Special Public Health Research Articles

Data analysis workflow for the detection of canine vector-borne pathogens using 16\xa0S rRNA Next-Generation Sequencing

BackgroundVector-borne diseases (VBDs) impact both human and veterinary medicine and pose special public health challenges. The main bacterial vector-borne pathogens (VBPs) of importance in veterinary medicine include Anaplasma spp., Bartonella spp., Ehrlichia spp., and Spotted Fever Group Rickettsia. Taxon-targeted PCR assays are the current gold standard for VBP diagnostics but limitations on the detection of genetically diverse organisms support a novel approach for broader detection of VBPs. We present a methodology for genetic characterization of VBPs using Next-Generation Sequencing (NGS) and computational approaches. A major advantage of NGS is the ability to detect multiple organisms present in the same clinical sample in an unsupervised (i.e. non-targeted) and semi-quantitative way. The Standard Operating Procedure (SOP) presented here combines industry-standard microbiome analysis tools with our ad-hoc bioinformatic scripts to form a complete analysis pipeline accessible to veterinary scientists and freely available for download and use at https://github.com/eltonjrv/microbiome.westernu/tree/SOP.ResultsWe tested and validated our SOP by mimicking single, double, and triple infections in genomic canine DNA using serial dilutions of plasmids containing the entire 16 S rRNA gene sequence of (A) phagocytophilum, (B) v. berkhoffii, and E. canis. NGS with broad-range 16 S rRNA primers followed by our bioinformatics SOP was capable of detecting these pathogens in biological replicates of different dilutions. These results illustrate the ability of NGS to detect and genetically characterize multi-infections with different amounts of pathogens in a single sample.ConclusionsBloodborne microbiomics & metagenomics approaches may help expand the molecular diagnostic toolbox in veterinary and human medicine. In this paper, we present both in vitro and in silico detailed protocols that can be combined into a single workflow that may provide a significant improvement in VBP diagnostics and also facilitate future applications of microbiome research in veterinary medicine.

Harmful diatoms and dinoflagellates in the Indian Ocean: a study from Southern coast of Sri Lanka

Harmful diatoms and dinoflagellates in the Indian Ocean: a study from Southern coast of Sri Lanka

The emerging issue of cognitive disorders and dementia among migrants

Abstract Background Due to population aging, people with a migration background are (and will be) increasingly exposed to the burden of chronic, age-related diseases. Specifically, the occurrence of dementia and cognitive disorders in this population of individuals can assume special clinical and public health relevance. The ImmiDem project (GR-2016-02364975) is aimed at characterizing the emerging phenomenon of cognitive disorders in migrants in Italy. Methods The number of dementia and mild cognitive impairment (MCI) cases among migrants living in the extended European Union was calculated by applying the age- and gender-specific prevalence rates of these conditions to the population data of international migrants provided by Eurostat. A pilot survey was addressed to a representative sample of Italian centers for cognitive disorders and dementia (CCDDs) with the aim of collecting information on the number of migrants attending these services, the adopted diagnostic, and the possible barriers and resources in the provision of care. Results Nearly 700,000 cases of dementia and 680,000 cases of MCI can be estimated in the migrant population living in Europe in 2018. Nevertheless, the number of migrants referred to the surveyed CCDDs was very low and was considered as stable over the last 5 years. Most of CCDDs reported the possibility of contacting cultural mediators and/or interpreters, while only a few reported the availability and regular use of translated and/or cross-cultural cognitive assessment tools. Conclusions The data produced by the ImmiDem project allow a preliminary characterization of the emerging phenomenon of cognitive disturbances in the migrant population. The survey will be extended to all Italian dementia services (CDCD, day centers, residential structures). Activities aimed at identifying and promoting dedicated care pathways or good practices will also be conducted. Key messages The clinical and epidemiological characterization of cognitive disorders occurring in migrants represent an emerging public health matter for Western countries. The onset of dementia in migrants can result in important clinical-diagnostic and healthcare complexities.

