scholarly journals The social and spatial ecology of dengue presence and burden during an outbreak in Guayaquil, Ecuador, 2012

2017 ◽  
Author(s):  
Catherine A. Lippi ◽  
Anna M. Stewart-Ibarra ◽  
Ángel G. Muñoz ◽  
Mercy J. Borbor ◽  
Raúl Mejía ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Garbage Collection ◽  
Significant Risk ◽  
Dengue Case ◽  
List Type ◽  
Housing Conditions ◽  
Social Ecological ◽  
Piped Water ◽  
Block Level

AbstractDengue fever, a mosquito-borne viral disease, is an ongoing public health problem in Ecuador and throughout the tropics, yet we have a limited understanding of the disease transmission dynamics in these regions. The objective of this study was to characterize the spatial dynamics and social-ecological risk factors associated with a recent dengue outbreak in Guayaquil, Ecuador. We examined georeferenced dengue cases (n = 4,248) and block-level census data variables to identify potential social-ecological variables associated with the presence and burden of dengue fever in Guayaquil in 2012. We applied LISA and Moran’s I tests to analyze hotspots of dengue cases and used multimodel selection in R computing language to identify covariates associated with dengue incidence at the census zone level. Significant hotspots of dengue transmission were found near the North Central and Southern portions of Guayaquil. Significant risk factors for presence of dengue included poor housing conditions (e.g., poor condition of ceiling, floors, and walls), access to paved roads, and receipt of remittances. Counterintuitive positive correlations with dengue presence were observed with several municipal services such as garbage collection and access to piped water. Risk factors for the increased burden of dengue included poor housing conditions, garbage collection, receipt of remittances, and sharing a property with more than one household. Social factors such as education and household demographics were negatively correlated with increased dengue burden. Our findings elucidate underlying differences with dengue presence and burden and indicate the potential to develop dengue vulnerability and risk maps to inform disease prevention and control - information that is also relevant for emerging epidemics of chikungunya and zika.HighlightsIn 2012, Guayaquil, Ecuador had a large outbreak of dengue casesDengue case presence and burden exhibited spatial heterogeneity at the census block levelSocial-ecological drivers of case presence and burden differed in this outbreak, highlighting the need to model both types of epidemiological dataAccess to municipal resources such as garbage collection and piped water had counterintuitive relationships with dengue presence, but poor housing, garbage collection and remittances correlated to dengue burden.Our findings inform risk mapping and vector control and surveillance allocation, relevant to this and other concurrent emergent epidemics such as chikungunya and zika

Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Fatality ◽  
Case Control ◽  
Case Definition ◽  
P Value ◽  
Factors Associated ◽  
Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

scholarly journals A community based case-control study to determine the risk factors of dengue fever in Bangladesh

2021 ◽  
Author(s):  
Md. Sahidur Rahman ◽  
Fatema Mehejabin ◽  
Rumana Rashid
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Potential Risk ◽  
Case Control Study ◽  
Dengue Infection ◽  
Significant Risk ◽  
Case Control ◽  
College Hospital ◽  
Tropical Country ◽  
Control Study

In a tropical country like Bangladesh where the climatic condition favors the growth of Aedes mosquito vectors, the success of dengue prevention depends largely on the proper identification and controlling of the socio-demographic and lifestyle-related risk factors. A case-control study including 150 cases and 150 controls were conducted aimed to explore the potential risk and protective factors and their association with dengue virus infection in the Chattogram district of Bangladesh. Cases were confirmed for dengue patients admitted in Chattogram medical college hospital and Bangladesh institute of tropical and infectious diseases during August and September 2019. Whereas, controls were non-dengue patients admitted in other departments of the same hospitals through gender age and location matching. The questionnaire data were collected through telephone-based interviews which included information regarding general demography, daily life activities, housing with its surroundings status. Chi-square and binary logistic regression were performed for identifying potential risk factors and their association with the occurrences of dengue fever. The study found that travel history to the high incidence area, the place of staying most of the time, living in 21 to 40 years old houses, and the temporary residence of the city were statistically significant risk factors for getting the dengue infection. On contrary, Quality of indoor daylight, ventilation, bus stand/garage, stagnant water, and any construction site around 250 meters of the house did not show significant association with dengue fever.

scholarly journals Central venous catheter-associated thrombosis in children with congenital hyperinsulinism

