant pathogens being, Pseudomonas aeruginosa and Methicillin Resistant Staphylococcus aureus (MRSA). Trauma and water exposure were main risk factors with co-morbidities like diabetes, hypertension and liver cirrhosis. A 20.5% of patients were immunocompromised. There was one case of Necrotising Fasciitis (NF) which resulted in patient’s death. Cotrimoxazole, 3rd and 4th generation cephalosporins. Aztreonam and Tigecycline were the most effective antibiotics while eight of the isolates were Multidrug Resistant (MDR). Thirty-three patients recovered completely and three patients died of complications. Conclusion: Aeromonas hydrophila must be regarded as an emerging pathogen of SSTIs mainly in patients with preexisting ulcers and can be MDR. Such infections have a good prognosis if prompt medical, surgical and supportive treatment is given.

Impact of knowledge and perception of the Swachh Bharat Abhiyan on the health behavior patterns of rural residents in India

Background and Aim of Study: Swachh Bharat Abhiyan (SBA) was launched by the Prime Minister of India to accelerate the efforts for achieving universal sanitation. To ensure adequate participation, community must be sensitized about the mission objectives and its role in bringing the desired change. The aim of the study: to assess the knowledge, perception and practices regarding SBA among rural people, and to study the association between their socio epidemiological factors and awareness regarding SBA. Material and Methods: Community based cross-sectional study was conducted for duration of 6 months (April to September 2021) at a rural area of south Tamilnadu. A sample of 250 subjects was included and was administered a predesigned, pretested, semi structured questionnaire. The responses were recorded and appropriate statistical tests were applied. Results: Mean age group of our study participants was 47.6 ± 9.8 years. Television 126 (50.4%) and newspaper 41 (16.4%) were found to be the main source of information about SBA. This study showed out of 250 participants, 142 (56.8%) of them had good knowledge and 174 (69.6%) had good perception score. Our study found a statistical significant association between educational status and level of knowledge and perception score. Conclusions: The present study found that majority of the subjects were aware of SBA and were having positive attitude and perception but very less practicing in our day today life. Increasing awareness regarding health hazards of open-air defecation and improper disposal of solid waste will create a change in their behavior in adopting healthy lifestyle.

A scoping review of foot-and-mouth disease risk, based on spatial and spatio-temporal analysis of outbreaks in endemic settings.

Foot-and-mouth disease (FMD) is one of the most important transboundary animal diseases affecting livestock and wildlife species worldwide. Sustained viral circulation, as evidenced by serological surveys and the recurrence of outbreaks, suggests endemic transmission cycles in some parts of Africa, Asia and the Middle East. This is the result of a complex process in which multiple serotypes, multi-host interactions and numerous socio-epidemiological factors converge to facilitate disease introduction, survival and spread. Spatial and spatio-temporal analyses have been increasingly used to explore the burden of the disease by identifying high-risk areas, analysing temporal trends and exploring the factors that contribute to the outbreaks. We systematically retrieved spatial and spatial-temporal studies on FMD outbreaks to summarize variations on their methodological approaches and identify the epidemiological factors associated with the outbreaks in endemic contexts. Fifty-one studies were included in the final review. A high proportion of papers described and visualized the outbreaks (72.5%) and 49.0% used one or more approaches to study their spatial, temporal and spatio-temporal aggregation. The epidemiological aspects commonly linked to FMD risk are broadly categorizable into themes such as (a) animal demographics and interactions, (b) spatial accessibility, (c) trade, (d) socio-economic and (e) environmental factors. The consistency of these themes across studies underlines the different pathways in which the virus is sustained in endemic areas, with the potential to exploit them to design tailored evidence based-control programmes for the local needs. There was limited data linking the socio-economics of communities and modelled FMD outbreaks, leaving a gap in the current knowledge. A thorough analysis of FMD outbreaks requires a systemic view as multiple epidemiological factors contribute to viral circulation and may improve the accuracy of disease mapping. Future studies should explore the links between socio-economic and epidemiological factors as a foundation for translating the identified opportunities into interventions to improve the outcomes of FMD surveillance and control initiatives in endemic contexts.