Eminent but nameless: Lydia das Dôres Matta and Brazilian nursing after 1930

The article analyzes the process of reconstructing the nursing profession in Brazil post-1930. We examine teaching practices in higher education and the reinsertion of black women in professional nursing through the biography of Lydia das Dôres Matta, a nurse trained in the second class graduated from the São Paulo School of Nursing as a scholarship student in the Special Public Health Service Nursing Program. The results allow reflections on the professional identity of Brazilian nursing from the trajectory of a black woman, as well as on the historiography of nursing in Brazil.

Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program.

Malignant mesothelioma (MM) is an important health problem due to ongoing asbestos exposure. Environmental asbestos exposure leads to a high risk of MM in Turkey. The Turkish Mesothelioma Working Group and the Turkish Public Health Institute designed and performed the Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program (TUNMES-EAECP). The aim of this study was to analyze the results of the TUNMES-EAECP. Patients diagnosed with MM (code C45.0–C45.9) between 2008 and 2012 were identified. The “from case to the field” method was used to determine the villages with current or previous asbestos exposure. Special public health teams took soil samples from these villages, which were then examined using an X-ray diffractometer. Direct Standardized Average Annual Mesothelioma Incidence Rate (AMIR) and relative risk (RR) of MM were calculated. Finally, a projection on the incidence of MM between 2013 and 2033 was made. The number of confirmed MM cases was 5617 with a male to female ratio of 1.36. Mean age was 61.7 ± 13.4 (20–96) years. The median survival was eight (95% CI 7.6–8.4) months. Asbestos exposure continues in 379 villages, with 158,068 people still living in high risk areas. The standardized AMIR was 2.33/100,000 per year. The risk of MM was higher in males, in both sexes over the age of 40, in asbestos-containing provinces, and in those where the TUNMES was organized. Among the population with continuing asbestos exposure in rural areas, the number of MM cases between 2013 and 2033 was estimated as 2511. As such, the incidence of MM in Turkey is as high as in industrialized countries. Asbestos exposure in rural areas continues to be a serious problem in Turkey, which obviates the necessity for effective preventive measures.

Insights on Klebsiella pneumoniae Biofilms Assembled on Different Surfaces Using Phenotypic and Genotypic Approaches

Klebsiella pneumoniae is a prominent etiological agent of healthcare associated infections (HAIs). In this context, multidrug-resistant and biofilm-producing bacteria are of special public health concern due to the difficulties associated with treatment of human infections and eradication from hospital environments. Here, in order to study the impact of medical devices-associated materials on the biofilm dynamics, we performed biofilm phenotypic analyses through a classic and a new scanning electron microscopy (SEM) technique for three multidrug-resistant K. pneumoniae isolates growing on polystyrene and silicone. We also applied whole-genome sequencing (WGS) to search for genetic clues underlying biofilm phenotypic differences. We found major differences in the extracellular polymeric substances (EPS) content among the three strains, which were further corroborated by in-depth EPS composition analysis. WGS analysis revealed a high nucleotide similarity within the core-genome, but relevant differences in the accessory genome that may account for the detected biofilm phenotypic dissimilarities, such as genes already associated with biofilm formation in other pathogenic bacteria (e.g., genes coding haemogglutinins and haemolysins). These data reinforce that the research efforts to defeat bacterial biofilms should take into account that their dynamics may be contingent on the medical devices-associated materials.

Prevalence of and contributing factors to overweight and obesity among the schoolchildren of Podgorica, Montenegro

