scholarly journals Estimating the incidence of typhoidal Salmonella from cross-sectional serology using antibody dynamics following infection

2021 ◽  
Author(s):  
Kristen Aiemjoy ◽  
Jessica C Seidman ◽  
Senjuti Saha ◽  
Sira Jam Munira ◽  
Mohammad Saiful Islam Sajib ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Rank Order ◽  
Population Level ◽  
Incidence Rates ◽  
Clinical Severity ◽  
Igg Antibody ◽  
Two Phase ◽  
Cross Sectional ◽  
Catchment Areas

The incidence of enteric fever, an invasive bacterial infection caused by typhoidal Salmonellae, is largely unknown in regions lacking blood culture surveillance. New serologic markers have proven accurate in diagnosing enteric fever, but whether they could be used to reliably estimate population-level incidence is unknown. We collected longitudinal blood samples from blood culture-confirmed enteric fever cases enrolled from surveillance studies in Bangladesh, Nepal, Pakistan and Ghana and conducted cross-sectional sero-surveys in the catchment areas of each surveillance site. We used ELISAs to measure quantitative IgA and IgG antibody responses to Hemolysin E (HlyE) and S. Typhi lipopolysaccharide (LPS). We used Bayesian hierarchical models to fit two-phase power-function decay models to the longitudinal sero-responses among enteric fever cases and used the joint distributions of the peak antibody titers and decay rate to estimate population-level incidence rates from cross-sectional serosurveys. The longitudinal antibody kinetics for all antigen-isotypes were similar across countries and did not vary by clinical severity. The incidence of typhoidal Salmonella infection ranged between 41.2 per 100 person years (95% CI: 34.0-50.1) in Dhaka, Bangladesh to 5.8 (95% CI: 4.8-7.1) in Kavrepalanchok, Nepal and followed the same rank order as clinical incidence estimates. The approach described here has the potential to expand the geographic scope of typhoidal Salmonella surveillance and generate incidence estimates that are comparable across geographic regions and time.

scholarly journals Comparison of Antibody Titre Against Salmonella Species among Healthy Individuals and Febrile Patients

2018 ◽  
Vol 14 (3) ◽  
pp. 132-136
Author(s):  
Achut Barakoti ◽  
Junu Richhinbung Rai ◽  
Ram Prasad Adhikari ◽  
Laxmi Kant Khanal
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Significant Proportion ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Resource Limited ◽  
Culture Positive ◽  
Apparently Healthy

Background: Widal tube agglutination test is a widely used laboratory test for diagnosis of enteric fever   especially in resource limited countries where blood culture are not routinely available. We studied the titres from different groups including febrile and healthy populations in order to identify the significant agglutination titre. Materials and Methods: This was a hospital based cross-sectional study. Subjects were divided into three groups: 1) 60 healthy blood samples from volunteer students, 2) 60 febrile non-typhoidal cases and 3) 58 culture positive patient for enteric fever. Results: Among 60 apparently healthy volunteers, agglutination of ≥ 1:20 for anti O and anti-H titres against serotype Typhi were seen in 40 and 46 samples respectively. A significant proportion of   sample had a titre of ≥1:80 (n=19) and 1:160 (n=14) for anti O and anti-H titres against serotype Typhi respectively among healthy individuals. Similar observations were seen in febrile non typhoidal cases except for one which had a titre of ≥1:320 for anti O and anti-H titres against serotype Typhi. In blood culture positive typhoid cases, 56 samples showed agglutinations of ≥1:80 for both anti O and anti-H titres against serotype Typhi. However two of the total sample tested showed no agglutinations. In all cases from three groups, anti-H titre for S. enterica serotype Paratyphi A and B were below 1:80. Conclusions: Widal test can be used as presumptive diagnostic tool in all the suspected cases of enteric fever if the titres are specifically raised.Keywords: enteric fever; titre; widal aggultination test. 

scholarly journals Pattern of Antibiotic Sensitivity in Enteric Fever: A Tertiary Care Hospital Experience

