Food anaphylaxis in the United Kingdom: analysis of national data, 1998-2018

Abstract Objective To describe time trends for hospital admissions due to food anaphylaxis in the United Kingdom over the past 20 years. Design Analysis of national data, 1998-2018. Setting Data relating to hospital admissions for anaphylaxis and deaths, and prescription data for adrenaline autoinjector devices. Participants UK population as a whole and devolved nations (England, Scotland, Wales, and Northern Ireland). Main outcome measures Time trends, age, and sex distributions for hospital admissions for anaphylaxis due to food and non-food triggers, and how these admission rates compare with the case fatality rate (number of fatalities as a proportion of hospital admissions). Results Between 1998 and 2018, 101 891 people were admitted to hospital for anaphylaxis. Of these admissions, 30 700 (30.1%) were coded as due to a food trigger. Food anaphylaxis admissions increased from 1.23 to 4.04 per 100 000 population per year (from 1998 to 2018), an annual increase of 5.7% (95% confidence interval 5.5% to 5.9%, P<0.001). The largest increase in hospital admissions was observed in children younger than 15 years, with an increase from 2.1 to 9.2 admissions per 100 000 population per year (an annual increase of 6.6%, 95% confidence interval 6.3% to 7.0%). For comparison, the annual increase was 5.9% (5.6% to 6.2%) in people aged 15-59 years and 2.1% (1.8% to 3.1%) in those aged 60 years and older. 152 deaths were identified where the fatal event was probably caused by food induced anaphylaxis. The case fatality rate decreased from 0.7% to 0.19% for confirmed fatal food anaphylaxis (rate ratio 0.931, 95% confidence interval 0.904 to 0.959, P<0.001) and to 0.30% for suspected fatal food anaphylaxis (0.970, 0.945 to 0.996, P=0.024). At least 46% (86 of 187, which also includes 35 deaths in 1992-98) of deaths were triggered by peanut or tree nut. Cow’s milk was responsible for 17 of 66 (26%) deaths in school aged children. Over the same time period, prescriptions for adrenaline autoinjectors increased by 336% (estimated rate ratio 1.113, 95% confidence interval 1.112 to 1.113; an increase of 11% per year). Conclusions Hospital admissions for food induced anaphylaxis have increased from 1998 to 2018, however the case fatality rate has decreased. In school aged children, cow’s milk is now the most common single cause of fatal anaphylaxis.

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An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria

SAGE Open Medicine ◽

10.1177/20503121211008344 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110083

Author(s):

Omoleke Semeeh ◽

Biniam Getachew ◽

Yusuf Taofik ◽

Lukman Surajudeen ◽

Assad Hassan ◽

...

Keyword(s):

Confidence Interval ◽

Disease Transmission ◽

Attack Rate ◽

Odds Ratio ◽

Case Fatality Rate ◽

Adjusted Odds Ratio ◽

Case Fatality ◽

Immunization Coverage ◽

Fatality Rate ◽

Vaccine Preventable Diseases

Introduction: In 2019, we investigated the profile of the cases and controls and the determinants of pertussis transmission in Kebbi State, Northwestern Nigeria, to inform better immunization and surveillance strategies. Methods: Community-based unmatched case–control study and review of the 2019 pertussis routine surveillance data in the affected settlements in the state were conducted. A total of 52 suspected cases of pertussis and 107 control from two local government areas in Kebbi State were recruited. Data were analyzed using descriptive and inferential statistics. Results: The highest attack rate was observed among between 1- and 4-year age group followed by children less than 1-year old, and the least attack rate was among those above 15 years. The overall attack rate and the case fatality rate were 2.10% and 0.10%, respectively. A higher attack rate was observed among women, whereas the case fatality rate was more among males. From the community survey, we observed that the cases were less likely to have pertussis vaccination history (adjusted odds ratio = 0.28, 95% confidence interval = 0.11–0.74) compared with the controls. Knowing pertussis prevention methods were found protective for pertussis transmission (adjusted odds ratio = 0.14, 95% confidence interval = 0.04–0.45). Conclusion: This study showed the vulnerability of children under 5 years, especially under 1 year, to vaccine-preventable diseases in rural populations, where “real” immunization coverage is sub-optimal, and the dominant socio-demographic factors are supportive of disease transmission. We found immunization and knowledge of the preventive measures to be protective against pertussis outbreaks. Therefore, routine immunization services must be intensified to improve coverage and prevent future pertussis outbreak(s).