Introduction/Objective. Childhood obesity is an emerging public health problem. The national prevalence of child overweight/obesity in Montenegro has increased by one third in the last decade. As the overwhelming majority of Montenegrin population is urban, investigation of obesity and correlates among urban children is of special public health interest. The aim of this study was to investigate the prevalence of and contributing factors to obesity among schoolchildren of Podgorica. Method. The sample included 1,134 schoolchildren (49.8% boys) aged 7?12 years, from 10 elementary schools in Podgorica. We measured children?s body mass, body height, and waist circumference to calculate body mass index (BMI) and waist-to-height ratio. The research instrument was a closed type of the original questionnaire. Nutritional status was assessed according to the criteria recommended by the American Centers for Disease Control and Prevention, World Health Organization and International Obesity Task Force. Results. Among the investigated children there were 21.2% and 6% overweight and obese children, respectively. Obesity was more frequent among boys (7.6%) compared to girls (4.4%). In a multiple regression, childhood obesity was positively related to the following: male gender, younger age, lower number of siblings, parental obesity, and low physical activity. Conclusion. One out of five urban Montenegrin schoolchildren is overweight/obese, with obesity being twice as frequent among boys compared to girls. A program against obesity among urban Montenegrin children should focus on the revealed contributing factors.

Incarceration Rates and Traits of Sexual Minorities in the United States: National Inmate Survey, 2011-2012.

To report characteristics of sexual minority US inmates. We drew our data from the National Inmate Survey, 2011-2012, a probability sample of inmates in US prisons and jails. We determined weighted proportions and odds ratios with 95% confidence intervals to estimate differences between sexual minority and heterosexual inmates. Sexual minorities (those who self-identify as lesbian, gay, or bisexual or report a same-sex sexual experience before arrival at the facility) were disproportionately incarcerated: 9.3% of men in prison, 6.2% of men in jail, 42.1% of women in prison, and 35.7% of women in jail were sexual minorities. The incarceration rate of self-identified lesbian, gay, or bisexual persons was 1882 per 100 000, more than 3 times that of the US adult population. Compared with straight inmates, sexual minorities were more likely to have been sexually victimized as children, to have been sexually victimized while incarcerated, to have experienced solitary confinement and other sanctions, and to report current psychological distress. There is disproportionate incarceration, mistreatment, harsh punishment, and sexual victimization of sexual minority inmates, which calls for special public policy and health interventions.

Detection of Bacterial Vaginosis and Comparison Of Clinical & Microbiological Methods Among Women Attending Chittagong Medical College Hospital

Bacterial vaginosis is a special public health concern in the world because of high burden of reproductive and pregnancy related morbidity. This present study was undertaken to detect the bacterial vaginosis in reproductive women by different clinical and microbiological methods on patients attending at the out patient department of Gynaecology and Obstetrics of Chittagong Medical College Hospital. A total of 170 sexually active female in the age group of 15-45 years, with abnormal vaginal discharge were selected for the study. In this study bacterial vaginosis was detected by Amsel clinical criteria (Clinical method) Gram stain Nugent criteria (Gold Standard) culture and by newly developed BV assay test and compared these methods. Out of 170 study cases, 43(25.30%) cases were diagnosed as bacterial vaginosis by Amsel criteria, 45(26.47%) cases were positive by Nugent criteria, 46(27.06%) cases were positive by BV assay test and 38(22.35%) cases were culture positive for Gardnerella vaginalis. Sensitivity of the clinical criteria (Amsel) BV assay test, and culture were 95.5%, 97.8% and 84.4% respectively in response to Gold standard Nugent criteria. All these findings make the BV assay test more accurate and reliable screening procedure for the diagnosis of bacterial vaginosis which help our physicians and patients.
 JCMCTA 2016 ; 27 (1) : 40 - 45

Antimicrobial Resistance of Escherichia coli, Enterococci, Pseudomonas aeruginosa, and Staphylococcus aureus from Raw Fish and Seafood Imported into Switzerland

