Evaluating Percentage-Based Reporting of Glucose-6-Phosphate Dehydrogenase (G6PD) Enzymatic Activity in a National Reference Laboratory: Assessment of Patient Eligibility for Plasmodium vivax Radical Cure Therapy

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S82-S82
Author(s):  
Emilia Calvaresi ◽  
Jonathan Genzen
Keyword(s):  
Normal Activity ◽  
Population Based ◽  
G6pd Activity ◽  
World Health ◽  
Reference Laboratory ◽  
Data Sets ◽  
Radical Cure ◽  
Laboratory Assessment ◽  
Data Set ◽  
Health Organization

Abstract Objectives The World Health Organization recommends measurement of G6PD activity prior to initiation of 8-aminoquinolones for the treatment of P vivax malaria. An estimated 400 million people worldwide have G6PD deficiency, making them susceptible to hemolysis under oxidative stress. A new single-dose therapy (radical cure) for malaria with tafenoquine is contraindicated in patients with <70% normal G6PD activity due to its prolonged circulating half-life. However, most clinical laboratories report G6PD activity in units g/Hb or units/1012 RBC and do not provide percentage of normal activity, making potential eligibility determination challenging. Methods Using an IRB-exempt protocol, a limited data set of consecutive G6PD quantitative results was retrieved from the clinical laboratory’s enterprise data warehouse. Laboratory testing of these specimens was previously performed at 37°C using an automated enzymatic assay (Pointe Scientific) configured on a cobas c501 chemistry analyzer (Roche Diagnostics). Data were assembled to include adults age 18 to 89 years and excluded repeat results from the same patients as well as outliers. Conclusion The final data set included 52,216 results (female, 55.9%, n = 29,173; male, 44.1%, n = 23,043) from 47 US states. An adjusted male median (100% G6PD activity) was derived using an approach proposed by the Bangkok Workshop guidelines (Domingo et al., Malaria Journal, 2013), modified to more accurately differentiate bimodal peaks in population G6PD histograms. The laboratory-specific, adjusted male median was 12.7 U g/Hb and was similar to peak values derived from alternative curve-fitting approaches. Applying this median to gender-specific data sets, 5.4% of males and 3.8% of females were found to have <70% of normal activity (<8.9 U g/Hb). This study demonstrates the feasibility of percentage-based G6PD result reporting in adults; further studies will query percentage-based reporting in pediatric populations. Population-based medians will vary based on G6PD assay type and temperature and should be established by laboratories prior to percentage-based reporting.

Evaluating Percentage-Based Reporting of Glucose-6-Phosphate Dehydrogenase (G6PD) Enzymatic Activity

2020 ◽  
Vol 154 (2) ◽  
pp. 248-254
Author(s):  
Emilia C Calvaresi ◽  
Jonathan R Genzen
Keyword(s):  
G6pd Activity ◽  
World Health ◽  
Reference Laboratory ◽  
Adult Males ◽  
Data Set ◽  
National Reference ◽  
Institutional Review ◽  
Retrospective Data Analysis ◽  
Health Organization ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract Objectives The World Health Organization recommends measurement of glucose-6-phosphate dehydrogenase (G6PD) activity before initiation of 8-aminoquinoline therapy. A new drug for malaria prophylaxis and treatment (tafenoquine) is contraindicated in patients with G6PD deficiency or unknown G6PD status given its prolonged half-life. Assessments of percentage of normal G6PD activity using laboratory-specific result distributions are not widely available, making tafenoquine-eligibility decisions potentially challenging. Methods Using an institutional review board–exempt protocol, a data set of quantitative G6PD results was retrieved from a national reference laboratory. G6PD testing was previously performed at 37 °C using an automated enzymatic assay configured on a Roche cobas c501 chemistry analyzer. Results Overall, 52,216 results from patients 18 years and older and 6,397 results from patients younger than 18 years were obtained. A modified adjusted male median of 12.7 U/g Hb was derived for adult males in this assay configuration. Result distributions showed higher G6PD activity in neonates. Conclusions Retrospective data analysis can be used to determine laboratory-specific normal G6PD activity values in clinical populations and thus can assist in clinical-eligibility considerations for 8-aminoquinoline treatment.