Psychological Assessment of Family Caregivers of Patients With COVID-19 in the United States of America and India.

Background and objectiveThe coronavirus disease 2019 (COVID-19) pandemic has highlighted the shortcomings worldwide in terms of preparedness protocols related to epidemics. A key area of research that is evidently overlooked across the globe is the mental health of family caregivers taking care of patients with COVID-19. In light of this, this study aimed to engage in a comparative analysis between the two worst affected countries, India and the United States of America (USA), which differ considerably in their demography, socio-epidemiological factors, and health system efficiency.MethodsA cross-sectional study was conducted among 1,250 family caregivers of patients with COVID-19 in India and the USA to assess their stress, anxiety, and sleep disturbance levels using the 10-item Perceived Stress Scale (PSS-10), the 7-item Generalized Anxiety Disorder (GAD-7) scale, and the Pittsburgh Sleep Quality Index (PSQI), respectively. Psychological assessment questionnaires were administered through online mode, which gathered demographic information and responses on several self-reporting scales. The main outcome measures were self-reported ratings on PSS, GAD-7 scale, and PSQI.ResultsWe found that 75.4% of the family members of COVID-19 patients suffered from mental health issues. The scores of all three scales were higher in caregivers from the USA than in India, more evident and pronounced in caregivers of hospitalized patients. The test scores were statistically significant (p<0.05) indicating a negative impact of having a dependent member in the family, being married, being of younger age, and having a longer duration of COVID-19 infection. Vaccines were found to have a life-enhancing effect.ConclusionOur findings highlight that the mental health of family caregivers is an ignored aspect and must be addressed. We recommend the implementation of well-researched and appropriate legislation, treatment programs, and health policies that involve not only the patients but also their families.

Socio-epidemiological factors and comorbidities associated with Chagas disease manifestations in two urban reference health care centres in Rio de Janeiro, Brazil.

Chagas disease (CD) is still an important public health issue in Latin America. This study aims to analyse the association between socio-epidemiological factors and comorbidities with clinical manifestations of CD. We performed a cross-sectional study of 985 adult patients (65±11y; 59.5% women) with CD. Data collection was based on questionnaires and medical records review. CD clinical forms (indeterminate, digestive, cardiac and cardiodigestive) and the stages of the cardiac form were classified according to the II Brazilian Consensus on CD. Statistical analyses were based on univariate and multivariate logistic regression. Older age and Brazilian birth state (Minas Gerais and Bahia) were associated with a greater likelihood of the cardiac form of CD. A greater likelihood of the digestive form was seen in men and those of older age. Patients with arterial hypertension and diabetes were less likely to have the digestive form. Men had a greater likelihood of having a more severe cardiac presentation. Those from Minas Gerais and Bahia states had a greater likelihood of having stage B1 or B2. The results reinforce the aging of the CD population living in urban areas in Brazil, the high prevalence of comorbidities and that epidemiology, sex and the presence of comorbidities may be related to the clinical form of CD.

Socio-epidemiological Factors associated with the Incidence of Cerebrospinal Meningitis in Sub-Saharan Africa (P18-2.005)

Socio-epidemiological Factors associated with the Incidence of Cerebrospinal Meningitis in Sub-Saharan Africa (P18-2.005)

A mathematical modeling approach to measure the probability of HIV-1 transmission for different high-risk groups of Pakistan.