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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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Incidence of and Risk Factors for Nosocomial Bloodstream Infections in Adults in the United States, 2003

Infection Control and Hospital Epidemiology ◽

10.1086/606167 ◽

2009 ◽

Vol 30 (11) ◽

pp. 1036-1044 ◽

Cited By ~ 31

Author(s):

Omar M. AL-Rawajfah ◽

Frank Stetzer ◽

Jeanne Beauchamp Hewitt

Keyword(s):

United States ◽

Risk Factors ◽

Case Fatality Rate ◽

Nationwide Inpatient Sample ◽

Hospital Admissions ◽

Case Fatality ◽

The United States ◽

Fatality Rate ◽

The Us ◽

National Estimates

Background.Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.Objective.The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.Methods.This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population. Cases of nosocomial BSI were defined by using 1 or more International Classification of Diseases, 9th Revision, Clinical Modification codes in the secondary field(s) that corresponded to BSIs that occurred at least 48 hours after admission. The comparison group consisted of all patients without BSI codes in their NIS records. Weighted data were used to generate US national estimates of nosocomial BSIs. Logistic regression was used to identify independent risk factors for nosocomial BSI.Results.The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50). The total maximum rescaled R2 was 0.22.Conclusions.The Nationwide Inpatient Sample was useful for estimating national incidence and case-fatality rates, as well as examining independent predictors of nosocomial BSI.

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Estimation of the basic reproduction number, average incubation time, asymptomatic infection rate, and case fatality rate for COVID-19: Meta-analysis and sensitivity analysis

10.1101/2020.04.28.20083758 ◽

2020 ◽

Cited By ~ 3

Author(s):

Wenqing He ◽

Grace Y. Yi ◽

Yayuan Zhu

Keyword(s):

Confidence Interval ◽

Basic Reproduction Number ◽

Incubation Time ◽

Case Fatality Rate ◽

Reproduction Number ◽

Meta Analysis ◽

Case Fatality ◽

Asymptomatic Infection ◽

Fatality Rate ◽

The Basic Reproduction Number

AbstractThe coronavirus disease 2019 (COVID-19) has been found to be caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, comprehensive knowledge of COVID-19 remains incomplete and many important features are still unknown. This manuscripts conduct a meta-analysis and a sensitivity study to answer the questions: What is the basic reproduction number? How long is the incubation time of the disease on average? What portion of infections are asymptomatic? And ultimately, what is the case fatality rate? Our studies estimate the basic reproduction number to be 3.15 with the 95% interval (2.41, 3.90), the average incubation time to be 5.08 days with the 95% confidence interval (4.77, 5.39) (in day), the asymptomatic infection rate to be 46% with the 95% confidence interval (18.48%, 73.60%), and the case fatality rate to be 2.72% with 95% confidence interval (1.29%, 4.16%) where asymptomatic infections are accounted for.

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Impact of a multifaceted intervention to improve emergency care on newborn and child health outcomes in Rwanda

Health Policy and Planning ◽

10.1093/heapol/czab109 ◽

2021 ◽

Author(s):

Celestin Hategeka ◽

Larry D Lynd ◽

Cynthia Kenyon ◽

Lisine Tuyisenge ◽

Michael R Law

Keyword(s):

