scholarly journals Clinical management and impact of scarlet fever in the modern era: findings from a cross-sectional study of cases in London, 2018–2019

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e057772
Author(s):  
Michael Trent Herdman ◽  
Rebecca Cordery ◽  
Basel Karo ◽  
Amrit Kaur Purba ◽  
Lipi Begum ◽  
...  
Keyword(s):  
Sore Throat ◽  
Scarlet Fever ◽  
Quantitative Description ◽  
Delayed Diagnosis ◽  
Case Definition ◽  
Free Text ◽  
Care Seeking ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Factors Associated

ObjectivesIn response to increasing incidence of scarlet fever and wider outbreaks of group A streptococcal infections in London, we aimed to characterise the epidemiology, symptoms, management and consequences of scarlet fever, and to identify factors associated with delayed diagnosis.Design and settingCross-sectional community-based study of children with scarlet fever notified to London’s three Health Protection Teams, 2018–2019.ParticipantsFrom 2575 directly invited notified cases plus invitations via parental networks at 410 schools/nurseries with notified outbreaks of confirmed/probable scarlet fever, we received 477 responses (19% of those directly invited), of which 412 met the case definition. Median age was 4 years (range <1 to 16), 48% were female, and 70% were of white ethnicity.Outcome measuresPreplanned measures included quantitative description of case demographics, symptoms, care-seeking, and clinical, social, and economic impact on cases and households. After survey completion, secondary analyses of factors associated with delayed diagnosis (by logistic regression) and consequences of delayed diagnosis (by Cox’s regression), and qualitative analysis of free text comments were added.ResultsRash was reported for 89% of cases, but followed onset of other symptoms for 71%, with a median 1-day delay. Pattern of onset varied with age: sore throat was more common at onset among children 5 years and older (OR3.1, 95% CI 1.9 to 5.0). At first consultation, for 28%, scarlet fever was not considered: in these cases, symptoms were frequently attributed to viral infection (60%, 64/106). Delay in diagnosis beyond first consultation occurred more frequently among children aged 5+ who presented with sore throat (OR 2.8 vs 5+without sore throat; 95% CI 1.3 to 5.8). Cases with delayed diagnosis took, on average, 1 day longer to return to baseline activities.ConclusionsScarlet fever may be initially overlooked, especially among older children presenting with sore throat. Raising awareness among carers and practitioners may aid identification and timely treatment.

scholarly journals Younger age of onset and uveitis associated with HLA-B27 and delayed diagnosis in Thai patients with axial spondyloarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Naphruet Limsakul ◽  
Praveena Chiowchanwisawakit ◽  
Parichart Permpikul ◽  
Yubolrat Thanaketpaisarn
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Delayed Diagnosis ◽  
Musculoskeletal Symptom ◽  
Hla B27 ◽  
Delay In Diagnosis ◽  
Factors Associated ◽  
Younger Age

AbstractTo identify characteristics associated with HLA-B27, and to identify factors associated with delayed diagnosis in Thai patients with axial spondyloarthritis (axSpA). This cross-sectional study included Thai patients were diagnosed with axSpA by a rheumatologist at Siriraj Hospital. Clinical data were collected. Regression analyses were employed to identify factors associated with study outcomes. Of total 177 patients, 127 (72%) were positive HLA-B27. Uveitis [Odds ratio (OR) 4.0], age at onset of the first musculoskeletal symptom of ≤ 28 years [OR 3.5], female [OR 0.4], and psoriasis [OR 0.4] were significantly associated with HLA-B27 in multiple regression analysis. Those with positive HLA-B27 had less spinal flexibility. Elevated C-reactive protein (p = 0.012) was associated with shorter delay in diagnosis, while uveitis (p < 0.001) and younger age at onset of the first symptom (p = 0.002) were associated with longer delay in diagnosis in multiple regression analysis. Younger age at onset of the first musculoskeletal symptom and uveitis were associated with HLA-B27 and delayed diagnosis in axSpA patients. Young people with musculoskeletal symptom and uveitis should be referred to a rheumatologist to rule out or make a timely diagnosis of axSpA.

scholarly journals Current status of periodontitis and its association with tobacco use amongst adult population of Sunsari district, in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
K. Goel ◽  
S. Sharma ◽  
D. D. Baral ◽  
S. K. Agrawal
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Periodontal Diseases ◽  
Adult Population ◽  
Multivariate Logistic Regression Analysis ◽  
Case Definition ◽  
Current Status ◽  
Cross Sectional ◽  
Factors Associated ◽  
Significant Factors