Since 2010, the number of new HIV-1 cases has declined by 30% globally, however, in few countries, such as Pakistan, the cases have continued to increase, where the country witnessed a 57% increase in the number of new infections between 2010 and 2020. The HIV-1 epidemic in Pakistan is concentrated in certain high-risk groups, however, it is unknown which high-risk group has a higher likelihood of transmitting HIV-1 infections to vulnerable populations. This study aimed to apply mathematical probabilistic modeling to estimate the probability of HIV-1 transmission for different high-risk groups of Pakistan. MATLAB software was used to conduct probabilistic modeling (chance estimation) of HIV-1 transmission for different high-risk groups of Pakistan, and also draw a comparison between Pakistan and different high- and low- HIV-1 prevalence countries. Our results revealed that Pakistan overall had the lowest probability of HIV-1 transmission as compared to other countries included in this study; however, within Pakistan, certain high-risk groups such as people who inject drugs (PWID) and the region of Larkana exhibited a high probability of HIV-1 transmissions. Our study suggests that the concentrated HIV-1 epidemic in Pakistan has a high likelihood of expansion from certain high-risk groups to other vulnerable populations. Further studies to understand the socio-epidemiological factors driving the expansion of the HIV-1 epidemic within the country will guide specific HIV-1 intervention strategies to control the spread of HIV-1 from high-risk to other vulnerable populations.

Socio-Epidemiological Factors with Negative Impact on Infant Morbidity, Mortality Rates, and the Occurrence of Birth Defects.

In the last 30–40 years, developed countries in particular, but also developing ones, have seen an increase in life expectancy and a decrease in infant mortality and morbidity rates. These factors are due to an increase in living standards, a decrease in differences between social classes, the increased accessibility of education to women, and the implementation of some public health measures. When certain basic social and medical measures are implemented on a large scale, their benefits are first reflected in lower infant mortality rates, and only in the second stage are such benefits reflected in decreasing neonatal mortality rates and a smaller number of stillbirths. In this study, we review the literature on these factors. We extrapolate and compare this literature with data recorded in our country in the hopes of finding the reasons why Romania ranks first in the European Union in terms of infant mortality rates. We found that lowering the infant morbidity, mortality, and congenital malformation rates is an absolute priority in Romania, which requires the involvement of decision makers in taking effective measures regarding food supplementation or enhancement using folic acid, adequate counselling of couples, monitoring of all pregnancies, setting antenatal diagnosis, implementing optimal delivery management and therapeutic approaches to problematic pregnancies in other hospitals and by involving the population in health education, avoiding occupational or in-home exposure to toxic factors, avoiding drug use, and implementing disease and infection prevention measures for pregnant women.

The pattern of medication used by acne patients: Study from a tertiary care center of North India

Background: Acne vulgaris is a common cutaneous condition seen globally and has a considerable psychosocial impact. Many patients with acne try various forms of self-medication, alternative therapies, and prescription medicines for the treatment of acne. Methods: We studied various patterns of acne treatments used in a cross-sectional study among patients presenting in a tertiary care hospital. A 2-part questionnaire was used to evaluate the socio-epidemiologic factors and responses to treatments used by acne patients presenting at our center for the first time. The patients used self-medication, alternative therapies (e.g., Ayurveda), treatments from general practitioners, and also specialists. Results: Most of the patients reported either no treatment response or even deterioration. Several patients even used topical steroids and suffered adverse effects (corticosteroid-induced rosacea-like facial dermatitis). Conclusion: The findings of our study stress the role of appropriate counseling of acne patients in management. Improvement in the doctor-patient relationship is also essential to enhance the treatment efficacy in acne.

Studies on Factors Influencing Influenza Vaccination Rates in Patients with Chronic Obstructive Pulmonary Disease