Time Series ◽

Confidence Interval ◽

Hospital Mortality ◽

Case Fatality Rate ◽

Case Fatality ◽

Mortality Rates ◽

Fatality Rate ◽

Paediatric Hospital ◽

Child Health Outcomes ◽

And Child Health

Abstract Implementing context-appropriate neonatal and paediatric advanced life support management interventions has increasingly been recommended as one of the approaches to reduce under-five mortality in resource-constrained settings like Rwanda. One such intervention is ETAT+, which stands for Emergency Triage, Assessment and Treatment plus Admission care for severely ill newborns and children. In 2013, ETAT+ was implemented in Rwandan district hospitals. We evaluated the impact of the ETAT+ intervention on newborn and child health outcomes. We used monthly time-series data from the DHIS2-enabled Rwanda Health Management Information System from 2012 to 2016 to examine neonatal and paediatric hospital mortality rates. Each hospital contributed data for 12 and 36 months before and after ETAT+ implementation, respectively. Using controlled interrupted time-series analysis and segmented regression model, we estimated longitudinal changes in neonatal and paediatric hospital mortality rates in intervention hospitals relative to matched concurrent control hospitals. We also studied changes in case fatality rate specifically for ETAT+-targeted conditions. Our study cohort consisted of 7 intervention hospitals and 14 matched control hospitals contributing 142 424 neonatal and paediatric hospital admissions. After controlling for secular trends and autocorrelations, we found that the ETAT+ implementation had no statistically significant impact on the rate of all-cause neonatal and paediatric hospital mortality in intervention hospitals relative to control hospitals. However, the case fatality rate for ETAT+-targeted neonatal conditions decreased immediately following implementation by 5% (95% confidence interval: −9.25, −0.77) and over time by 0.8% monthly (95% confidence interval: −1.36, −0.25) in intervention hospitals compared with control hospitals. Case fatality rate for ETAT+-targeted paediatric conditions did not decrease following the ETAT+ implementation. While ETAT+ focuses on improving the quality of hospital care for both newborns and children, we only found an impact on neonatal hospital mortality for ETAT+-targeted conditions that should be interpreted with caution given the relatively short pre-intervention period and potential regression to the mean.

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Chagas Disease-Related Mortality in Spain, 1997 to 2018

Microorganisms ◽

10.3390/microorganisms9091991 ◽

2021 ◽

Vol 9 (9) ◽

pp. 1991

Author(s):

Jose-Manuel Ramos-Rincon ◽

Jara Llenas-García ◽

Hector Pinargote-Celorio ◽

Veronica Sánchez-García ◽

Philip Wikman-Jorgensen ◽

...

Keyword(s):

Hiv Infection ◽

Chagas Disease ◽

Case Fatality Rate ◽

Hospital Admissions ◽

Multivariable Analysis ◽

Age Groups ◽

Case Fatality ◽

Fatality Rate ◽

Infected People ◽

Male Sex

Background. Chagas disease (CD) is associated with excess mortality in infected people in endemic countries, but little information is available in non-endemic countries. The aim of the study was to analyze mortality in patients admitted to the hospital with CD in Spain. Methods. A retrospective, observational study using the Spanish National Hospital Discharge Database. We used the CD diagnostic codes of the 9th and 10th International Classification of Diseases to retrieve CD cases from the national public registry from 1997 to 2018. Results. Of the 5022 hospital admissions in people with CD, there were 56 deaths (case fatality rate (CFR) 1.1%, 95% confidence interval (CI) 0.8%, 1.4%), 20 (35.7%) of which were considered directly related to CD. The median age was higher in those who died (54.5 vs. 38 years; p < 0.001). The CFR increased with age, peaking in the 70–79-year (7.9%, odds ratio (OR) 6.27, 95% CI 1.27, 30.90) and 80–89-year (16.7%, OR 14.7, 95% CI 2.70, 79.90) age groups. Men comprised a higher proportion of those who died compared to survivors (50% vs. 22.6%; p < 0.001). Non-survivors were more likely to have neoplasms (19.6% vs. 3.4%; p < 0.001), heart failure (17.9% vs. 7.2%; p = 0.002), diabetes (12.5% vs. 3.7%; p = 0.001), chronic kidney failure (8.9% vs. 1.6%; p < 0.001), and HIV (8.9% vs. 0.8%; p < 0.001). In the multivariable analysis, the variables associated with mortality were age (adjusted OR (aOR) 1.05; 95% CI: 1.03, 1.07), male sex (aOR 1.79, 95% CI 1.03, 3.14), cancer (aOR: 4.84, 95% CI 2.13, 11.22), and HIV infection (aOR 14.10 95% CI 4.88, 40.73). Conclusions. The case fatality rate of CD hospitalization was about 1%. The mortality risk increased with age, male sex, cancer, and HIV infection.

