scholarly journals Preliminary results of models to predict areas in the Americas with increased likelihood of Zika virus transmission in 2017

2017 ◽  
Author(s):  
◽  
Jason Asher ◽  
Christopher Barker ◽  
Grace Chen ◽  
Derek Cummings ◽  
...  
Keyword(s):  
Relative Risk ◽  
Virus Vaccine ◽  
Zika Virus ◽  
Virus Transmission ◽  
Incidence Rates ◽  
Efficacy Study ◽  
Virus Activity ◽  
Low Incidence ◽  
Study Sites

AbstractNumerous Zika virus vaccines are being developed. However, identifying sites to evaluate the efficacy of a Zika virus vaccine is challenging due to the general decrease in Zika virus activity. We compare results from three different modeling approaches to estimate areas that may have increased relative risk of Zika virus transmission during 2017. The analysis focused on eight priority countries (i.e., Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru). The models projected low incidence rates during 2017 for all locations in the priority countries but identified several subnational areas that may have increased relative risk of Zika virus transmission in 2017. Given the projected low incidence of disease, the total number of participants, number of study sites, or duration of study follow-up may need to be increased to meet the efficacy study endpoints.

scholarly journals Multiple Sclerosis incidence rate in southern Iran: A Bayesian epidemiological study

2020 ◽  
Author(s):  
Naeimehossadat Asmarian ◽  
Zahra Sharafi ◽  
Amin Mousavi ◽  
Reis Jacques ◽  
Ibon Tamayo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Relative Risk ◽  
Incidence Rate ◽  
Vitamin D3 ◽  
Poisson Model ◽  
Incidence Rates ◽  
Fars Province ◽  
Spatio Temporal ◽  
Low Incidence

Abstract Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.3 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the effects of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The effects of percentage of vitamin D intake, smoking, percentage of people with normal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province. Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.8 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D3 intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in Vitamin D3 intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.Conclusion: Spatial analysis of MS revealed low incidence rate of this disease in the south and south east of Fars province, which is due to the effects of different covariates. As suggested by previous studies, vitamin D and smoking, among all covaiates, might be associated with high incidence of MS.

scholarly journals The Association of Diabetic Retinopathy and Cardiovascular Disease: A 13-Year Nationwide Population-Based Cohort Study

2021 ◽  
Vol 18 (15) ◽  
pp. 8106
Author(s):  
Chin-Yuan Hsu ◽  
Chee-Ming Lee ◽  
Kuan-Yu Chou ◽  
Chia-Yi Lee ◽  
Hung-Chi Chen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Diabetic Retinopathy ◽  
Cohort Study ◽  
Relative Risk ◽  
Retrospective Cohort ◽  
Clinical Care ◽  
Population Based ◽  
Incidence Rates ◽  
Research Database

Objectives: Previous studies have demonstrated that patients with diabetic retinopathy (DR) have a higher prevalence of risk factors known to be associated with cardiovascular disease (CVD). We hypothesized that patients with more severe DR could have a higher relative risk of CVD. Methods: To test this hypothesis, we used the National Health Insurance Research Database (NHIRD) to evaluate whether associations exist between DR and CVD. The data for this nationwide population-based retrospective cohort study were obtained from the NHIRD in Taiwan from 2001 to 2013. The assessed study outcome used was the incidence and other statistical analyses of CVD in patients with DR during a 13-year follow-up period. Results: Our findings obtained from 2001 to 2013 suggest that the incidence rates of CVD are 2.026 times that of diabetes mellitus (DM) without DR (95% C.I. = 1.876–2.187) and 2.75 times that of DM with DR (95% C.I. = 2.487–3.04) compared with the Non-DM group. Conclusion: The relative risk of CVD in DR was greater than that in the Non-DM group for both men and women. Targeted monitoring of DM, especially the co-existence of diabetic retinopathy, is of utmost importance in the clinical care of the DM population.

scholarly journals Monitoring for Local Transmission of Zika Virus using Emergency Department Data

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Amanda Wahnich ◽  
Ramona Lall ◽  
Don Weiss
Keyword(s):  
Emergency Department ◽  
Zika Virus ◽  
Cluster Size ◽  
Virus Disease ◽  
Virus Transmission ◽  
Newyork City ◽  
Travel History ◽  
Ed Visits ◽  
Local Transmission