Risk Factor Identification, Classification and Prediction Summary of Chronic Kidney Disease

2020 ◽  
Vol 13 ◽  
Author(s):  
Pramila Arulanthu ◽  
Eswaran Perumal
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Disease Diagnosis ◽  
Medical Data ◽  
Machine Learning Algorithms ◽  
World Health ◽  
Medical Field ◽  
Data Set ◽  
Medical Issues ◽  
Health Organization

: The medical data has an enormous quantity of information. This data set requires effective classification for accurate prediction. Predicting medical issues is an extremely difficult task in which Chronic Kidney Disease (CKD) is one of the major unpredictable diseases in medical field. Perhaps certain medical experts do not have identical awareness and skill to solve the issues of their patients. Most of the medical experts may have underprivileged results on disease diagnosis of their patients. Sometimes patients may lose their life in nature. As per the Global Burden of Disease (GBD-2015) study, death by CKD was ranked 17th place and GBD-2010 report 27th among the causes of death globally. Death by CKD is constituted 2·9% of all death between the year 2010 and 2013 among people from 15 to 69 age. As per World Health Organization (WHO-2005) report, 58 million people expired by CKD. Hence, this article presents the state of art review on Chronic Kidney Disease (CKD) classification and prediction. Normally, advanced data mining techniques, fuzzy and machine learning algorithms are used to classify medical data and disease diagnosis. This study reviews and summarizes many classification techniques and disease diagnosis methods presented earlier. The main intention of this review is to point out and address some of the issues and complications of the existing methods. It is also attempts to discuss the limitations and accuracy level of the existing CKD classification and disease diagnosis methods.

Triage Management, Survival, and the Law in the Age of Ebola

2014 ◽  
Vol 9 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Frederick M Burkle ◽  
Christopher M Burkle
Keyword(s):  
Public Health ◽  
International Health ◽  
Epidemiological Data ◽  
Population Based ◽  
World Health ◽  
Economic Stability ◽  
Budget Cuts ◽  
The Public ◽  
Level 3 ◽  
Health Organization

AbstractLiberia, Sierra Leone, and Guinea lack the public health infrastructure, economic stability, and overall governance to stem the spread of Ebola. Even with robust outside assistance, the epidemiological data have not improved. Vital resource management is haphazard and left to the discretion of individual Ebola treatment units. Only recently has the International Health Regulations (IHR) and World Health Organization (WHO) declared Ebola a Public Health Emergency of International Concern, making this crisis their fifth ongoing level 3 emergency. In particular, the WHO has been severely compromised by post-2003 severe acute respiratory syndrome (SARS) staffing, budget cuts, a weakened IHR treaty, and no unambiguous legal mandate. Population-based triage management under a central authority is indicated to control the transmission and ensure fair and decisive resource allocation across all triage categories. The shared responsibilities critical to global health solutions must be realized and the rightful attention, sustained resources, and properly placed legal authority be assured within the WHO, the IHR, and the vulnerable nations. (Disaster Med Public Health Preparedness. 2014;0:1-6)

Comparativa de modelos multivariados basados en aprendizaje automático para la predicción del riesgo de diabetes en etapas tempranas

2021 ◽  
Author(s):  
◽  
Zayra Ramírez Gaytán
Keyword(s):  
World Health ◽  
Degenerative Diseases ◽  
Decision Tree Algorithm ◽  
Data Set ◽  
The World ◽  
Long Time ◽  
Life Threatening ◽  
Health Organization ◽  
Logistic Regression Algorithm ◽  
Asymptomatic Phase

Diabetes is one of the fastest-growing, life-threatening, chronic degenerative diseases. According to the World Health Organization (WHO), it has affected 422 million people worldwide in 2018. Approximately 50% of all people who suffer diabetes are not diagnosed due to the asymptomatic phase which usually lasts a long time. In this work, a data set of 520 instances has been used. The data set has been analyzed with the next three algorithms: logistic regression algorithm, decision trees and random forest. The results show that the decision tree algorithm had better performance with an AUC of 98%. Also, it was found the most common symptoms that a person with a risk of diabetes presents are polyuria, polydipsia and sudden weight loss.

scholarly journals Australian National Enterovirus Reference Laboratory annual report, 2017

2020 ◽  
Vol 44 ◽  
Author(s):  
Jason A Roberts ◽  
Linda K Hobday ◽  
Aishah Ibrahim ◽  
Bruce R Thorley
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Performance Criterion ◽  
World Health ◽  
Reference Laboratory ◽  
Surveillance Systems ◽  
Disease Surveillance System ◽  
Enterovirus A71 ◽  
Clinical Surveillance ◽  
Health Organization

Australia monitors its polio-free status by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the World Health Organization (WHO). Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2017, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 1.33 non-polio AFP cases per 100,000 children, meeting the WHO performance criterion for a sensitive surveillance system. Three non-polio enteroviruses, coxsackievirus B1, echovirus 11 and enterovirus A71, were identified from clinical specimens collected from AFP cases. Australia established enterovirus and environmental surveillance systems to complement the clinical system focussed on children and an ambiguous vaccine-derived poliovirus type 2 was isolated from sewage in Melbourne. In 2017, 22 cases of wild polio were reported with three countries remaining endemic: Afghanistan, Nigeria and Pakistan.

