693. Congenital Zika Syndrome: Assessing the Fatality Rate Since the 2015 Zika Outbreak

Abstract Background Many studies have demonstrated a causal link between Zika virus (ZIKV) infection, microcephaly (MCP) and other congenital abnormalities (CA). This study aimed to determine the perinatal case fatality rate in cases of Congenital Zika Syndrome (CZS) in the Rio Grande do Norte State (RN), a Brazilian Northeast State highly impacted by the Zika virus outbreak. Methods A cross-sectional study was conducted using data obtained through the State Health Department (SHD) for cases of MCP and CA in Rio Grande do Norte from April 2015 to December 31, 2017. Definition of perinatal period: commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth. Perinatal case fatality rate is defined as the number of deaths as a fraction of the number of sick persons with a specific disease (×100). Results During the study period, there were 519 cases of MCP and others CA notified in RN, of which 150 were confirmed and 126 remain under investigation. The remaining 243 cases have been ruled out by presenting normal exams or due to presenting microcephaly by non-infectious causes. Of the total confirmed cases, 30.0% (45/150) died after birth or during pregnancy. 64.4% (29/45) of confirmed deaths had ZIKV infection during pregnancy and 4.4% (02/45) had a positive TORCH blood test. The deaths related to Zika were confirmed using either clinical/epidemiological/radiological (the presence of typical and indicative alterations of congenital ZIKV infection) or clinical/epidemiological/serological (RT-PCR and/or IgM/IgG antibodies against ZIKV). Eleven cases remain under investigation and five were ruled out. Conclusion This study highlights a high rate of perinatal lethality (64.4%) in cases of CZS. Despite the growing number of CZS cases, the real incidence and prevalence might be higher due to the underreporting and lack of resources for confirmatory diagnostic tests (laboratory and imaging). Due to the high rate of lethality, our findings predict an increase in the infant mortality rate in areas endemic for arboviruses. Because the severe neurological complications caused by CZS, it is likely to pose a substantial burden on public spending on healthcare. This study may be used to better describe the congenital Zika syndrome, its prognosis and natural history. Disclosures All authors: No reported disclosures.

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Perinatal Case Fatality Rate Related to Congenital Zika Syndrome in Brazil: a Cross-Sectional Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.054 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S22-S22

Author(s):

Igor Thiago Queiroz ◽

Jessika Thais Da Silva Maia ◽

Gleysson Rosa ◽

Tatyana Vidal Mendes ◽

S Jayne Alves Vidal ◽

...

Keyword(s):

Case Fatality Rate ◽

Case Fatality ◽

Rio Grande ◽

Cross Sectional Study ◽

High Rate ◽

Fatality Rate ◽

Sectional Study ◽

Zikv Infection ◽

Cross Sectional ◽

Congenital Zika Syndrome

Abstract Background Many studies have demonstrated a causal link between Zika virus (ZIKV) infection, microcephaly (MCP), and other congenital abnormalities (CA). This study aimed to determine perinatal case fatality rate in cases of Congenital Zika Syndrome (CZS) in the Rio Grande do Norte State (RN), a Brazilian Northeast State highly impacted by the Zika virus outbreak. Methods A cross-sectional study was conducted using data obtained through the State Health Department (SHD) for cases of MCP and CA in Rio Grande do Norte from April 2015 to February 5, 2016. Definition of perinatal period: commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth. Results During the study period, there were 486 cases of MCP and others CA notified in RN, of which 142 were confirmed and 108 remain under investigation. The remaining 236 cases have been ruled out by presenting normal examinations or due to presenting microcephaly by noninfectious causes. Of the total confirmed cases, 26.7% (38/142) died after birth or during pregnancy. 15.78% (06/38) of confirmed deaths had ZIKV infection during pregnancy and 2.63% (01/38) had a positive TORCH blood test. The six cases related to ZIKV were confirmed by RT–PCR and/or IgM/IgG antibodies against ZIKV. The remaining cases of deaths remain either under investigation or have been ruled out. Conclusion This study highlights a high rate of perinatal lethality (15.78%) in cases of CZS. Despite the growing number of CZS cases, the real incidence and prevalence might be higher due to the underreporting and lack of resources for confirmatory diagnostic tests (laboratory and imaging). Due to the high rate of lethality and the ongoing uncontrolled ZIKV outbreak, this study predicts an increase in the infant mortality rate in Brazil and highlights the need for developing public health programs to control the ZIKV outbreak. Disclosures All authors: No reported disclosures.

