Clostridium difficile the hospital plague

Objectives Sub-Saharan Africa faces a shortage of skilled epidemiologists to prevent, detect, and respond to health threats. Tanzania has implemented one of the first Centers for Disease Control and Prevention Field Epidemiology Training Program (FETP) Intermediate courses in Africa. This course aims to strengthen health workforce capacity in surveillance system assessment, outbreak investigation, and evaluation, prioritizing HIV control. We conducted an outcome evaluation of this new course. Methods We used a pre/post evaluation design using data from 4 cohorts of trainees who took the FETP Intermediate course from 2017 to 2020. We conducted knowledge assessments before and after each cohort and combined those results. Outcomes included knowledge and self-rated competency and trends in integrated disease surveillance and response (IDSR) data. We collected data through tests, field assignments, exit interviews, and data audits. We compared the mean change in pre-/posttest scores using linear regression and 95% CIs. We used content analysis to summarize exit interviews. Results Fifty-three FETP trainees from 10 regions enrolled in the FETP Intermediate course, and 52 (99.0%) completed the course. We found substantial increases in mean knowledge (44.0 to 68.0 points) and self-rated competency (4.14 to 4.43) scores before and after the course. Trainees evaluated 52 surveillance systems and 52 district HIV care programs, and 39 (75.0%) trainees participated in outbreak investigations. From before to after cohort 1, timeliness and completeness of IDSR reports increased from 4.2% to 52.1% and from 27.4% to 76.5%, respectively. Course strengths were quality of instruction, individualized mentoring, and practical skills gained. Challenges were mentor availability, limited time for data analysis practice, and balancing work and field assignments. Conclusions The Tanzania FETP Intermediate course substantially improved trainee knowledge and helped to improve local data quality and reporting. This course is a promising model to strengthen subnational capacity to prevent, detect, and respond to public health threats in Africa.

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Natural disasters and the dengue epidemic during COVID-19 outbreak are a deadly combination for public health threats in Bangladesh

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.493 ◽

2020 ◽

pp. 1-6

Author(s):

Rumana Sultana ◽

Md. Shafiul Alam

Keyword(s):

Public Health ◽

Natural Disasters ◽

Health Threats ◽

Dengue Epidemic

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Planning and preparing for public health threats at airports

Globalization and Health ◽

10.1186/s12992-018-0323-3 ◽

2018 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

Greg Martin ◽

Mairin Boland

Keyword(s):

Public Health ◽

Health Threats

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A Comparison of Burden of Disease from Toxic Waste Sites with other Recognized Public Health Threats in India, Indonesia and the Philippines

Journal of Health and Pollution ◽

10.5696/2156-9614-4-7.2 ◽

2014 ◽

Vol 4 (7) ◽

pp. 2-13 ◽

Cited By ~ 5

Author(s):

Jack Caravanos ◽

Lina Hernandez Gutierrez ◽

Bret Ericson ◽

Richard Fuller

Keyword(s):

Public Health ◽

Burden Of Disease ◽

Chemical Exposure ◽

The Philippines ◽

Toxic Waste ◽

World Health ◽

Health Conditions ◽

Chromium Vi ◽

Life Years ◽

Health Threats

Background. Although toxic waste sites have been well investigated in many developed countries, their prevalence and health impact have not been well documented in low and middle income countries where risks attributable to environmental pollution are generally higher than in developed nations. Methods. We compared the burden of disease from toxic waste sites expressed in disability-adjusted life-years (DALYs) with the same measurement for other threats in India, Indonesia and the Philippines. We used Blacksmith Institute for a Pure Earth's DALY estimates for chemical exposure at 373 toxic waste sites in the 3 countries and World Health Organization (WHO) DALY estimates for different health conditions in the same countries. Results. Chromium VI causes the majority of DALYs among chemicals in India, while lead does so in the Philippines and Indonesia. In India, exposure to chromium VI showed higher DALY estimates than health conditions such as multiple sclerosis, Parkinson's disease and various cancers. In Indonesia, exposure to chromium VI and lead presented higher DALYs than conditions such as upper respiratory infections. In the Philippines, lead had higher DALYs than most of the examined conditions, including malaria and human immunodeficiency virus (HIV)/AIDS. Conclusions. This study highlights that the burden of disease expressed in DALYs from toxic waste sites may be greater than previously recognized and greater than other well addressed public health threats. We call attention to the need for surveillance of toxic waste sites, epidemiological analysis of the associations between exposure to toxic chemicals and outcomes, and remediation of chemical contamination in India, Indonesia and the Philippines.