2019 ◽  
Vol 2019 ◽  
Author(s):  
Daphne Yau ◽  
Maria Salomon-Estebanez ◽  
Amish Chinoy ◽  
John Grainger ◽  
Ross J Craigie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Venous Catheter ◽  
Significant Proportion ◽  
Significant Risk ◽  
Venous Catheter ◽  
Bleeding Complications ◽  
Compound Heterozygous ◽  
Congenital Hyperinsulinism ◽  
List Type ◽  
Central Venous

Summary Congenital hyperinsulinism (CHI) is an important cause of severe hypoglycaemia in infancy. To correct hypoglycaemia, high concentrations of dextrose are often required through a central venous catheter (CVC) with consequent risk of thrombosis. We describe a series of six cases of CHI due to varying aetiologies from our centre requiring CVC for the management of hypoglycaemia, who developed thrombosis in association with CVC. We subsequently analysed the incidence and risk factors for CVC-associated thrombosis, as well as the outcomes of enoxaparin prophylaxis. The six cases occurred over a 3-year period; we identified an additional 27 patients with CHI who required CVC insertion during this period (n = 33 total), and a separate cohort of patients with CHI and CVC who received enoxaparin prophylaxis (n = 7). The incidence of CVC-associated thrombosis was 18% (6/33) over the 3 years, a rate of 4.2 thromboses/1000 CVC days. There was no difference in the frequency of genetic mutations or focal CHI in those that developed thromboses. However, compound heterozygous/homozygous potassium ATP channel mutations correlated with thrombosis (R2 = 0.40, P = 0.001). No difference was observed in CVC duration, high concentration dextrose or glucagon infused through the CVC. In patients receiving enoxaparin prophylaxis, none developed thrombosis or bleeding complications. The characteristics of these patients did not differ significantly from those with thrombosis not on prophylaxis. We therefore conclude that CVC-associated thrombosis can occur in a significant proportion (18%) of patients with CHI, particularly in severe CHI, for which anticoagulant prophylaxis may be indicated. Learning points: CVC insertion is one of the most significant risk factors for thrombosis in the paediatric population. Risk factors for CVC-associated thrombosis include increased duration of CVC placement, malpositioning and infusion of blood products. To our knowledge, this is the first study to evaluate CVC-associated thrombosis in patients with congenital hyperinsulinism (CHI). The incidence of CVC-associated thrombosis development is significant (18%) in CHI patients and higher compared to other neonates with CVC. CHI severity may be a risk factor for thrombosis development. Although effective prophylaxis for CVC-associated thrombosis in infancy is yet to be established, our preliminary experience suggests the safety and efficacy of enoxoaparin prophylaxis in this population and requires on-going evaluation.

scholarly journals Social-ecological factors and preventive actions decrease the risk of dengue infection at the household-level: results from a prospective dengue surveillance study in Machala, Ecuador

2017 ◽  
Author(s):  
Aileen Kenneson ◽  
Efraín Beltrán-Ayala ◽  
Mercy J. Borbor-Cordova ◽  
Mark E. Polhemus ◽  
Sadie J. Ryan ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Vector Control ◽  
Disease Outbreaks ◽  
Ecological Factors ◽  
Bed Nets ◽  
Household Level ◽  
Social Ecological ◽  
Piped Water ◽  
Abandoned Properties

ABSTRACTBackgroundIn Ecuador, dengue virus (DENV) infections transmitted by the Aedes aegypti mosquito are among the greatest public health concerns in urban coastal communities. Community- and household-level vector control is the principal means of controlling disease outbreaks. This study aimed to assess the impact of knowledge, attitudes, and practices (KAPs) and social-ecological factors on the presence or absence of DENV infections in the household..MethodsIn 2014 and 2015, individuals with DENV infections from sentinel clinics were invited to participate in the study, as well as members of their household and members of four neighboring households located within 200 meters. We conducted diagnostic testing for DENV on all study participants; we surveyed heads of households (HOHs) regarding demographics, housing conditions and KAPs. We compared KAPs and social-ecological factors between households with (n=139) versus without (n=80) DENV infections, using bivariate analyses and multivariate logistic regression models with and without interactions.ResultsSignificant risk factors in multivariate models included proximity to abandoned properties, interruptions in piped water, and shaded patios (p<0.05). Significant protective factors included use of mosquito bed nets, fumigation inside the home, piped water inside the home (p<0.05). In bivariate analyses (but not multivariate modeling), DENV infections was positively associated with HOHs who were male, employed, and of younger age than households without infections (p<0.05). DENV infections were not associated with knowledgeattitude, or reported barriers to prevention activities.DiscussionSpecific actions that can be considered to decrease the risk of DENV infections in the household include targeting vector control in highly shaded properties, fumigating inside the home, and use of mosquito bed nets. Community-level interventions include clean-up of abandoned properties, daily trash pick-up, and reliable piped water inside houses. These findings can inform interventions to reduce the risk of other diseases transmitted by the Ae. aegypti mosquito, such as chikungunya and Zika fever.Author summaryDengue, chikungunya and Zika viruses are transmitted to people primarily by the Aedes aegypti mosquitoes in tropical and subtropical regions. Diseases transmitted by the Ae. aegypti mosquito are a growing public health concern. Mosquito control is the principal means of preventing and controlling disease outbreaks. In this study, we compared the characteristics of households with and without DENV infections in the city of Machala, Ecuador. We found that risk factors for DENV infection included proximity to abandoned properties, interruptions in the piped water supply, and a highly shaded patio. Protective factors included the use of mosquito bed nets, fumigation inside the home, and piped water inside the home. These findings can be used to inform targeted vector control interventions by the public health sector at the household and community levels.