ObjectiveCase and cluster identification of emergency department visitsrelated to local transmission of Zika virus.IntroductionThe first travel-associated cases of Zika virus infection in NewYork City (NYC) were identified in January 2016. Local transmissionof Zika virus from imported cases is possible due to presence ofAedes albopictus mosquitos. Timely detection of local Zika virustransmission could inform public health interventions and mitigateadditional spread of illness. Daily emergency department (ED) visitsurveillance to detect individual cases and spatio-temporal clusters oflocally-acquired Zika virus disease was initiated in June 2016.MethodsED visits were classified into two Zika syndromes based onchief complaint text and the International Classification of Diseasesversion 9 and 10 diagnosis codes for patients≥6 years old: 1) feverand 2) Zika-like illness. Zika-like illness was defined as visits withmention of Zika; symptoms of rash, fever, and either joint pain orconjunctivitis; diagnosis of Guillain-Barré syndrome; or diagnosis ofrare and non-endemic arboviral infection.We applied the prospective space-time permutation scan statistic1in SaTScan daily since June 2016 to the fever syndrome, selectedas a single representative symptom, to detect clusters by hospital orzip code of patient residence. The maximum spatial cluster size is20% of observed visits, and the maximum temporal cluster size is 14days – reflecting the incubation period.2The study period is 90 days.Statistical significance is determined using Monte Carlo simulations(N=999). Any cluster with a recurrence interval≥365 days issummarized in a map and line-list of contributing visits. The mapdepicts the zip codes of the cluster with an overlay of census tracts athighest risk for human importation of Zika virus, as estimated by azero-inflated Poisson regression model developed at NYC DOHMHthat is updated regularly to reflect the most recent available data onconfirmed cases.Zika-like illness syndrome visits are output in a daily line-list.DOHMH staff contact the EDs that patients visited to determinetravel to Zika-affected country, clinical suspicion of Zika infection,and laboratory testing.ResultsDuring June 1–August 16, 2016, we observed a mean of 253(range: 202-299) ED visits for the fever syndrome per day. Sixteenspatio-temporal fever syndrome clusters have been detected. Of these,2 clusters were during testing and optimization of scan parameters,13 were due to data quality issues, and 1 was dismissed due to thelarge geographic range of the cluster, spanning 3 boroughs.During June 1–August 16, 2016, we observed a mean of 2.7(range: 0-7) ED visits for the Zika-like illness syndrome. Daily countsranged from 0-3 visits from June 1-June 16 and 1-7 visits since June16. Nineteen visits that occurred from July 31-August 4 were furtherinvestigated to establish a protocol for follow-up. Of those, elevenpatients reported recent travel to countries with local transmission,one had travel over 3 months ago and an alternate diagnosis, six hadunknown travel history due to incomplete follow-up, and one reportedno travel. The one without travel had a diagnosis inconsistent withZika virus disease. Subsequently, analysts contacted EDs only for thesubset of Zika-like illness syndrome visits with no indication of travelor without an alternate discharge diagnosis. Findings from this effortwill be presented.ConclusionsThe fever syndrome provides a means to monitor for clusters usingED data. Prospective cluster detection signal volume was manageableand has not identified clusters requiring additional investigation.The Zika-like illness syndrome can be used for case finding.Contacting EDs helps to supplement information missing in thesyndromic system, such as travel history as well as Zika testing anddiagnosis. As Zika-like illness syndrome counts are low and diseaseis emergent, contacting EDs is feasible and helpful in ruling out localZika virus transmission. No visits or clusters to-date have indicatedlocal transmission.

scholarly journals Socio-Demographic Factors Involved in a Low-Incidence Phase of SARS-CoV-2 Spread in Sicily, Italy

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 867
Author(s):  
Emanuele Amodio ◽  
Michele Battisti ◽  
Carmelo Massimo Maida ◽  
Maurizio Zarcone ◽  
Alessandra Casuccio ◽  
...  
Keyword(s):  
Demographic Data ◽  
Multivariable Analysis ◽  
Virus Transmission ◽  
Urban Mobility ◽  
Virus Spread ◽  
Low Incidence ◽  
Socio Demographic Factors ◽  
University Degree ◽  
Risk Infection

Background: The present study analysed SARS-CoV-2 cases observed in Sicily and investigated social determinants that could have an impact on the virus spread. Methods: SARS-CoV-2 cases observed among Sicilian residents between the 1 February 2020 and 15 October 2020 have been included in the analyses. Age, sex, date of infection detection, residency, clinical outcomes, and exposure route have been evaluated. Each case has been linked to the census section of residency and its socio-demographic data. Results: A total of 10,114 patients (202.3 cases per 100,000 residents; 95% CI = 198.4–206.2) were analysed: 45.4% were asymptomatic and 3.62% were deceased during follow-up. Asymptomatic or mild cases were more frequent among young groups. A multivariable analysis found a reduced risk of SARS-CoV-2 cases was found in census sections with higher male prevalence (adj-OR = 0.99, 95% CI = 0.99–0.99; p < 0.001) and presence of immigrants (adj-OR = 0.89, 95% CI 0.86–0.92; p < 0.001). Proportion of residents aged <15 years, residents with a university degree, residents with secondary education, extra-urban mobility, presence of home for rent, and presence of more than five homes per building were found to increase the risk of SARS-CoV-2 incidence. Conclusion: Routinely collected socio-demographic data can be predictors of SARS-CoV-2 risk infection and they may have a role in mapping high risk micro-areas for virus transmission.