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Clostridium difficile as an Emerging Foodborne Pathogen of Public Health Significance

ACTA SCIENTIFIC MICROBIOLOGY ◽

10.31080/asmi.2021.04.0834 ◽

2021 ◽

Vol 4 (5) ◽

pp. 46-49

Author(s):

Mahendra Pal ◽

Mati Roba Bulcha

Keyword(s):

Public Health ◽

Clostridium Difficile ◽

Foodborne Pathogen ◽

Public Health Significance ◽

Health Significance

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Detection of antibiotic resistance toxigenic Clostridium difficile in processed retail lettuce

Food Quality and Safety ◽

10.1093/fqsafe/fyx032 ◽

2018 ◽

Vol 2 (1) ◽

pp. 37-41 ◽

Cited By ~ 2

Author(s):

Yi Han ◽

Joan King ◽

Marlene E Janes

Keyword(s):

Public Health ◽

Antibiotic Resistance ◽

Clostridium Difficile ◽

Antimicrobial Treatment ◽

Retail Stores ◽

Toxin A ◽

Toxin B ◽

Health Concerns ◽

Ribotype 027 ◽

Infectious Diarrhoea

Abstract Objectives: Clostridium difficile is the major cause of infectious diarrhoea in humans after antimicrobial treatment. Clostridium difficile has been isolated from food animals and meat. The main purpose of this study was to characterize C. difficile isolated from retail lettuce and determine the antibiotic resistance using five common clinical-selected antibiotics (metronidazole, vancomycin, clindamycin, erythromycin, and cefotaxime). Materials and Methods: Lettuce samples (grown in California, Arkansas, and Louisiana) were purchased from retail stores. Results: Toxigenic C. difficile was isolated from 13.8 per cent (41/297) of the lettuce samples. Among the toxigenic isolates, only 82.9 per cent (34/41) produced toxin B, 17.1 per cent (7/41) produced both toxin A and toxin B, and two of the Louisiana C. difficile isolates were identified as ribotype 027. Under the treatment of the five antibiotics, the virulence C. difficile isolates were identified as having antibiotic resistance to metronidazole, vancomycin, and erythromycin. Conclusion: The present study reports the highest prevalence of toxigenic C. difficile in US retail lettuce. The antibiotic resistance to metronidazole, vancomycin, and erythromycin of the isolated C. difficile from retail lettuces could lead to public health concerns.

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Survey on antimicrobial usage in local dairy cows in North-central Nigeria: Drivers for misuse and public health threats

PLoS ONE ◽

10.1371/journal.pone.0224949 ◽

2019 ◽

Vol 14 (12) ◽

pp. e0224949

Author(s):

Nma Bida Alhaji ◽

Mohammed Baba Aliyu ◽

Ibrahim Ghali-Mohammed ◽

Ismail Ayoade Odetokun

Keyword(s):

Public Health ◽

Dairy Cows ◽

North Central ◽

Antimicrobial Usage ◽

Health Threats

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Clostridium difficile Infection Epidemiology over a Period of 8 Years—A Single Centre Study

Sustainability ◽

10.3390/su12114439 ◽

2020 ◽

Vol 12 (11) ◽

pp. 4439 ◽

Cited By ~ 1

Author(s):

Nicoleta Negrut ◽

Delia Carmen Nistor-Cseppento ◽

Shamim Ahmad Khan ◽

Carmen Pantis ◽

Teodor Andrei Maghiar ◽

...

Keyword(s):

Public Health ◽

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Healthcare Services ◽

Common Infectious Disease ◽

Single Centre Study ◽

Significant Public Health ◽

The Mean ◽

North Western ◽

Antibiotic Associated Diarrhoea

Clostridium difficile infection (CDI) is the most common infectious disease related to antibiotic-associated diarrhoea and is a current leading cause of morbidity/mortality, with substantial consequences for healthcare services and overall public health. Thus, we performed a retrospective epidemiological study of CDI for a long period (8 years), in an infectious hospital located in north-western Romania, which serves an entire county of the country (617,827 inhabitants). From 2011 to 2018, 877 patients were diagnosed with CDI; the mean incidence of this disease was 2.76 cases/10,000 patient-days, with an increasing trend in the annual incidence until 2016, at which point there was a decrease. The most commonly afflicted were patients in the 75–84 age group, observed in winter and spring. The results show that the antibiotics were administered in 679 (77.42%) subjects, within the last 3 months before CDI, statistically significant more than proton-pump inhibitors (PPIs)—128 (14.60%) and antidepressant medications—60 (6.84%), which were administered during the same period (p < 0.001). No medication was reported in 10 (6.84%) cases of CDI, in the last 3 months of the study. The fatality rate attained 4.1%, tripling in 2018 vs. 2011. CDI became a significant public health conundrum that can, nevertheless, be combatted through a judicious use of antibiotics.

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