2014 ◽  
Vol 15 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Md. Mehedi Hasan ◽  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
...  
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Drug Resistant Strains

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124

Cross-sectional surveys

2020 ◽  
pp. 127-144
Author(s):  
Martin Prince ◽  
Jayati Das-Munshi
Keyword(s):  
Mental Disorders ◽  
Population Level ◽  
Cross Sectional Study ◽  
Psychiatric Epidemiology ◽  
Service Planning ◽  
Base Population ◽  
Sectional Study ◽  
Two Phase ◽  
Cross Sectional ◽  
Study Designs

This chapter provides an overview of cross-sectional study designs. The chapter covers the application of cross-sectional surveys, the importance of defining the base population and methods to determine sampling, the issues of non-response, representativeness, and generalizability in cross-sectional surveys, as well as more specific methodological issues such as two-phase surveys. The practicalities of conducting cross-sectional surveys from initial design stages through to analyses and dissemination stages are covered. An overview is provided on the strength and limitations of cross-sectional surveys and their application to wider contexts, where there may be concerns around service planning and the population-level impact of mental disorders. The chapter concludes with an overview of landmark international cross-sectional surveys which have informed psychiatric epidemiology worldwide.

scholarly journals Retrospective evaluation of the effectiveness of indoor residual spray with pirimiphos‐methyl (Actellic) on malaria transmission in Zambia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseph Keating ◽  
Joshua O. Yukich ◽  
John M. Miller ◽  
Sara Scates ◽  
Busiku Hamainza ◽  
...  
Keyword(s):  
Insecticide Resistance ◽  
Health Facility ◽  
Malaria Case ◽  
Malaria Incidence ◽  
Population Level ◽  
World Health ◽  
Effective Population ◽  
Cross Sectional ◽  
Pyrethroid Insecticides ◽  
Catchment Areas

Abstract Background Widespread insecticide resistance to pyrethroids could thwart progress towards elimination. Recently, the World Health Organization has encouraged the use of non-pyrethroid insecticides to reduce the spread of insecticide resistance. An electronic tool for implementing and tracking coverage of IRS campaigns has recently been tested (mSpray), using satellite imagery to improve the accuracy and efficiency of the enumeration process. The purpose of this paper is to retrospectively analyse cross-sectional observational data to provide evidence of the epidemiological effectiveness of having introduced Actellic 300CS and the mSpray platform into IRS programmes across Zambia. Methods Health facility catchment areas in 40 high burden districts in 5 selected provinces were initially targeted for spraying. The mSpray platform was used in 7 districts in Luapula Province. An observational study design was used to assess the relationship between IRS exposure and confirmed malaria case incidence. A random effects Poisson model was used to quantify the effect of IRS (with and without use of the mSpray platform) on confirmed malaria case incidence over the period 2013–2017; analysis was restricted to the 4 provinces where IRS was conducted in each year 2014–2016. Results IRS was conducted in 283 health facility catchment areas from 2014 to 2016; 198 health facilities from the same provinces, that received no IRS during this period, served as a comparison. IRS appears to be associated with reduced confirmed malaria incidence; the incidence rate ratio (IRR) was lower in areas with IRS but without mSpray, compared to areas with no IRS (IRR = 0.91, 95% CI 0.84–0.98). Receiving IRS with mSpray significantly lowered confirmed case incidence (IRR = 0.75, 95% CI 0.66–0.86) compared to no IRS. IRS with mSpray resulted in lower incidence compared to IRS without mSpray (IRR = 0.83, 95% CI 0.72–0.95). Conclusions IRS using Actellic-CS appears to substantially reduce malaria incidence in Zambia. The use of the mSpray tool appears to improve the effectiveness of the IRS programme, possibly through improved population level coverage. The results of this study lend credence to the anecdotal evidence of the effectiveness of 3GIRS using Actellic, and the importance of exploring new platforms for improving effective population coverage of areas targeted for spraying.

scholarly journals Public health surveillance of habitual physical activity in adolescents and adults in Namibia: a cross-sectional validation of activity questionnaires against accelerometry