TBE in Italy

2020 ◽  
Keyword(s):  
Surveillance System ◽  
Ad Hoc ◽  
National Level ◽  
Case Series ◽  
Incidence Rates ◽  
Mountainous Regions ◽  
North East ◽  
The North ◽  
Tick Borne Encephalitis ◽  
Low Incidence

Italy is considered a low-incidence country for tick-borne encephalitis (TBE) in Europe.1 Areas at higher risk for TBE in Italy are geographically clustered in the forested and mountainous regions and provinces in the north east part of the country, as suggested by TBE case series published over the last decade.2-5 A national enhanced surveillance system for TBE has been established since 2017.6 Before this, information on the occurrence of TBE cases at the national level in Italy was lacking. Both incidence rates and the geographical distribution of the disease were mostly inferred from endemic areas where surveillance was already in place, ad hoc studies and international literature.1

Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy — Brazil, 2015

2016 ◽  
Vol 65 (9) ◽  
Author(s):  
Wanderson Kleber de Oliveira ◽  
Juan Cortez-Escalante ◽  
Wanessa Tenório Gonçalves Holanda De Oliveira ◽  
Greice Madeleine Ikeda do Carmo ◽  
Cláudio Maierovitch Pessanha Henriques ◽  
...  
Keyword(s):  
Zika Virus ◽  
Virus Transmission ◽  
First Trimester ◽  
First Trimester Of Pregnancy

Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy — Brazil, 2015

2016 ◽  
Vol 65 (9) ◽  
pp. 242-247 ◽  
Author(s):  
Wanderson Kleber de Oliveira ◽  
Juan Cortez-Escalante ◽  
Wanessa Tenório Gonçalves Holanda De Oliveira ◽  
Greice Madeleine Ikeda do Carmo ◽  
Cláudio Maierovitch Pessanha Henriques ◽  
...  
Keyword(s):  
Zika Virus ◽  
Virus Transmission ◽  
First Trimester ◽  
First Trimester Of Pregnancy

SKIN MELANOMA INCIDENCE IN WORKERS OCUPATIONALLY EXPOSED TO IONIZING RADIATION OVER A PROLONGED PERIOD

2019 ◽  
Vol 65 (3) ◽  
pp. 441-446
Author(s):  
Valentina Rybkina ◽  
Tamara Azizova ◽  
Yevgeniya Grigoreva
Keyword(s):  
Ionizing Radiation ◽  
Gamma Rays ◽  
Disease Risk ◽  
Incidence Rates ◽  
Study Cohort ◽  
Calendar Period ◽  
Skin Melanoma ◽  
Melanoma Incidence ◽  
Occupationally Exposed

Purpose of the study. The study is aimed to investigate skin melanoma incidence in workers occupationally exposed to radiation over a prolonged period. Materials and methods. Skin melanoma incidence was studied in a cohort of workers first employed at nuclear facility Mayak Production Association (PA) between 1948 and 1982 who had been followed up till 31.12.2013 (22,377 individuals). Mean cumulative doses from external gamma-rays over the whole follow-up period were 0.54±0.001 Sv in males and 0.44±0.002 Sv in females. Incident rates for skin melanoma were analyzed by sex, attained age, calendar period of diagnostics and radiation dose using worldwide standard and the direct standardization technique. Results. 60 skin melanoma cases (37 in males and 23 in females) were registered in the study cohort over the whole follow-up period. The standardized skin melanoma incident rate was 8.51±1.46 in males and 8.78±2.27 in females per 100000 workers revealing statistically higher rates compared to corresponding rates for general populations of the Russian Federation, Urals Federal District and Chelyabinsk region. Skin melanoma incidence was significantly increased in the period of 1994 - 2013 as compared to the period of 1974 - 1993. Skin melanoma incidence excess in females was greater than that for males. Skin melanoma incidence increment in females was mostly driven by modifications of disease occurrence risk while in males it was driven by a combined effect of age pattern modifications in the study cohort and increase of disease risk. Conclusions. Skin melanoma incidence rates in the cohort of workers occupationally exposed to ionizing radiation over a prolonged period were associated with sex and attained age workers and the calendar period of diagnostics. No significant association of skin melanoma incidence with dose from external gamma-rays was observed. A significantly increasing trend was observed for skin melanoma incidence by the end of the follow-up in both males and females.

scholarly journals COVID-19 Pandemic and Helsinki University Hospital Personnel Psychological Well-Being: Six-Month Follow-Up Results