scholarly journals Leading causes of blindness and visual impairment in the region of Eastern Herzegovina

2006 ◽  
Vol 59 (1-2) ◽  
pp. 15-18 ◽  
Author(s):  
Lala Ceklic ◽  
Slobodanka Latinovic ◽  
Petar Aleksic
Keyword(s):  
Visual Impairment ◽  
Visually Impaired ◽  
Age Distribution ◽  
Epidemiological Studies ◽  
Population Based ◽  
World Health ◽  
Visual Disability ◽  
Common Causes ◽  
Health Organization ◽  
Blind Persons

Introduction. Visual impairment and blindness are serious social and health problems in the world. 1992 classification of visual disorders by World Health Organization has recently been implemented. The goal of this study was to determine common causes of visual impairment and blindness in the region of Eastern Herzegovina. Material and methods. In this population based study we have analyzed medical records stored in the regional Association of Visually Impaired and Blind Persons of the Republic of Srpska (Trebinje, Bileca, Foca, Eastern Sarajevo). The analysis included sex and age distribution of registered population, classification and leading causes of visual disability and blindness. Results. There are 298 registered persons with visual disability and blindness in the region of Eastern Herzegovina and Eastern Sarajevo. The prevalence of visual impairment and blindness in the aforementioned region is 0.1%. Among the studied population, there are more males than females with visual disability or blindness (56% versus 44%). Most (78%) of registered persons are blind, and only 22% are visually impaired. 43% of registered population are in the IV category and only 8.38% are registered in the II category. Only 2% of registered population are children. Common causes of visual disability and blindness in the region of Eastern Herzegovina are: glaucoma (22%), cataract (17%), myopia alta (13%), diabetic retinopathy (12%) and ocular trauma (11%). Common causes of children's visual impairment include: optic nerve anomalies, congenital cataract and premature retinopathy. Discussion and conclusion Compared with literature data, common causes of blindness and visual impairment in the region of Eastern Herzegovina do not differ significantly from those in other regions. Registration is based on the WHO model, but it is possible only by performing active epidemiological studies. .

scholarly journals Estimates of mortality rates in people with diabetes and cardiovascular disease using administrative pharmaceutical data

2019 ◽  
Vol 4 (3) ◽  
Author(s):  
Shaun Purkiss ◽  
Tessa Keegel ◽  
Hassan Vally ◽  
Dennis Wollersheim
Keyword(s):  
Cardiovascular Disease ◽  
Mortality Risk ◽  
Age Groups ◽  
Mortality Rates ◽  
World Health ◽  
Data Set ◽  
Medication Discontinuation ◽  
Disease Mortality ◽  
Health Organization

BackgroundQuantifying the mortality risk for people with diabetes is challenging because of associated comorbidities. The recording of cause specific mortality from accompanying cardiovascular disease in death certificate notifications has been considered to underestimate the overall mortality risk in persons with diabetes. Main AimDevelop a technique to quantify mortality risk from pharmaceutical administrative data and apply it to persons diagnosed with diabetes, and associated cardiovascular disease and dyslipidaemia before death. MethodsPersons with diabetes, cardiovascular disease and dyslipidaemia were identified in a publicly available Australian Pharmaceutical data set using World Health Organization anatomic therapeutic codes assigned to medications received. Diabetes associated multi-morbidity cohorts were constructed and a proxy mortality (PM) event determined from medication and service discontinuation. Estimates of mortality rates were calculated from 2004 for 10 years and compared persons with diabetes alone and associated cardiovascular disease and dyslipidemia. ResultsThis study identified 346,201 individuals within the 2004 calendar year as having received treatments for diabetes (n=51,422), dyslipidaemia (n=169,323) and cardiovascular disease including hypertension (n=280,105). Follow up was 3.3 x 106 person-years. Overall crude PM was 26.1 per 1000 person-years. PM rates were highest in persons with cardiovascular disease and diabetes in combination (47.5 per 100 person years). Statin treatments significantly improved the mortality rates in all persons with diabetes and cardiovascular disease alone and in combination over age groups >44 years (p<.001). Age specific diabetes PM rates using pharmaceutical data correlated well with Australian data from the National Diabetes Service Scheme (r=0.82) ConclusionProxy mortality events calculated from medication discontinuation in persons with chronic conditions can provide an alternative method to estimate disease mortality rates. The technique also allows the assessment of mortality risk in persons with chronic disease multi-morbidity.

scholarly journals Trajectories and Determinants of Physical Activity during COVID-19 Pandemic: A Population-Based Study of Middle-Aged and Elderly Individuals in The Netherlands