2020 ◽  
Author(s):  
Hilde L Nashandi ◽  
John J Reilly ◽  
Xanne Janssen
Keyword(s):  
Physical Activity ◽  
Adolescent Girls ◽  
Rank Order ◽  
Vigorous Physical Activity ◽  
Population Level ◽  
Self Report ◽  
Adult Women ◽  
Cross Sectional ◽  
Individual Level ◽  
Activity Questionnaires

Abstract Background Monitoring population-level physical activity is crucial for examining adherence to global guidelines and addressing obesity. This study validated self-reported moderate-to-vigorous physical activity (MVPA) against an accurate device-based method in Namibia. Methods Adolescent girls (n = 52, mean age 16.2 years [SD 1.6]) and adult women (n = 51, mean age 31.3 years [SD 4.7]) completed the PACE+/GPAQ self-report questionnaires and were asked to wear an Actigraph accelerometer for 7 days. Validity of self-reported MVPA was assessed using rank-order correlations between self-report and accelerometry, and classification ability of the questionnaires with Mann–Whitney tests, kappa’s, sensitivity and specificity. Results In the adolescents, Spearman’s rank coefficients between self-reported MVPA (days/week) and accelerometry measured MVPA were positive but not significant (r = 0.240; P = 0.104). In the adults, self-reported MVPA (minutes/day) was moderately and significantly correlated with accelerometer-measured MVPA (r = 0.396; P = 0.008). In both groups, there was fair agreement between accelerometry and questionnaire-defined tertiles of MVPA (adolescents κ = 0.267; P = 0.010; adults κ = 0.284; P = 0.008), and measured MVPA was significantly higher in the individuals self-reporting higher MVPA than those reporting lower MVPA. Conclusions The PACE+ and GPAQ questionnaires have a degree of validity in adolescent girls and adult females in Namibia, though more suitable for population than individual level measurement.

scholarly journals 437. Asymptomatic Healthcare Worker COVID-19 Testing Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S286-S287
Author(s):  
Lucy E Horton ◽  
Randy Taplitz ◽  
Francesca J Torriani ◽  
Shira R Abeles ◽  
Lydia Ikeda ◽  
...  
Keyword(s):  
Health System ◽  
San Diego ◽  
Panel Member ◽  
Healthcare Setting ◽  
Incidence Rates ◽  
Common Source ◽  
Antibody Testing ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Testing Program

Abstract Background The SARS-CoV-2 pandemic remains a major threat worldwide. Healthcare workers (HCWs) are particularly impacted by the COVID-19 pandemic with high infection rates reported from HCWs in hard-hit regions2,3, raising concerns about nosocomial infections and the effectiveness of personal protective equipment in protecting HCWs. Asymptomatic infection is estimated 17.9% to 33.3%4 and is a common source of transmission5. We designed a HCW testing program to address patient and employee concerns about exposures in the healthcare setting at our 808-bed health system. During the time of employee testing, the mean (range) number of inpatients with a diagnosis of COVID was 30 (22–38) of a mean (range) daily census of 560 (492–602) (approximately 5.4%). Methods This opt-in program offered SARS-CoV-2 testing of asymptomatic HCWs with paired nasopharyngeal or mid-turbinate swab for PCR (Roche) and serum IgG antibody testing (Diazyme). While initially designed as a pilot project in the Emergency Departments and COVID-19 units, it was quickly expanded to a health system-wide initiative. Results From April 22 to June 2, PCR testing was performed on 5826 asymptomatic HCWs with four PCR tests resulting positive (0.09%). Of 5589 serologic tests (anti-SARS-CoV-2 IgG) performed, 57 tested positive (1.02 %). All HCW with a positive IgG had a concurrent negative PCR. Conclusion In this cross-sectional evaluation, the point prevalence of SARS-CoV-2 IgG in asymptomatic HCWs at UC San Diego was less than 1%, supporting modeling estimations at the San Diego County level of very low levels of community exposure at the time of this testing. Further analyses of incidence rates and potential risk factors such as employee roles within the healthcare system, community and healthcare exposures, and home zip code are underway. Asymptomatic HCW testing is a strategy that can provide the perception of additional safety to both the workforce and patients as the health system reopens, while potentially reduce transmission from asymptomatic persons through active case finding and isolation. Disclosures Randy Taplitz, MD, Merck (Advisor or Review Panel member)

scholarly journals Comparison of the Lytic Blood Culture Method with the Conventional Blood Culture Method in Cases of Enteric Fever in a Tertiary Care Hospital