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Perinatal Case Fatality Rate Related to Congenital Zika Syndrome in Brazil: A Cross-Sectional Study

Pediatric Neurology ◽

10.1016/j.pediatrneurol.2017.11.012 ◽

2018 ◽

Vol 81 ◽

pp. 47-48 ◽

Cited By ~ 2

Author(s):

Nilson N. Mendes Neto ◽

Jessika Thais da Silva Maia ◽

Marcelo Rodrigues Zacarkim ◽

Igor Queiroz ◽

Angelle Desiree Labeaud ◽

...

Keyword(s):

Case Fatality Rate ◽

Case Fatality ◽

Cross Sectional Study ◽

Fatality Rate ◽

Sectional Study ◽

Cross Sectional ◽

Congenital Zika Syndrome

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Sebaran Infeksi Leptospira Patogenik pada Tikus dan Cecurut di Daerah Pasca Banjir Kabupaten Pati dan Endemis Boyolali

BALABA JURNAL LITBANG PENGENDALIAN PENYAKIT BERSUMBER BINATANG BANJARNEGARA ◽

10.22435/blb.v13i2.279 ◽

2018 ◽

pp. 173-182

Author(s):

Zumrotus Sholichah ◽

Rahmawati Rahmawati

Keyword(s):

Case Fatality Rate ◽

Endemic Area ◽

Case Fatality ◽

Google Earth ◽

Transmission Risk ◽

Random Pattern ◽

Fatality Rate ◽

Pathogenic Leptospira ◽

Cross Sectional ◽

Cross Sectional Design

Until March 2014 leptospirosis cases and its Case Fatality Rate increased in Pati and Boyolali. This study aims to describe distribution of infected rats and shrews in flood area in Pati and endemic area in Boyolali. Research carried out by the cross sectional design on March-April 2014. Coordinate of Leptospira infected rats and shrews were mapped using google earth with home range buffer. Data analyzed descriptively to describe distribution of infected rats and shrews. Pathogenic Leptospira sp. infected rats and shrews spread with random pattern. This results could be an explanation of higher transmission risk. of leptospirosis in the area of study

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Global epidemiology of septic shock: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-032289 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032289

Author(s):

Frank Leonel Tianyi ◽

Joel Noutakdie Tochie ◽

Celestin Danwang ◽

Aime Mbonda ◽

Mazou N Temgoua ◽

...

Keyword(s):

Systematic Review ◽

Septic Shock ◽

Case Fatality Rate ◽

Hospital Admissions ◽

Meta Analysis ◽

Case Fatality ◽

Primary Study ◽

Fatality Rate ◽

Cross Sectional ◽

Global Epidemiology

BackgroundSeptic shock is a life-threatening infection frequently responsible for hospital admissions or may be acquired as nosocomial infection in hospitalized patients with resultant significant morbidity and mortality . There is a dearth of data on a résumé and meta-analysis on the global epidemiology of this potentially deadly condition. Therefore, we propose the first systematic review to synthesize existing data on the global incidence, prevalence and case fatality rate of septic shock worldwide.MethodsWe will include cross-sectional, case-control and cohort studies reporting on the incidence, and case fatality rate of septic shock. Electronic databases including PubMed, Embase, WHO Global Health Library and Web of Science will be searched for relevant records published between 1 January 2000 and 31 August 2019. Independents reviewers will perform study selection and data extraction, as well as assessment of methodological quality of included studies. Appropriate meta-analysis will then be used to pool studies judged to be clinically homogenous. Egger’s test and funnel plots will be used to detect publication bias. Findings will be reported and compared by human development level of countries.Ethics and disseminationBeing a review, ethical approval is not required as it was obtained in the primary study which will make up the review. This review is expected to provide relevant data to help in evaluating the burden of septic shock in the general population. The overall findings of this research will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019129783.

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1671. Impact of Zika Syndrome on Brazilian Infant Mortality Rate

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1535 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S611-S612

Author(s):

Nilson Nogueira Mendes Neto ◽

Jessika T da S. Maia ◽

Marcelo Zacarkim ◽

Igor T Queiroz ◽

Gleyson Rosa ◽

...