BACKGROUND : With low influenza vaccination rates among the chronically ill, approaches to increase these rates among risk patients with chronic obstructive pulmonary disease (COPD) are to be uncovered. METHODS : 120 COPD patients from Magdeburg filled out a questionnaire and were analyzed regarding the influenza vaccination status 2015/2016 or 2016/2017. Vaccinated and unvaccinated were compared in socio-epidemiological factors, the health belief model (HBM), self-efficacy (GESIS-ASKU), anxiety/depression (HADS-D) and disease processing (FKV-LIS). RESULTS : 62.5 % (n = 75) were vaccinated, 31.7 % (n = 38) unvaccinated, 5.8 % (n = 7) made no statement. In over or equal to 60-year-olds 76 % were vaccinated, in under 60-year-olds 42 % were vaccinated. 60 % (n = 72) knew to belong to a risk group. Unvaccinated indicated greater concern about side effects of the vaccination (p = .004) and drew a worse benefit-expense balance (p = .001). Unvaccinated were more often uncertain about the vaccination protection and the severity of influenza (p ≤ .001). Vaccinated were highly motivated to think about vaccination themselves and more often had a positive vaccination history (p = .001). COPD patients showed a lower self-efficacy than the reference group of the German general population (p = .000), vaccinated and unvaccinated did not differ (p = .418). No difference between vaccinated and unvaccinated was found in the processing of the disease and in depression and anxiety, but unvaccinated tended to give higher anxiety values. CONCLUSION : Measures should particularly target COPD patients under 60 years of age with a negative vaccination history and sensitize them as risk patients. Widespread uncertainties about the severity of influenza and vaccination protection should be addressed. It should be communicated that influenza vaccination does not lead to exacerbation. The vaccination recommendation should increasingly be made by pulmonologists.

A study of seroprevalence of herpes simplex virus infection in STI clinic attendees

Background: Herpes simplex virus infections are prevalent worldwide. They are caused by Herpes simplex virus Type-1 (HSV-1) and type-2 (HSV-2). HSV-1 causes orolabial disease. Genital herpes may be caused by either HSV-2 or HSV-1, large majority of cases being caused by HSV-2. HSV-1 is acquired during early childhood by most of the individuals. The acquisition of HSV-2 starts around puberty or thereafter. The ability of the virus to successfully avoid clearance by the immune system by entering a non-replicating state known as latency leads to life long persistence of infection with unpredictable reactivation and transmission. Detecting antibodies plays an important role in identifying those infected. Type specific tests have been developed that are based on the protein Glycoprotein G from HSV-2 (gG2) or Glycoprotein G from HSV-1 (gG1). As very limited sequence homology exists between gG1 and gG2, assays based on detecting these type specific epitopes using ELISA can reliably differentiate between antibodies to HSV-1 and HSV-2. Objectives 1. To study the Seroprevalence of Herpes simplex virus infection in patients attending the STI clinic.2. To study the risk factors and other socioepidemiological factors associated with HSV-2 seropositivity.3. To study the seroprevalence of HSV infection in HIV positive individuals.4. To study the proportion of subclinical seropositives for HSV infection. Material and methods: The study was carried out from July 2017 to June 2019. All patients reporting to DVL OPD at GITAM institute of Medical sciences & Research, Visakhapatnam, Andhra Pradesh were examined and evaluated. 82 consecutive patients of both sexes with STI complaints, in the age group of 15-70 years were studied. Patients with genital herpes as well as patients with other STI complaints including both HIV positive and HIV negative patients were included in the study.With prior permission from ethical committee and consent from patients, blood samples were collected and tested for HSV-1 IgG and IgM antibodies and HSV-2 IgG and IgM antibodies.Results: Out of 82 patients 42 (51%) were females and 40 (49%) were males; 41 (50%) were HIV positive and the other 41(50%) were HIV negative.Out of 82 patients, 39(47.6%) had genital herpes and 43 (52.5%) had other STDs which include genital candidiasis (18.3%), non specific urethritis (13.4%), Condyloma acuminate (14.6%) and genital molluscum contagiosum (6.1%).Out of 82 patients, 2(2.4%) were seropositive for HSV-1 IgM and 68 (82.9%) were seropositive for HSV-1 IgG.Out of 82 patients, 4(5%) were seropositive for HSV-2 IgM and 40(48.8%) are seropositive for HSV-2 IgG.Out of 39 patients with genital herpes 21(53.8%) were seropositive for HSV-2 and out of 43 patients with other STDs without genital herpes 19 (44.2%) were seropositive for HSV-2, indicating that the proportion of subclinical seropositivity was 44.2% in our studyConclusion: From our study we conclude that Herpes simplex virus infection is common in STI clinic attendees in our hospital. Prevalence of HSV-1 and HSV-2 serum antibodies provide an epidemiological measure of population burden of these infections. The high seroprevalence of HSV-2 in HIV patients potentiates the need for regular HSV-2 screening in HIV positive individuals and proper counselling and treatment of HSV-2 seropositives during outbreaks will efficiently lower the frequency of recurrences and decrease the transmission of both HSV and HIV infections.