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Perbedaan Kasus Covid-19 pada Masa Lockdown dan New Normal di Indonesia

Jurnal Kesehatan Vokasional ◽

10.22146/jkesvo.62889 ◽

2021 ◽

Vol 6 (3) ◽

pp. 182

Author(s):

Nugroho Susanto

Keyword(s):

Confidence Interval ◽

Case Fatality Rate ◽

Case Fatality ◽

T Test ◽

Fatality Rate ◽

Cross Sectional ◽

New Normal

Latar Belakang: Pandemi COVID-19 berdampak pada peningkatan angka kesakitan dan kematian di sejumlah negara. Kasus terkonfirmasi COVID-19 yang tercatat 414.179 dengan 18.440 angka kematian (CFR 4,4%) dilaporkan di 192 negara. Adanya penerapan kebijakan lockdown pada Maret-Mei 2020 dan new normal di Juni 2020 berdampak pada perbedaan kasus di kedua periode tersebut.Tujuan: Mengetahui perbedaan kasus terkonfirmasi, angka kematian, dan case fatality rate (CFR) COVID-19 antara masa lockdown dan new normal di Indonesia.Metode: Penelitian kualitatif dengan pendekatan cross-sectional disertai telaah dokumen online. Penelitian ini mengidentifikasi kasus COVID-19 selama 156 hari yang dilaporkan oleh Kementerian Kesehatan RI melalui laman https://covid19.kemkes.go.id/. Pengumpulan data dilakukan dari Maret−Agustus 2020. Analisis data menggunakan uji independent t test dengan confidence interval 95% (α = 0,05)Hasil: Rerata kasus terkonfirmasi dan kematian akibat COVID-19 lebih tinggi pada saat new normal dibanding saat lockdown, yaitu 338,6±213,1; 1483,7±485,7 dan 20,7±14,1; 58,9±21,9, sedangkan case fatalty rate lebih rendah pada new normal dibanding lockdown (0,04±0,01; 0,08±0,07). Terdapat perbedaan yang signifikan pada kasus terkonfirmasi (p = 0,000), angka kematian (p = 0,000), dan case fatalty rate COVID-19 (p = 0,000) antara masa pemberlakuan lockdown dan new normal.Kesimpulan: Meskipun rerata kasus terkonfirmasi dan kematian lebih tinggi di masa new normal, rerata fatalitas kematiannya lebih rendah.

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Invasive meningococcal disease in Malta: an epidemiological overview, 1994–2007

Journal of Medical Microbiology ◽

10.1099/jmm.0.011312-0 ◽

2009 ◽

Vol 58 (11) ◽

pp. 1492-1498 ◽

Cited By ~ 6

Author(s):

Mark Muscat ◽

Gianfranco Spiteri ◽

Neville Calleja ◽

Julie Haider ◽

Stephen J. Gray ◽

...

Keyword(s):

Confidence Interval ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Case Fatality ◽