Keyword(s):

Infant Mortality ◽

Zika Virus ◽

Case Fatality ◽

Health Department ◽

Perinatal Period ◽

Cross Sectional Study ◽

Infant Mortality Rate ◽

Cross Sectional ◽

Using Data ◽

Serological Data

Abstract Background Infant mortality in Brazil has increased for the first time in 26 years. This study aimed to define the Zika Syndrome (ZS) perinatal case fatality rate (PCF) since the 2015 Zika outbreak in a Brazilian northeast state highly impacted by the virus. Methods Cross-sectional study conducted using data obtained through the State Health Department for cases of microcephaly (MCP) and congenital abnormalities (CA) in Rio Grande do Norte State (RN) from April 2015 to March 2, 2019. Perinatal period: commencing at 22 completed weeks (154 days) of gestation until 7 days after birth. PCF was defined as the number of deaths as a fraction of the number of sick persons with the specific disease (×100). Results There were 535 reported cases of MCP and others CA notified in RN during this period: 4 in 2014, 337 in 2015, 157 in 2016, 21 in 2017, 14 in 2018, and 2 in 2019. Of these, 151 were confirmed and 135 remain under investigation. The remaining 247 cases were ruled out by normal physical exams or due to noninfectious cause of MCP. Of the total confirmed cases, 35.8% (54/151) died after birth or during pregnancy. Zika virus infection during pregnancy was confirmed in 55.5% (30/54) of deaths and 1.8% (01/54) had a positive TORCH blood test. The odds ratio for the Zika PCF was found to be 1.57 (95% CI: 0.7940–3.1398; P = 0.1928). Deaths related to Zika were confirmed using a combination of clinical and epidemiological findings paired with either radiological information or molecular/serological data (RT–PCR and/or IgM/IgG antibodies against Zika). Twelve cases remain under investigation and 7 were ruled out as MCP. The highest number of confirmed MCP cases occurred between August 2015 and February 2016. The prevalence increased in September, with a peak in November 2015 (20.1 cases per 1,000 live births). Conclusion Before the recent Brazilian Zika outbreak, the incidence of MCP in RN between 2010 and 2014 was 1.8 cases/year. The real incidence and prevalence might be higher due to the underreporting and lack of resources for confirmatory diagnostic tests (laboratory and imaging). This study indicates that Zika virus accounted for a substantial proportion of MCP cases seen during the years studied, and suggests that ZS contributed to an increase in infant mortality in Brazil. Disclosures All authors: No reported disclosures.

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Road Traffic Collisions—Case Fatality Rate, Crash Injury Rate, and Number of Motor Vehicles: Time Trends between a Developed and Developing Country

The American Surgeon ◽

10.1177/000313481007600933 ◽

2010 ◽

Vol 76 (9) ◽

pp. 977-981 ◽

Cited By ~ 3

Author(s):

Sanchia S. Goonewardene ◽

Khalid Baloch ◽

Keith Porter ◽

Ian Sargeant ◽

Gamini Punchihewa

Keyword(s):

Visual Impairment ◽

Case Fatality Rate ◽

Road Traffic ◽

Case Fatality ◽

Injury Rate ◽

Cross Sectional Study ◽

Motor Vehicles ◽

Fatality Rate ◽

Cross Sectional ◽

The Uk

Road traffic collisions (RTCs) are one of the most common preventable causes of death and disability worldwide. We investigated changes in numbers of motor vehicles, case fatality rate, and crash injury rate for the most present recorded year (2002) 5 and 10 years before that in the United Kingdom (UK) and Sri Lanka (SL). We also investigated environmental and individual factors impacting patients at South Birmingham Trauma Unit, UK and Colombo General Hospital, SL. We conducted a descriptive cross-sectional study (both quantitative and qualitative). Over the 10-year period, numbers of motor vehicles have risen in both countries; the crash injury remained stable in both countries. Case fatality rate (far higher) in SL has decreased, as in the UK. Three hundred and twenty-five patients took part in the survey in SL, with 83 in the UK. In the categories investigated, including patient demographics, RTC environment, visual impairment, pedestrian and driver factors, the majority of results were significantly different between the two countries. Target factors such as inadequate street lighting, visual impairment, speeding, and not wearing seatbelts at time of accident were identified, and recommendations developed as a result.

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Regional Differences in Epidemiological and Clinical Characteristics, Treatment, and Clinical Outcomes of COVID-19 in Wuhan and Remote Areas of Hubei Province

Frontiers in Medicine ◽

10.3389/fmed.2021.667623 ◽

2021 ◽

Vol 8 ◽

Author(s):

Honggang Ren ◽

Xingyi Guo ◽

Antonio Palazón-Bru ◽

Pengcheng Yang ◽

Nan Huo ◽

...