A total of 44 samples of salmon, pangasius (shark catfish), shrimps, and oysters were tested for the presence of Escherichia coli, enterococci, Pseudomonas aeruginosa, and Staphylococcus aureus, which are indicator organisms commonly used in programs to monitor antibiotic resistance. The isolated bacterial strains, confirmed by matrix-assisted laser desorption ionization time-of-flight mass spectroscopy, were tested against a panel of 29 antimicrobial agents to obtain MICs. Across the four sample types, Enterococcus faecalis (59%) was most common, followed by E. coli (55%), P. aeruginosa (27%), and S. aureus (9%). All bacterial species were resistant to some antibiotics. The highest rates of resistance were in E. faecalis to tetracycline (16%), in E. coli to ciprofloxacin (22%), and in S. aureus to penicillin (56%). Antibiotic resistance was found among all sample types, but salmon and oysters were less burdened than were shrimps and pangasius. Multidrug-resistant (MDR) strains were exclusively found in shrimps and pangasius: 17% of pangasius samples (MDR E. coli and S. aureus) and 64% of shrimps (MDR E. coli, E. faecalis, and S. aureus). Two of these MDR E. coli isolates from shrimps (one from an organic sample) were resistant to seven antimicrobial agents. Based on these findings, E. coli in pangasius, shrimps, and oysters, E. faecalis in pangasius, shrimps, and salmon, and P. aeruginosa in pangasius and shrimps are potential candidates for programs monitoring antimicrobial resistance. Enrichment methods for the detection of MDR bacteria of special public health concern, such as methicillin-resistant S. aureus and E. coli producing extended-spectrum β-lactamases and carbapenemases, should be implemented.

The leprosy "drama": Governador Valadares, public health policies, and their territorial implications in the 1980s

The incidence of leprosy in Governador Valadares, Brazil, in the 1980s spurred this town to pioneer the introduction of polychemotherapy. The aim of this research was to understand how the different actors involved in this context interacted, especially the employees and patients at the Special Public Health Service. To identify the territories that these interactions inevitably constituted, a variety of theoretical instruments were used, including dramatism (Burke) and performance (Turner). By taking a theatrical metaphor, we sought to find out the dynamics by which the different actors took the stage and established their most significant relationships in a dynamic process of constituted and reconstituted territories.

An Explanatory Study On The Effect Of Education On The Demand For Preventive Healthcare Among Malaria Patients: A Case Study Of Asonomaso Hospital

Malaria accounts for about 90% of the global clinical cases each year. It is estimated that about 9% of overall mortality in Ghana is caused by malaria infections. Among the malaria deaths, 40% occurred among infants and children under the age of five. Due to the colossal unenthusiastic impact malaria is posturing to the socio-economic lives of the inhabitants of subSaharan Africa. Stakeholders have launched special public health programmes to help salvage the situation. In view of that the study sought to find out the effect of education on demand for preventive healthcare good against malaria infection. The study used a sample size of 800 respondents across the inhabitants of Kwabre East District in Ashanti Region. The study sampled healthcare facility users of Asonomaso Government Hospital (i.e. patients from Kasaam, Ntonso, Bonwire e.t.c.). The study adopted a recursive analysis since both descriptive and quantitative methods were used for the data analysis. A random sampling method was used to solicit for malaria outpatients respondents in the study area. The study find out that education level has a positive effect on the demand for preventive healthcare good. The further find out that the social media such as radio and television stations are the main source of information. The recommended that The various stakeholders should intensify the media advert on the use of the preventive care and the need to use such care. The education curriculum should be structured in such a way that part of the physical education syllabus should give a basic knowledge on the use of

Multiple Logistic Regression Analysis on the Health Checkup Data and the Lifestyle Habits of Medicated Residents: A Population-Based Cohort Study