2017 ◽  
Vol 3 (1) ◽  
pp. 6-10
Author(s):  
Safia Sultana ◽  
Md Akram Hossain ◽  
Md Abdoullah Al Maruf ◽  
Mohammad Abdul Gani
Keyword(s):  
Blood Culture ◽  
Culture System ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Culture Method ◽  
Contamination Rate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Blood Culture System ◽  
Centrifugation Method

Background: Blood Culture is the gold standard and accurate method of diagnosing bacteremia in enteric fever; however, conventional blood culture is slow in isolating Salmonella typhi and Salmonella paratyphi.Objective: The main aim of this study was to compare the result of the lytic centrifugation method with conventional blood culture system for the accurate diagnosis of enteric fever in febrile patients.Methodology: The cross-sectional study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between July 2010 and June 2011 including 200 individuals of different ages and sexes. Of them, 150 were clinically suspected cases of typhoid fever and 50 controls comprising of 25 non-typhoidal febrile patients and 25 healthy individuals. Both types of blood culture were performed for each of the cases and controls.Result: The lytic centrifugation method recovered more organisms (17.3%) than the conventional blood culture method (13.3%). Time required for isolation of S. typhi and S. paratyphi A was short in lytic method (18-20hours) than conventional method (42-72hours). Total contamination rate was 0.5% by lytic as compared to the conventional blood culture method which was 5.0%.Conclusion: In conclusion the lytic method is better than conventional blood culture system for good result, short isolation time and less chance of contamination.Bangladesh Journal of Infectious Diseases 2016;3(1):6-10

ANTIMICROBIAL SUSCEPTIBILITY IN CULTURE POSITIVE ENTERIC FEVER

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Manish Kulshrestha ◽  
Dr. Anjali Kulshrestha
Keyword(s):  
Bone Marrow ◽  
Blood Culture ◽  
Nalidixic Acid ◽  
Antimicrobial Susceptibility ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Multidrug Resistant ◽  
Bone Marrow Culture ◽  
Diffusion Method ◽  
Culture Positive

INTRODUCTION: Enteric fever includes typhoid and paratyphoid fever. Peak incidence is seen in children 5–15 years of age; but in regions where the disease is highly endemic, as in India, children younger than 5 years of age may have the highest infection rates. There are about 22 million new typhoid cases occur each year. Young children in poor, resource limited areas, who make up the majority of the new cases and there is a mortality figures of 215,000 deaths annually. A sharp decline in the rates of complications and mortality due to typhoid fever is observed as a result of introduction of effective antibiotic therapy since 1950s. MDR-ST became endemic in many areas of Asia, including India soon after multidrug-resistant strains of Salmonella enterica serotype typhi (MDR-ST) that were resistant to all the three first-line drugs then in use, namely chloramphenicol, amoxycillin and co-trimoxazole emerged in early 1990s. MATERIAL AND METHODS: Only blood culture or bone marrow culture positive cases were included. The patients with culture isolated enteric fever were included in the study. Antimicrobial susceptibility testing was carried out by disk diffusion method using antibiotic discs. The analysis of the antimicrobial susceptibility was carried out as per CLSI interpretative guidelines. RESULTS: A total of 82 culture positive cases were included in the present study. 80 culture isolates were from blood culture and 2 from the bone marrow culture. Salmonella entericasubspecies enterica serovartyphi (S typhi) was isolated from 67 (81.70%) patients while Salmonella enterica subspecies entericaserovarparatyphi (S paratyphi A) was isolated from 13 (15.85%) cases and 2 (2.44%) were Salmonella enterica subspecies entericaserovarschottmuelleri (S paratyphi B). Of the 82 cases 65(79.3%) isolates were resistant to ciprofloxacin, 17 (20.7%) were resistant to nalidixic acid, one (1.2%) case each was resistant to Cefotaxime and ceftriaxone, 2 (2.4%) were resistant to chloramphenicol, 10 (12.2%) were resistant and to cotrimoxazole 3 (3.7%) were resistant. CONCLUSION: In a culture positive cases 65(79.3%) isolates were resistant to ciprofloxacin and 17 (20.7%) were resistant to nalidixic acid. Multidrug resistant isolates were 65(79.3%).