Keyword(s):

Regional Differences ◽

Case Fatality Rate ◽

Clinical Characteristics ◽

Case Fatality ◽

Cross Sectional Study ◽

Hubei Province ◽

Fatality Rate ◽

Cross Sectional ◽

Suburban Areas

Background: The Coronavirus disease 2019 (COVID-19) pandemic has been a major threat to global health. Regional differences in epidemiological and clinical characteristics, treatment and outcomes of patients have not yet been investigated. This study was conducted to investigate these differences amongCOVID-19 patients in Hubei Province, China.Methods: This retrospective cross-sectional study analyzed data on 289 COVID-19 patients from designated hospitals in three regions:Urban (Wuhan Union West Hospital), Suburban areas of Wuhan (Hannan Hospital) and Enshi city, between February 8 and 20, 2020. The final date of follow-up was December 14th, 2020. The outcomes were case fatality rate and epidemiological and clinical data.Results: Urban Wuhan experienced a significantly higher case fatality rate (21.5%) than suburban Wuhan (5.23%) and rural area of Enshi (3.51%). Urban Wuhan had a higher proportion of patients on mechanical ventilation (24.05%) than suburban Wuhan (0%) and rural Enshi (3.57%). Treatment with glucocorticoids was equivalent in urban and suburban Wuhan (46.84 and 45.75%, respectively) and higher than Enshi (25.00%). Urban Wuhan had a higher proportion of patients with abnormal tests including liver function and serum electrolytes and a higher rate of pneumonia (p < 0.01 for all). Urban Wuhan also had a higher incidence of respiratory failure, heart disease, liver disease and shock, compared with the other two regions (all p < 0.05).Conclusions: Our findings revealed that there are regional differences in COVID-19. These findings provide novel insights into the distribution of appropriate resources for the prevention, control and treatment of COVID-19 for the global community.

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Case Fatality Rate Related to Microcephaly Congenital Zika Syndrome and Associated Factors: A Nationwide Retrospective Study in Brazil †

Viruses ◽

10.3390/v12111228 ◽

2020 ◽

Vol 12 (11) ◽

pp. 1228

Author(s):

Maria Conceição N. Costa ◽

Luciana Lobato Cardim ◽

Maria Gloria Teixeira ◽

Mauricio L. Barreto ◽

Rita de Cassia Oliveira de Carvalho-Sauer ◽

...

Keyword(s):

Case Fatality Rate ◽

Very Low Birth Weight ◽

Clinical Manifestations ◽

Case Fatality ◽

Preterm Births ◽

Population Based ◽

Fatality Rate ◽

Maternal Characteristics ◽

Logistic Regression Models ◽

Congenital Zika Syndrome

Background: The clinical manifestations of microcephaly/congenital Zika syndrome (microcephaly/CZS) have harmful consequences on the child’s health, increasing vulnerability to childhood morbidity and mortality. This study analyzes the case fatality rate and child–maternal characteristics of cases and deaths related to microcephaly/CZS in Brazil, 2015–2017. Methods: Population-based study developed by linkage of three information systems. We estimate frequencies of cases, deaths, case fatality rate related to microcephaly/CZS according to child and maternal characteristics and causes of death. Multivariate logistic regression models were applied. Results: The microcephaly/CZS case fatality rate was 10% (95% CI 9.2–10.7). Death related to microcephaly/CZS was associated to moderate (OR = 2.15; 95% CI 1.63–2.83), and very low birth weight (OR = 3.77; 95% CI 2.20–6.46); late preterm births (OR = 1.65; 95% CI 1.21–2.23), Apgar < 7 at 1st (OR = 5.98; 95% CI 4.46–8.02) and 5th minutes (OR = 4.13; 95% CI 2.78–6.13), among others. Conclusions: A high microcephaly/CZS case fatality rate and important factors associated with deaths related to this syndrome were observed. These results can alert health teams to these problems and increase awareness about the factors that may be associated with worse outcomes.