THE CHARACTERISTICS OF HOSPITALIZED MEASLES AFFECTED CHILDREN DURING THE 2017-2018 EPIDEMIC IN THE JABLANICA DISTRICT

Despite the availability of safe, effective and inexpensive vaccine since the 1960s, in 2018, more than 140.000 people worldwide died from measles. The aim of this study was to determine socio-epidemiological and clinical characteristics among hospitalized, measles-infected children during the epidemic from December 2017 to July 2018 in the Jablanica District and to estimate the influence of socio-epidemiological factors on the severity of disease. This cross-sectional study involved 55 measles-infected, hospitalized children at the Pediatric Department of the General Hospital of Leskovac. Data were collected with an original questionnaire and analyzed using descriptive statistics methods. The influence of factors on the severity of disease among infected children with and without complications was examined using ch² and t-test. P < 0.05 was considered statistically significant. During the measles epidemic in the Jablanica District in 2017-2018, 110 children were affected, aged 0-19 years. Out of a total measles affected children in the Jablanica District only 9 (8.18%) were vaccinated, of which 5 (4.54%) were hospitalized. A total of 55 measles-infected, hospitalized children aged 22.85 ± 23.94 months were analyzed. The most infected children, 25 (45.45%), were aged 0-12 months. The infected children were mostly living in poor conditions, 34 (61.81%). Pneumonia was the most common complication, 24 (51.88%). There were no lethal outcomes. Severe complications were more frequent in younger children (p < 0.05), in children who lived in poor conditions (p < 0.05) and in those who had infection during the winter (p < 0.05). The development and implementation of strategies to achieve high coverage for measles vaccination and revaccination are necessary for measles elimination.

Clinico-Seroepidemiological Evaluation of Toxocariasis in Asthmatic Egyptian Children

Background: Toxocariasis was recorded as one of the most commonly zoonotic helminthic infections in the world and still a poorly diagnosed disease hence largely unknown either to health professionals and/or the general of Egyptian population. The excretory-secretory antigens of T. canis larvae (TES) are widely used for both the diagnosis and seroepidemiological studies. Aim of the work: The aim of the present study was to assess the relationship between toxocariasis and bronchial asthma in asthmatic children through means of a case-control study in Cairo, Egypt and to determine its relation to epidemiological risk factors, laboratory tests and clinical signs. Patients and Methods: The study included two groups (Group1): asthmatic group included 72 children with confirmed asthmatic bronchitis and (Group 2): non-asthmatic group included 72 children selected randomly as a control group. The sociodemographic data was assessed as risk factors for toxocariasis based on a questionnaire collected from the children’s parents or guardians. The selected cases were subjected to stool analysis to exclude other parasitic infection, CBC for eosinophilia and immunoblot assay for detection of Toxocara canis IgG. Results: Out of 72 asthmatic patients toxocariasis IgG was positive in 16 cases (22.2%), negative in 56 cases (78.6%) compared to 5 positive cases (6.9%), and 67 negative cases (93.1%) in control group. There was a significant relation between positive antiToxocara IgG and asthmatic bronchitis. This study confirmed a significant correlation between the seroprevalence of Toxocara and possible socioepidemiological factors as contact with pets, geophagia and residence. Conclusion: Rising knowledge of toxocariasis will enable pediatricians to consider it as a cause of asthmatic bronchitis in their patients, initiate appropriate treatment, and educate patients and parents on how to avoid becoming infected

Clinico-Seroepidemiological Evaluation of Toxocariasis in Asthmatic Egyptian Children