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3832
Author(s):  
Amy Hofman ◽  
Marlou A. M. Limpens ◽  
Tosca O. E. de Crom ◽  
Mohammad Arfan Ikram ◽  
Annemarie I. Luik ◽  
...  
Keyword(s):  
Physical Activity ◽  
The Netherlands ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Public Health Problem ◽  
Population Based ◽  
World Health ◽  
Major Public Health Problem ◽  
Middle Aged ◽  
Health Organization

Physical inactivity is a major public health problem, and there are concerns this might have increased during the COVID-19 pandemic. We aimed to identify distinct trajectories of physical activity over a 6-week period after the first restrictive measures and to explore determinants of these trajectories in a population-based cohort of middle-aged and elderly in the Netherlands (n = 5777). We observed that at least 59% of participants did not meet the World Health Organization recommendations for physical activity. Using latent class trajectory analyses over three time points, we identified five distinct trajectories, including four steady trajectories at different levels (very low, low, medium and high) and one increasing trajectory. Using multinomial logistic regression analyses, we observed that, compared to the ‘steadily high’ trajectory, participants in the ‘steadily very low’ trajectory were more often older, lower educated, reporting poorer physical health, more depressive symptoms, consuming a less healthy diet, smoking, and lower alcohol use, and were less often retired. A similar pattern of determinants was seen for those in the increasing trajectory, albeit with smaller effect sizes. Concluding, we observed low levels of physical activity that generally remained during the pandemic. The determinants we described can help identify groups that require additional preventive interventions.

scholarly journals A cluster of rubella in Malta, December 2007 - January 2008

2008 ◽  
Vol 13 (16) ◽  
Author(s):  
G Spiteri ◽  
A-M Fenech Magrin ◽  
M Muscat
Keyword(s):  
Close Contact ◽  
Control Unit ◽  
World Health ◽  
Work Place ◽  
Reference Laboratory ◽  
The Third ◽  
Health Organization ◽  
Travel Abroad ◽  
In The Beginning ◽  
And Control

A cluster of rubella has been identified by the Infectious Disease Prevention and Control Unit (IDCU) of Malta in the beginning of January 2008. Two men and a woman aged between 23 and 28 years were affected. The index case had onset of illness on 23 December 2007. The second case had onset of rash on 3 January and the third case displayed symptoms on 6 January 2008. Two of the three cases were laboratory-confirmed (IgM positive), the third displayed typical symptoms and was a close contact of a laboratory-confirmed case but was IgM and IgG negative. None of the affected patients had received vaccination against rubella and there was no history of recent travel abroad. All three cases were linked through a work place. Blood samples were submitted to the World Health Organization (WHO) Regional Reference Laboratory for Measles and Rubella, Luxembourg, for further investigations. None of the cases had any complications. To date no further cases have been identified.

scholarly journals Investigation of the international comparability of population-based routine hospital data set derived comorbidity scores for patients with lung cancer

Thorax ◽  
2017 ◽  
Vol 73 (4) ◽  
pp. 339-349 ◽  
Author(s):  
Margreet Lüchtenborg ◽  
Eva J A Morris ◽  
Daniela Tataru ◽  
Victoria H Coupland ◽  
Andrew Smith ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Survival ◽  
Population Based ◽  
Data Sets ◽  
Hospital Data ◽  
Data Set ◽  
Discharge Data ◽  
International Differences ◽  
Cancer Data ◽  
Comorbidity Scores

IntroductionThe International Cancer Benchmarking Partnership (ICBP) identified significant international differences in lung cancer survival. Differing levels of comorbid disease across ICBP countries has been suggested as a potential explanation of this variation but, to date, no studies have quantified its impact. This study investigated whether comparable, robust comorbidity scores can be derived from the different routine population-based cancer data sets available in the ICBP jurisdictions and, if so, use them to quantify international variation in comorbidity and determine its influence on outcome.MethodsLinked population-based lung cancer registry and hospital discharge data sets were acquired from nine ICBP jurisdictions in Australia, Canada, Norway and the UK providing a study population of 233 981 individuals. For each person in this cohort Charlson, Elixhauser and inpatient bed day Comorbidity Scores were derived relating to the 4–36 months prior to their lung cancer diagnosis. The scores were then compared to assess their validity and feasibility of use in international survival comparisons.ResultsIt was feasible to generate the three comorbidity scores for each jurisdiction, which were found to have good content, face and concurrent validity. Predictive validity was limited and there was evidence that the reliability was questionable.ConclusionThe results presented here indicate that interjurisdictional comparability of recorded comorbidity was limited due to probable differences in coding and hospital admission practices in each area. Before the contribution of comorbidity on international differences in cancer survival can be investigated an internationally harmonised comorbidity index is required.

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