Background: The residents currently taking prescribed medication have been exempted from the special public health guidance conducted in the act in Japan. This study analyzed blood pressure taken during the special health checks from 2008 to 2011 in light of resident lifestyle, focusing on comparisons between medicated and non-medicated residents. Methods: Health checkup data in retrospective cohort of 4,734 residents undergoing special health checks in B-City from 2008 to 2011 were analyzed. The participants were categorized as taking medication (medicated residents, n=1,083) and others (non-medicated residents, n=3,651). The multiple logistic regression analysis provided odds ratios (ORs) and 95% confidence intervals (95% CI). Results: The medicated residents had higher systolic and diastolic blood pressure than the non-medicated in both 2008 and 2011. Factors on which the OR was significantly higher for the hypertension group (normal blood pressure group=1) were alcohol consumption (OR: 1.30 (95% CI: 1.12-1.50)), and weight gain (OR: 1.45 (95% CI: 1.26-1.67)). Factors on which the OR was significantly higher for the diabetes mellitus group (normal blood glucose group=1) were smoking (OR: 3.14 (95% CI:1.69-5.80)). Factors on which the OR was significantly higher for the neutral fat high-flying group (normal neutral fat group=1) were alcohol consumption (OR: 1.30 (95% CI: 1.12-1.50)) and weight gain (OR: 1.45 (95% CI: 1.26-1.67)). Compared to the group with hypertension only, the group with multiple conditions who consumed alcohol in both 2008 and 2011 had an OR of 1.49 (95% CI: 1.29-1.72), and those who had weight gain of 10 kg had an OR of 1.74 (95% CI: 1.50-2.02). Conclusion: No improvement was found in the lifestyle habits of medicated residents. This study suggested that an appropriate health guidance will be needed to improve the lifestyle habits in medicated residents.

Violent and non-violent methods of attempted and completed suicide in Swedish young men: the role of early risk factors.

BackgroundThere is a paucity of studies on the role of early risk factors for the choice of methods for violent suicide attempts. Adolescent risk factors for the choice of violent or non-violent methods for suicide attempts and the risk of subsequent suicide were studied using a longitudinal design.MethodsA national Swedish cohort of 48 834 18–20-year-old young men conscripted for military service from 1969 to 1970 was followed through official registers during a 37-year period. Two questionnaires concerning their psychosocial background were answered by each conscript. Cox proportional hazard regression analyses were used to estimate the risk for different methods of attempted suicide and later suicide.ResultsA total of 1195 (2.4 %) men had made a suicide attempt and of these, 133 (11.1 %) committed suicide later. The number of suicide victims among the non-attempters was 482 (1 %). Half of the suicides occurred during the same year as the attempt. Suicide victims had earlier onset of suicidal behaviour and had more often used hanging as a method of attempted suicide than those who did not later commit suicide. The early risk factors for both violent and non-violent methods of suicide attempt were quite similar.ConclusionViolent suicide attempts, especially by hanging, are associated with a clearly elevated suicide risk in men and require special clinical and public health attention. The early risk factors related to the choice of either a violent or a non-violent suicide attempt method are interlinked and circumstantial factors temporally close to the suicide attempt, such as access to a specific method, may partly explain the choice of method.

Izabel dos Santos and the training of the health workers.

This article discusses the career of Izabel dos Santos (1927-2010) as a means of examining the connections between health schools and agendas in contemporary Brazil. The article highlights dos Santos's training and her work in the Serviço Especial de Saúde Pública (SESP- Special Public Health Service), the Pan American Health Organization (PAHO) and in the formulation and implementation of national training programs for human resources within the area of health from the late 1970s onwards. The article highlights dos Santos's central role in the formulation and implementation of training policies for health workers, especially nursing technicians and assistants, and demonstrates how she occupies an important place in the history of Brazilian public health.

Application of M13 phage display for identifying immunogenic proteins from tick (Ixodes scapularis) saliva

BackgroundTicks act as vectors for a large number of different pathogens, perhaps most notably Borrelia burgdorferi, the causative agent of Lyme disease. The most prominent tick vector in the United States is the blacklegged tick, Ixodes scapularis. Tick bites are of special public health concern since there are no vaccines available against most tick-transmitted pathogens. Based on the observation that certain non-natural host animals such as guinea pigs or humans can develop adaptive immune responses to tick bites, anti-tick vaccination is a potential approach to tackle health risks associated with tick bites.ResultsThe aim of this study was to use an oligopeptide phage display strategy to identify immunogenic salivary gland proteins from I. scapularis that are recognized by human immune sera. Oligopeptide libraries were generated from salivary gland mRNA of 18 h fed nymphal I. scapularis. Eight immunogenic oligopeptides were selected using human immune sera. Three selected immunogenic oligopeptides were cloned and produced as recombinant proteins. The immunogenic character of an identified metalloprotease (MP1) was validated with human sera. This enzyme has been described previously and was hypothesized as immunogenic which was confirmed in this study. Interestingly, it also has close homologs in other Ixodes species.ConclusionAn immunogenic protein of I. scapularis was identified by oligopeptide phage display. MP1 is a potential candidate for vaccine development.