Background: Toxocariasis was recorded as one of the most commonly zoonotic helminthic infections in the world and still a poorly diagnosed disease hence largely unknown either to health professionals and/or the general of Egyptian population. The excretory-secretory antigens of T. canis larvae (TES) are widely used for both the diagnosis and seroepidemiological studies. Aim of the work: The aim of the present study was to assess the relationship between toxocariasis and bronchial asthma in asthmatic children through means of a case-control study in Cairo, Egypt and to determine its relation to epidemiological risk factors, laboratory tests and clinical signs. Patients and Methods: The study included two groups (Group1): asthmatic group included 72 children with confirmed asthmatic bronchitis and (Group 2): non-asthmatic group included 72 children selected randomly as a control group. The sociodemographic data was assessed as risk factors for toxocariasis based on a questionnaire collected from the children’s parents or guardians. The selected cases were subjected to stool analysis to exclude other parasitic infection, CBC for eosinophilia and immunoblot assay for detection of Toxocara canis IgG. Results: Out of 72 asthmatic patients toxocariasis IgG was positive in 16 cases (22.2%), negative in 56 cases (78.6%) compared to 5 positive cases (6.9%), and 67 negative cases (93.1%) in control group. There was a significant relation between positive antiToxocara IgG and asthmatic bronchitis. This study confirmed a significant correlation between the seroprevalence of Toxocara and possible socioepidemiological factors as contact with pets, geophagia and residence. Conclusion: Rising knowledge of toxocariasis will enable pediatricians to consider it as a cause of asthmatic bronchitis in their patients, initiate appropriate treatment, and educate patients and parents on how to avoid becoming infected

Seroepidemiological Evaluation of Toxocariasis in Egyptian Children Suffering from Recurrent Urticaria

Background: human toxocariasis is one of the most common zoonotic helminthiases reported all over the world. Large spectrum of clinical diseases due to toxocariasis including cutaneous diseases particularly urticaria has been identified by recent diagnostic laboratory tests. Objective: it was to evaluate the Toxocara seroprevalence in children diagnosed with chronic urticaria (CU) and to identify its possible relationship with epidemiological, laboratory and clinical aspects, through a case–control study presented at the Dermatology Outpatient Clinic of Al-Azhar University Hospital in New Damietta City. Patients and Methods: seventy children diagnosed with CU and seventy healthy controls were included in the study. Sociodemographic risk factors for toxocariasis were analyzed based on a questionnaire collected from the children’s parents or guardians, then all of the children were subjected to thorough clinical examination, stool examination to exclude other parasites and blood samples were collected and tested for eosinophilic count by CBC as well as estimation of anti-Toxocara IgG antibodies by means of western blot (WB) test. Results: Toxocara IgG was positive in 18.5% (n=13). It was significantly higher than among the cross-matched 70 healthy controls (4.2%). This study confirmed the possibility of significant association between the seroprevalence of Toxocara and possible socioepidemiological factors as contact with pets or soil, geophagia as well as state of house. Regarding clinical manifestations and laboratory investigations, bronchial asthma, rhinitis and conjunctivitis were found to be significantly associated with Toxocara seroprevalence. Conclusion: Toxocara infection should be considered as an important cause of recurrent urticaria among children population in developing countries.

Seroepidemiological Evaluation of Toxocariasis in Egyptian Children Suffering from Recurrent Urticaria

Background: human toxocariasis is one of the most common zoonotic helminthiases reported all over the world. Large spectrum of clinical diseases due to toxocariasis including cutaneous diseases particularly urticaria has been identified by recent diagnostic laboratory tests. Objective: it was to evaluate the Toxocara seroprevalence in children diagnosed with chronic urticaria (CU) and to identify its possible relationship with epidemiological, laboratory and clinical aspects, through a case–control study presented at the Dermatology Outpatient Clinic of Al-Azhar University Hospital in New Damietta City. Patients and Methods: seventy children diagnosed with CU and seventy healthy controls were included in the study. Sociodemographic risk factors for toxocariasis were analyzed based on a questionnaire collected from the children’s parents or guardians, then all of the children were subjected to thorough clinical examination, stool examination to exclude other parasites and blood samples were collected and tested for eosinophilic count by CBC as well as estimation of anti-Toxocara IgG antibodies by means of western blot (WB) test. Results: Toxocara IgG was positive in 18.5% (n=13). It was significantly higher than among the cross-matched 70 healthy controls (4.2%). This study confirmed the possibility of significant association between the seroprevalence of Toxocara and possible socioepidemiological factors as contact with pets or soil, geophagia as well as state of house. Regarding clinical manifestations and laboratory investigations, bronchial asthma, rhinitis and conjunctivitis were found to be significantly associated with Toxocara seroprevalence. Conclusion: Toxocara infection should be considered as an important cause of recurrent urticaria among children population in developing countries.