Invasive Meningococcal Disease ◽

Fatality Rate ◽

Crude Incidence ◽

Laboratory Surveillance ◽

Methods Of Control

Since 1996, Malta has experienced an upsurge of invasive meningococcal disease (IMD) following an almost 30 year period with a negligible number of annually reported cases. We reviewed the 233 IMD cases notified during a 14 year period (1994–2007), and analysed epidemiological and laboratory surveillance data. The crude incidence per 100 000 inhabitants peaked in 2000 at 8.1 [95 % confidence interval (CI) 5.7–11.6] and again in 2006 at 8.9 (95 % CI 6.4–12.4), thereby placing Malta amongst the countries with the highest incidence of the disease in Europe. Of the total cases, 137 (59 %) were confirmed and 30 (13 %) were classified as probable. However, 66 cases (28 %) had no laboratory evidence of the disease and were classified as possible. Information on the serogroup was available for 114 cases. Serogroup B formed the largest proportion (76 %, n=87) followed by serogroup C (16 %, n=18). B : 4 : P1.19,15 strains (n=46) predominated throughout the study period since their first identification in 1998. With 28 deaths attributed to IMD, the overall case fatality rate was 12 %. Apart from stressing the importance of maintaining high vigilance for IMD, our findings underscore the importance of enhancing laboratory surveillance of the disease, including characterization of the meningococci. Until vaccines against a broad range of serogroup B meningococci become available for universal use, the main methods of control remain the early treatment of cases and the prevention of secondary cases.

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National trends in hospital admission, case fatality, and sex differences in atrial fibrillation-related strokes

International Journal of Stroke ◽

10.1177/1747493019881349 ◽

2019 ◽

Vol 15 (5) ◽

pp. 521-527

Author(s):

Gordon AE Jewett ◽

M Patrice Lindsay ◽

Cristina Goia ◽

Brandon Zagorski ◽

Noreen Kamal ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sex Differences ◽

Ischemic Stroke ◽

Case Fatality Rate ◽

Hospital Admissions ◽

Temporal Trends ◽

Case Fatality ◽

Fatality Rate ◽

Younger Women ◽

Increased Risk

Background and aim Atrial fibrillation is associated with increased risk of ischemic stroke and its global prevalence is increasing. We aimed to describe the contemporary temporal trends in hospital admissions, case fatality rate, as well as sex differences in atrial fibrillation-related stroke in Canada. Methods We conducted a retrospective cohort study using Canadian national administrative data to identify admissions to hospital for stroke with comorbid atrial fibrillation between 1 April 2007 and 31 March 2016. We determined temporal trends in the crude and the age- and sex-standardized admission and case fatality rates. We also evaluated for any sex differences in these outcomes. Results There were 222,100 admissions to hospital for ischemic (n = 182,990) or hemorrhagic (n = 39,110) stroke. Comorbid atrial fibrillation was present in 20.2% of admissions for ischemic strokes and 10.1% for hemorrhagic strokes. Over the study period, the age–sex adjusted proportion of admissions with atrial fibrillation increased from 16.3% to 20.5% (p = 0.02) for ischemic stroke and was stable for hemorrhagic stroke. In-hospital case fatality rate decreased for ischemic stroke with and without comorbid atrial fibrillation. Women aged 65 years and older with ischemic stroke were more likely to have comorbid atrial fibrillation compared to men, while this association was reversed in younger women. There were no sex differences in the case fatality rate for people with atrial fibrillation-related ischemic stroke. Conclusion Atrial fibrillation is present in an increasing proportion of people hospitalized in Canada with ischemic stroke and disproportionately affects older women. Renewed focus is needed on atrial fibrillation-related stroke prevention with particular attention to sex disparities.

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Legionnaires' disease outbreak in England – update

Weekly releases (1997–2007) ◽

10.2807/esw.06.33.01864-en ◽

2002 ◽

Vol 6 (33) ◽

Author(s):

Keyword(s):

Case Fatality Rate ◽

Case Fatality ◽

Disease Outbreak ◽

Case Definition ◽

Fatality Rate ◽

Standard Case ◽

North West ◽

The United Kingdom ◽

Control Team ◽

Legionnaires Disease

The outbreak of legionnaires’ disease in north west England has resulted in two more deaths since 7 August, bringing the total number of deaths in this outbreak to three (1). At 2 pm on 15 August 2002 the outbreak control team was aware of 116 confirmed cases of legionnaires’ disease that fit the standard case definition. At present the observed case-fatality rate of 2.7% is considerably lower than the rate observed in previous outbreaks in the United Kingdom.

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