2021 ◽  
Vol 18 (5) ◽  
pp. 2524
Author(s):  
Tanja Laukkala ◽  
Jaana Suvisaari ◽  
Tom Rosenström ◽  
Eero Pukkala ◽  
Kristiina Junttila ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Psychosocial Support ◽  
Well Being ◽  
Incidence Rates ◽  
University Hospital ◽  
Hospital Personnel ◽  
Front Line ◽  
Hospital District ◽  
Variation Explained

The COVID-19 pandemic has caused an unequally distributed extra workload to hospital personnel and first reports have indicated that especially front-line health care personnel are psychologically challenged. A majority of the Finnish COVID-19 patients are cared for in the Helsinki University Hospital district. The psychological distress of the Helsinki University Hospital personnel has been followed via an electronic survey monthly since June 2020. We report six-month follow-up results of a prospective 18-month cohort study. Individual variation explained much more of the total variance in psychological distress (68.5%, 95% CI 65.2–71.9%) and negative changes in sleep (75.6%, 95% CI 72.2–79.2%) than the study survey wave (1.6%, CI 0.5–5.5%; and 0.3%, CI 0.1–1.2%). Regional COVID-19 incidence rates correlated with the personnel’s psychological distress. In adjusted multilevel generalized linear multiple regression models, potentially traumatic COVID-19 pandemic-related events (OR 6.54, 95% CI 5.00–8.56) and front-line COVID-19 work (OR 1.81, 95% CI 1.37–2.39) was associated with personnel psychological distress but age and gender was not. While vaccinations have been initiated, creating hope, continuous follow-up and psychosocial support is still needed for all hospital personnel.

scholarly journals POS1015 ANTI-TNF DRUGS AND CARDIOVASCULAR EVENTS IN PATIENTS WITH SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 775.2-776
Author(s):  
C. W. S. Chan ◽  
P. H. LI ◽  
C. S. Lau ◽  
H. Y. Chung
Keyword(s):  
Risk Factors ◽  
Psoriatic Arthritis ◽  
Cardiovascular Events ◽  
Clinical Information ◽  
Incidence Rates ◽  
Major Adverse Cardiovascular Events ◽  
Cross Sectional ◽  
Cerebrovascular Events ◽  
Cardiovascular Morbidity And Mortality

Background:Cardiovascular (CVS) diseases are the leading cause of death worldwide and patients with rheumatic diseases have an increased CVS risk including stroke and myocardial infarction (MI) (1-3). CVS risk factors and CVS events are common in SpA (4). Delineating the CVS risk and the association with medications in patients with SpA would be useful.Objectives:The objective of this study was to delineate the CVS risk and the association with medications in patients with SpA.Methods:Patients with SpA and patients with non-specific back pain (NSBP) were identified in rheumatology and orthopedics clinics respectively. Clinical information and CVS events were retrieved. Incidence rates were calculated. Association analysis was performed to determine the CVS risk of SpA and other modifiable risk factors.Results:A total of 5046 patients (SpA 2616 and NSBP 2430) were included from eight centers. Over 56 484 person-years of follow-up, 160 strokes, 84 MI and 262 major adverse cardiovascular events (MACE) were identified. Hypercholesterolemia was more prevalent in SpA (SpA 34.2%, NSBP 28.7%, P<0.01). Crude incidence rates of stroke and MI were higher in SpA patients. SpA was associated with a higher risk of MACE (HR 1.66, 95%CI 1.22-2.27, P<0.01) and cerebrovascular events (HR 1.42, 95%CI 1.01-2.00, p=0.04). The use of anti-tumor necrosis factor (TNF) drugs was associated with a reduced risk of MACE (HR 0.37, 95%CI 0.17-0.80, P=0.01) and cerebrovascular events (HR 0.21, 95%CI 0.06-0.78, P=0.02).Conclusion:SpA is an independent CVS risk factor. Anti-TNF drugs were associated with a reduced CVS risk in these patients.References:[1]Crowson CS, Liao KP, Davis JM, 3rd, Solomon DH, Matteson EL, Knutson KL, et al. Rheumatoid arthritis and cardiovascular disease. Am Heart J. 2013;166(4):622-8 e1.[2]Verhoeven F, Prati C, Demougeot C, Wendling D. Cardiovascular risk in psoriatic arthritis, a narrative review. Joint Bone Spine. 2020;87(5):413-8.[3]Liew JW, Ramiro S, Gensler LS. Cardiovascular morbidity and mortality in ankylosing spondylitis and psoriatic arthritis. Best Pract Res Clin Rheumatol. 2018;32(3):369-89.[4]Molto A, Etcheto A, van der Heijde D, Landewe R, van den Bosch F, Bautista Molano W, et al. Prevalence of comorbidities and evaluation of their screening in spondyloarthritis: results of the international cross-sectional ASAS-COMOSPA study. Ann Rheum Dis. 2016;75(6):1016-23.Disclosure of Interests:None declared.

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