Socio-epidemiological and land cover risk factors for melioidosis in Kedah, Northern Malaysia.

BackgroundMelioidosis, a fatal infectious disease caused by Burkholderia pseudomallei, is increasingly diagnosed in tropical regions. However, data on risk factors and the geographic epidemiology of the disease are still limited. Previous studies have also largely been based on the analysis of case series data. Here, we undertook a more definitive hospital-based matched case-control study coupled with spatial analysis to identify demographic, socioeconomic and landscape risk factors for bacteremic melioidosis in the Kedah region of northern Malaysia.Methodology/Principal findingsWe obtained patient demographic and residential information and clinical presentation and medical history data from 254 confirmed melioidosis cases and 384 matched controls attending Hospital Sultanah Bahiyah (HSB), the main tertiary hospital of Alor Setar, the capital city of Kedah, during the period between 2005 and 2011. Crude and adjusted odds ratios employing conditional logistic regression analysis were used to assess if melioidosis in this region is related to risk factors connected with socio-demographics, various behavioural characteristics, and co-occurring diseases. Spatial clusters of cases were determined using a continuous Poisson model as deployed in SaTScan. A land cover map in conjunction with mapped case data was used to determine disease-land type associations using the Fisher’s exact test deploying simulated p-values. Crude and adjusted odds ratios indicate that melioidosis in this region is related to gender (males), race, occupation (farming) and co-occurring chronic diseases, particularly diabetes. Spatial analyses of disease incidence, however, showed that disease risk and geographic clustering of cases are related strongly to land cover types, with risk of disease increasing non-linearly with the degree of human modification of the natural ecosystem.Conclusions/SignificanceThese findings indicate that melioidosis represents a complex socio-ecological public health problem in Kedah, and that its control requires an understanding and modification of the coupled human and natural variables that govern disease transmission in endemic communities.

Functional iron deficiency in patients on hemodialysis: prevalence, nutritional assessment, and biomarkers of oxidative stress and inflammation

Introduction:Anemic patients with chronic kidney disease (CKD) can be divided into anemic patients without or with functional iron deficiency (FID). The increase in the number of cases of hemosiderosis in patients on hemodialysis (HD) attributed to excessive intravenous iron replacement has called for the investigation of the factors involved in the genesis of FID.Objectives:This study aimed to describe the prevalence of FID in patients with CKD on HD, characterize the included individuals in terms of clinical and workup parameters, and assess their nutritional, oxidative stress, and inflammation statuses. This cross-sectional study assembled a convenience sample of 183 patients with CKD on HD treated in Southern Brazil. Patients meeting the inclusion and exclusion criteria were divided into two groups, one with anemic subjects with FID and one with anemic patients without FID. Participants answered a questionnaire probing into socio-epidemiological factors, underwent anthropometric measurements, and were tested for markers of anemia, oxidative stress, inflammation, and nutrition.Statistical analysis:The date sets were treated on software package GraphPad InStat version 3.1. Variables were tested with the Kolmogorov-Smirnov, chi-square, Student’s t, and Mann-Whitney tests. Statistical significance was attributed to differences with a p < 0.05.Results:Markers of inflammation were not statistically different between the two groups. Markers of anemia and nutrition were significantly lower in patients with FID. Patients with FID were prescribed higher doses of parenteral iron (p < 0,05).Discussion:FID was associated with lower nutritional marker levels, but not to increased levels of markers of inflammation or oxidative stress, as reported in the literature. Additional studies on the subject are needed.