scholarly journals Risk Factors of Dengue Fever Outbreak in Karo District, North Sumatera, Indonesia

2019 ◽  
Vol 5 (1) ◽  
pp. 16-22
Author(s):  
Frans Yosep Sitepu
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Significant Risk ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Control Measures ◽  
Breeding Sites ◽  
Mosquito Breeding

Dengue fever (DF) infection continues to present a seriuos public health problem in North Sumatera, Indonesia. A DF outbreak was reported in Merek Sub-district, Karo District which is one tourist destination in North Sumatera during April-May 2017. An epidemiological investigation was conducted to identify the risk factors and recommend control measures. An observational study with a matched case control design was conducted. A case was defined as any resident of Merek sub-district who had suffer major clinical symptoms of DF such as fever, severe headache, pain behind eyes, muscle and joint pains, and rash from April – May, 2017. A control was defined as neighbors of cases who did not have clinical signs and symptoms of DF and were matched for age and sex. We interviewed 37 cases and 37 controls. Age cases ranged from 2 year to 37 years (median= 12 years). The multivariate analyses showed that presence of mosquito breeding sites (OR=4.87, 95%CI=1.33-17.85) and habit of hanging worn clothes (OR=5.12, 95%CI=1.25-21.03) were significant risk factors. It is recommended to eliminate mosquito breeding sites routinely, avoid habit of hanging worn clothes, and conduct strict surveillance of DF continously.

Risk factors of Dengue fever in urban areas of district Rawalpindi, Pakistan- 2017 (Preprint)

2021 ◽  
Author(s):  
Najma Javed Awan ◽  
Ambreen Chaudhry ◽  
Zakir Hussain ◽  
Zeeshan Iqbal Baig ◽  
Mirza Amir Baig ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Urban Areas ◽  
Febrile Illness ◽  
Control Measures ◽  
Dengue Case ◽  
Outbreak Area ◽  
Orbital Pain ◽  
Serotype Identification ◽  
At Home

BACKGROUND During August 2017, an increased number of suspected dengue fever cases were reported in the hospitals of district Rawalpindi. A case control study was conducted to measure the extent of the outbreak, to determine the risk factors, and recommend preventive measures. OBJECTIVE To determine the risk factors and recommend control measures. METHODS A case was defined as an acute febrile illness with one or more of the following; retro-orbital pain, headache, rash, myalgia, arthralgia, and hemorrhage, confirmed with ELISA among residents of Rawalpindi district from 30th Aug- 30th Oct. 2017. All ELISA confirmed cases were recruited from the hospital. Age and sex matched controls were selected from the same community. Frequencies, univariate and multivariate analysis was performed using epi Info 7. RESULTS Total 373 cases were recruited. The mean age was 36±2.9 years (range:10-69yeras) and 75% were male. The most affected age group was 21-30 years (AR 40%) followed by 31-40 years (AR 23%). Two deaths were reported (CFR 0.53%). The most frequent signs/symptoms were; fever (100%), myalgia (86%) headache (86%), and retro-orbital pain (73%). Serotype identification carried out in 322 cases and DEN-2 was dominant (34%, n=126). Contact with a confirmed dengue case (OR 4.27, CI: 3.14-5.81, P<0.0001) and stored water in open containers at home (OR 2.04, CI: 1.53-2.73, P <0.0001) and travel to a dengue outbreak area (OR 2.88, CI: 2.12-3.92, P<0.0001) had higher odds while the use of mosquito repellents (OR 0.12, CI 0.09-0.18, P < 0.0001) and regular water supply at home (OR 0.03, CI: 0.02-0.04, P <0.0001) showed a protective effect. Geographical distribution was limited to densely populated areas and all the water samples were tested positive for dengue larvae. CONCLUSIONS Stored water in containers inside houses and subsequent mosquito breeding was the most probable cause of this outbreak. The study led to a recommendation to undertake activities to improve the use of repellents and remove sources of breeding (indoor uncovered stored water).