PERIODONTAL DISEASE STATUS, KNOWLEDGE, ATTITUDE, PRACTICE AND TREATMENT NEEDS OF PREGNANT WOMEN

2018 ◽  
Vol 8 (6) ◽  
pp. 138-144
Author(s):  
Thien Nguyen Duc ◽  
Tai Tran Tan
Keyword(s):  
Periodontal Disease ◽  
Pregnant Women ◽  
Oral Hygiene ◽  
Disease Status ◽  
Incidence Rates ◽  
Gestation Period ◽  
Treatment Needs ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p<0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p>0.05). The mean values of GI and BOP indices differed by gestation period (p<0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p>0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p<0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs

scholarly journals Diagnostic Value of Clinical Features to Distinguish Enteric Fever From Other Febrile Illnesses in Bangladesh, Nepal, and Pakistan

2020 ◽  
Vol 71 (Supplement_3) ◽  
pp. S257-S265 ◽  
Author(s):  
Kristen Aiemjoy ◽  
Dipesh Tamrakar ◽  
Shampa Saha ◽  
Shiva R Naga ◽  
Alexander T Yu ◽  
...  
Keyword(s):  
Blood Culture ◽  
Clinical Features ◽  
Diagnostic Performance ◽  
Enteric Fever ◽  
Random Effect ◽  
Clinical Signs ◽  
Febrile Illness ◽  
Diagnostic Value ◽  
Case Definition ◽  
Mixed Effect

Abstract Background Enteric fever, a bacterial infection caused by Salmonella enterica serotypes Typhi and Paratyphi A, frequently presents as a nonlocalizing febrile illness that is difficult to distinguish from other infectious causes of fever. Blood culture is not widely available in endemic settings and, even when available, results can take up to 5 days. We evaluated the diagnostic performance of clinical features, including both reported symptoms and clinical signs, of enteric fever among patients participating in the Surveillance for Enteric Fever in Asia Project (SEAP), a 3-year surveillance study in Bangladesh, Nepal, and Pakistan. Methods Outpatients presenting with ≥3 consecutive days of reported fever and inpatients with clinically suspected enteric fever from all 6 SEAP study hospitals were eligible to participate. We evaluated the diagnostic performance of select clinical features against blood culture results among outpatients using mixed-effect regression models with a random effect for study site hospital. We also compared the clinical features of S. Typhi to S. Paratyphi A among both outpatients and inpatients. Results We enrolled 20 899 outpatients, of whom 2116 (10.1%) had positive blood cultures for S. Typhi and 297 (1.4%) had positive cultures for S. Paratyphi A. The sensitivity of absence of cough was the highest among all evaluated features, at 65.5% (95% confidence interval [CI], 55.0–74.7), followed by measured fever at presentation at 59.0% (95% CI, 51.6–65.9) and being unable to complete normal activities for 3 or more days at 51.0% (95% CI, 23.8–77.6). A combined case definition of 3 or more consecutive days of reported fever and 1 or more of the following (a) either the absence of cough, (b) fever at presentation, or (c) 3 or more consecutive days of being unable to conduct usual activity--yielded a sensitivity of 94.6% (95% CI, 93.4–95.5) and specificity of 13.6% (95% CI, 9.8–17.5). Conclusions Clinical features do not accurately distinguish blood culture–confirmed enteric fever from other febrile syndromes. Rapid, affordable, and accurate diagnostics are urgently needed, particularly in settings with limited or no blood culture capacity.

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