Local government and public dental health services: an analysis of inequality in use

The aim of this study was to identify factors associated with the use of primary and specialized public dental health services and private services. A population-based household survey was conducted in two cities of Bahia State, Brazil. Key informants provided data on socioeconomic variables and use of dental health services. Organization of the local public dental health service was ranked as worse versus better. Univariate and multivariate polytomous logistic regression was performed. Of the total of 1,290 individuals, 38.76% used private services, 33.80% used public primary care, and 17.29% used both primary care and the Center for Dental Specialties. Less use of both primary care and specialized public services was associated with lower education (OR = 1.47; 95%CI: 1.03-2.10) and worse organization of services (OR = 1.74; 95%CI: 1.22-2.48), when compared to the exclusive use of primary care. The study showed inequality in the use of dental services, even when comparing more homogeneous groups, namely users of public services.

Association between intimate partner violence and utilisation of maternal health services in Nigeria

This study examines the relationship between intimate partner violence and utilisation of maternal healthcare services. Data was extracted from the 2008 Nigeria Demographic and Health Survey. Data were analysed using the STATA. Results show that: 15.6% of the women have ever experienced at least one type of physical violence; 4.1% of the women have ever experienced at least one type of sexual violence; and 22.4% of the women have ever experienced at least one type of emotional violence. The logistic regression show that women who have ever experienced emotional violence were: 24.2% less likely to utilise skilled antenatal care (OR=0.7578,p<0.001); 36.0% less likely to have facility delivery (OR= 0.6399,p<0.001); and 37.3% less likely to have skilled assistance during delivery (OR=0.6272,p<0.001). The study suggested the need for a special public health programme that will focus on persons entering into marital unions at adolescence.

French medical journals since 1800

French medical journals take the lead among the 1 385 titles of the statistical survey (15.4%). Efficient tool in communication, with an important publishing market, linked to the rise of medicine in the 19(th) century, prosperity of medical journals do not only mean rise of specialties. Monthly periodicals dominate quickly the publishing market which is also characterized by complex links between generalist and highly specialized medicine, public health and professional training.

Stručna osnova za kontrolu mikrobiološke bezbednosti hrane koja se stavlja u promet

Food borne diseases are caused by ingestion of microorganismas, chemical and physical contaminants. Food can be contaminated at different points along food chain production and distribution. Existing scientific evidence strongly suggests that microbiological and micotoxine contamination of food are of special public health concern although it is widespreded opinion among general population that chemical contamination is the most harmful for human health. Technical base for microbiological food safety control has been prepared by the Codex Alimentarius Commission in conjuction with representatives of all UN member countries. Risk analyse approach has been established as a scientifically based method for food safety control from farm to fork. Safe foodstuffs could not contain microorganisms, their toxins or metabolites in a quantity that could harm human health. Microbiological criteria are used as a guidance for testing food acceptability. They always include testing samples of food on bacteria indicators of foecal and environmental contamination such are Enterobacteriaceae, Listeria monocytogenes, Salmonella, Escherichia coli. Confirmation of these bacteria in the tested food does not mean that someone who is going to consumed such food will be always getting sick nevertheless the tested food cannot be accepted as safe for the consumers. Absence of the indicator microorganisms is not an absolute garant of the absence of the harmfull microorganisms. The established system may include testing presence of the alternative microorganisms. It is expected that food business operators should have established internal system on good manufacturing and good hygienic practice including HACCP system.The system should be periodically tested and certificated on its effectivenes.