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Case Fatality Rate of COVID-19 and Association With Sociodemographic Characteristics of Populations in Ecuador, 2020

10.21203/rs.3.rs-444898/v1 ◽

2021 ◽

Author(s):

Karla Flores Sacoto ◽

Galo Sánchez Del Hierro ◽

Xavier Jarrín Estupiñan ◽

Felipe Moreno-Piedrahita Hernandez

Keyword(s):

Death Rate ◽

Case Fatality Rate ◽

Case Fatality ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Morbidity Rate ◽

Fatality Rate ◽

Cross Sectional ◽

The Impact

Abstract Background COVID-19 has caused deaths worldwide affecting the most vulnerable population with different case fatality rates. Socioeconomic conditions have demonstrated a role regarding the spread of infections and mortality. Socioeconomic characteristics of Ecuador related to poverty, ethnicity and demographic characteristics increase the impact of COVID-19 in certain populations. Methods Objective To analyze the influence of demographic factors on the COVID-19 case fatality rate (CFR) in Ecuador. Design: cross sectional study. Setting 24 provinces in Ecuador-221 cantons. Population: data including 233.277 confirmed COVID-19 cases of Ecuador. Primary and secondary outcome measures COVID-19 CFR and crude cause-specific death rate weight calculated using province-country level data from health ministry of Ecuador in data website. Results Ecuadors CFR is 4,03%, analyzed by cantons the CFR increases to a median of 5,75%, with cantons like Playas with a CFR of 32,39%. The morbidity rate has a median of 795,31 per 100 000 hab. with the highest rate in Isabela-Galápagos (10185,49), Aguarico-Orellana (9506,75) and Baños-Tungurahua (4156,85). And the crude COVID-19 death rate has a median of 39,73 per 100 000 hab. with the highest rate in Penipe-Chimborazo (201,29), 24 de Mayo-Manabí (143,79) and San Pedro de Huaca-Carchi (134,36). The correlations show relations with sociodemographic factors like poverty, ethnicity and scholarity. Conclusion The CFR is the proxy indicator of COVID-19 impact in Ecuador and the analysis made by location give us new information about the specific impact of this disease.

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ANALISIS FAKTOR-FAKTOR YANG MEMPENGARUHI OUTCOME TERAPI PASIEN PNEUMONIA DI RUMAH SAKIT UMUM PUSAT FATMAWATI JAKARTA

Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) ◽

10.22487/j25020749.2019.v5.i3.14049 ◽

2019 ◽

Vol 5 (3) ◽

pp. 18

Author(s):

Feri Setiadi ◽

Shirly Kumala ◽

Hesty Utami R ◽

Ahmad Subhan

Keyword(s):

Case Fatality Rate ◽

Case Fatality ◽

Community Acquired Pneumonia ◽

Fatality Rate ◽

Chi Square ◽

Cross Sectional ◽

Hospital Acquired Pneumonia ◽

Hospital Acquired

Berdasarkan data Riset Kesehatan Dasar (Riskesdas)2018 prevalensi pneumonia di jakarta 2.3 %. Pneumoni mempunyai case fatality rate (CFR) yang tinggi yaitu 7.6% sehingga beresiko mempunyai outcome terapi yang tidak baik. Oleh karena itu penelitian ini bertujuan menganalisis faktor-faktor yang mempengaruhi outcome terapi pasien pneumonia di RSUP Fatmawati. Penelitian ini dilakukan secara retrospektif dengan metode cross sectional pada pasien pneumonia (hospital acquired pneumonia/HAP dan community-acquired pneumonia/CAP) yang memenuhi kriteria inklusi selama periode januari-september 2018. Penelitian ini dilakukan dengan pengkajian data rekam medis pasien. Ada dua jenis outcome terapi yang digunakan yaitu pasien pulang/sembuh dan pasien meninggal. Analisis faktor yang mempengaruhi outcome dilakukan dengan uji chi square menggunakan SPSS. Selama penelitian didapatkan 40 pasien memenuhi kriteria inklusi terdiri dari 22 HAP dan 18 CAP. Hasil umur pasien (65.0%) berada pada kelompok usia 17-65 tahun. Lebih banyak pasien laki-laki (57.5%) dibandingkan pasien perempuan (42.5%). Sebagian besar pasien (37.5%) di rawat selama 8-14 hari. Penggunaan antibiotik (35.0%) terbanyak digunakan antibiotik ceftriaxone golongan sefalosporin. Proporsi pasien dengan outcome sembuh/pulang sebanyak (52.5%) dan pasien meninggal ( 47.5%). Hasil analisis statistik menunjukkan faktor yang signifikan mempengaruhi outcome adalah penyakit penyerta (P=0.022) Adapun faktor yang tidak ada hubungan bermakna terhadap outcome pasien pneumonia yaitu: usia pasien, lama perawatan dan kerasionalan antibiotik.

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