scholarly journals Exploring the utility of social-ecological and entomological risk factors for dengue infection as surveillance indicators in the dengue hyper-endemic city of Machala, Ecuador

2020 ◽  
Author(s):  
Catherine Lippi ◽  
Anna M. Stewart-Ibarra ◽  
Timothy P. Endy ◽  
Mark Abbott ◽  
Cinthya Cueva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aedes Aegypti ◽  
Dengue Infection ◽  
Good Condition ◽  
Ecological Factors ◽  
Dengue Case ◽  
Infection Status ◽  
Household Level ◽  
Targeted Interventions ◽  
Social Ecological

The management of mosquito-borne diseases is a challenge in southern coastal Ecuador, where dengue is hyper-endemic and co-circulates with other arboviral diseases. Prior work in the region has explored social-ecological factors, dengue case data, and entomological indices. In this study, we bring together entomological and epidemiological data to describe links between social-ecological factors associated with risk of dengue transmission at the household level in Machala, Ecuador. Households surveys were conducted from 2014-2016 to assess the presence of adult Aedes aegypti (collected via aspiration) and to enumerate housing conditions, demographics, and mosquito prevention behaviors. Household-level dengue infection status was determined by laboratory diagnostics in 2014-2015. Logistic models and multimodel selection were used to identify social-ecological variables associated with household presence of female Ae. aegypti and household dengue infection status, respectively. We identified significant risk factors for household-level dengue infection reflecting household condition, including bamboo cane construction material, shaded patios, and adjacency to abandoned properties, while housing structures in good condition were identified as protective against dengue infection. Aedes aegypti presence was associated with a greater than average number people per household and interrupted water supply, but was not associated with household level dengue infections. Models of Ae. aegypti presence were unstable, and not well resolved in ranking of competing models, suggesting that highly localized entomological surveillance indicators may not be indicative of risk in communities with hyperendemic dengue fever. These findings add to our understanding of the systems of mosquito-borne disease transmission in Machala, and in the larger region of southern Ecuador, aiding in the development of improved vector surveillance efforts, and targeted interventions.

scholarly journals Exploring the utility of social-ecological and entomological risk factors for dengue infection as surveillance indicators in the dengue hyper-endemic city of Machala, Ecuador

2021 ◽  
Vol 15 (3) ◽  
pp. e0009257
Author(s):  
Catherine A. Lippi ◽  
Anna M. Stewart-Ibarra ◽  
Timothy P. Endy ◽  
Mark Abbott ◽  
Cinthya Cueva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aedes Aegypti ◽  
Dengue Infection ◽  
Good Condition ◽  
Ecological Factors ◽  
Dengue Case ◽  
Infection Status ◽  
Household Level ◽  
Targeted Interventions ◽  
Social Ecological

The management of mosquito-borne diseases is a challenge in southern coastal Ecuador, where dengue is hyper-endemic and co-circulates with other arboviral diseases. Prior work in the region has explored social-ecological factors, dengue case data, and entomological indices. In this study, we bring together entomological and epidemiological data to describe links between social-ecological factors associated with risk of dengue transmission at the household level in Machala, Ecuador. Households surveys were conducted from 2014–2017 to assess the presence of adult Aedes aegypti (collected via aspiration) and to enumerate housing conditions, demographics, and mosquito prevention behaviors. Household-level dengue infection status was determined by laboratory diagnostics in 2014–2015. Bivariate analyses and multivariate logistic regression models were used to identify social-ecological variables associated with household presence of female Ae. aegypti and household dengue infection status, respectively. Aedes aegypti presence was associated with interruptions in water service and weekly trash collection, and household air conditioning was protective against mosquito presence. Presence of female Ae. aegypti was not associated with household dengue infections. We identified shaded patios and head of household employment status as risk factors for household-level dengue infection, while window screening in good condition was identified as protective against dengue infection. These findings add to our understanding of the systems of mosquito-borne disease transmission in Machala, and in the larger region of southern Ecuador, aiding in the development of improved vector surveillance efforts, and targeted interventions.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

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