Abstract Background Tobacco products are considered significant, but preventable factors related to initiation and progression of periodontal diseases. We assessed the prevalence of periodontitis and evaluated its association with tobacco use and other factors amongst the adult population of Sunsari district in eastern Nepal. Methods A community-based, cross-sectional study was conducted in rural municipalities in the province one of eastern Nepal. A total of 440 adults were interviewed with a set of a pre-tested semi-structured questionnaire. Data on social demographics, adverse oral habits followed by periodontal clinical examination were recorded. Prevalence of periodontitis was assessed by a case definition provided by CDC-AAP. Univariate and multivariate logistic regression analysis was done to measure the association between tobacco use and other factors with periodontitis. Results The overall prevalence of periodontitis was found to be 71.6%. Majority (85.4%) of tobacco users had periodontitis and they were significantly associated with the disease and its severity. The study identified age groups, 45–65 years (AOR = 7.58, 95% CI 3.93–14.61), plaque accumulation (AOR = 1.01, 95% CI 1.00–1.02), smoking (AOR = 3.14, 95% CI 1.36–7.27), khaini users (smokeless tobacco, AOR = 2.27, 95% CI 1.12–4.61) and teeth loss (AOR = 2.02, 95% CI 1.21–3.38) as the significant factors associated with periodontitis. Conclusion The prevalence of periodontitis is high in the surveyed rural adult population. Cigarette smoking along with the use of smokeless tobacco in the form of khaini were identified as significant factors associated with periodontitis.

scholarly journals The burden of self-reported acute gastrointestinal illness in Italy: a retrospective survey, 2008–2009

2011 ◽  
Vol 140 (7) ◽  
pp. 1193-1206 ◽  
Author(s):  
G. SCAVIA ◽  
F. BALDINELLI ◽  
L. BUSANI ◽  
A. CAPRIOLI
Keyword(s):  
Medical Care ◽  
Incidence Rate ◽  
Telephone Survey ◽  
Case Definition ◽  
Gastrointestinal Illness ◽  
Care Seeking ◽  
Acute Gastrointestinal Illness ◽  
Factors Associated ◽  
Duration Of Illness ◽  
Children And Young Adults

SUMMARYA retrospective telephone survey (n=3490) was conducted in Italy between 2008 and 2009 to estimate the occurrence of self-reported acute gastrointestinal illness (AGI) and to describe subjects' recourse to healthcare, using a symptom-based case definition. Three hundred and ten AGI cases were identified. The annual incidence rate was 1·08 episodes/person-year (95% confidence interval 0·90–1·14). The proportion of subjects consulting physicians was 39·5% while only 0·3% submitted a specimen for laboratory investigation. Risk factors for AGI and medical care-seeking were identified using logistic regression analysis. Females, children and young adults had a significantly higher incidence rate of AGI. Factors associated with medical care-seeking were age <10 years, presence of fever, diarrhoea, and duration of illness >3 days. Our results provide a relevant contribution towards estimating the global burden of AGI using standard methods that ensure a good level of comparability with other studies.

scholarly journals Current status of periodontitis and its association with tobacco use amongst adult population of Sunsari district, in Nepal

2020 ◽  
Author(s):  
Khushboo Goel ◽  
Shivalal Sharma ◽  
Dharnidhar Baral ◽  
Santosh Agrawal
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Periodontal Diseases ◽  
Adult Population ◽  
Multivariate Logistic Regression Analysis ◽  
Case Definition ◽  
Current Status ◽  
Cross Sectional ◽  
Factors Associated ◽  
Significant Factors

Abstract Background: Tobacco products are considered significant, but preventable factors related to initiation and progression of periodontal diseases. We assessed the prevalence of periodontitis and evaluated its association with tobacco use and other factors amongst the adult population of Sunsari district in eastern Nepal.Methods: A community-based, cross-sectional study was conducted in rural municipalities in the province one of eastern Nepal. A total of 440 adults were interviewed with a set of a standardized pre-tested semi-structured questionnaire. Data on social demographics, adverse oral habits followed by periodontal clinical examination were recorded. Prevalence of periodontitis was assessed by a case definition provided by CDC-AAP. Univariate and multivariate logistic regression analysis was done to measure the association between tobacco use and other factors with periodontitis.Results: The overall prevalence of periodontitis was found to be 71.6%. Majority (85.4%) of tobacco users had periodontitis and they were significantly associated with the disease and its severity. The study identified age groups, 45-65 years (AOR=7.58, 95% CI, 3.93-14.61), plaque accumulation (AOR=1.01, 95% CI, 1.00- 1.02), smoking (AOR=3.14, 95% CI, 1.36- 7.27), khaini users (smokeless tobacco, AOR=2.27, 95% CI, 1.12-4.61) and teeth loss (AOR=2.02, 95% CI, 1.21-3.38) as the significant factors associated with periodontitis. Conclusion: The prevalence of periodontitis is high in the surveyed rural adult population. Cigarette smoking along with the use of smokeless tobacco in the form of khaini were identified as significant factors associated with periodontitis.

Endometriosis-Associated Symptoms and Diagnostic Delay: An Online Survey

2020 ◽  
Author(s):  
Maryam Moradi ◽  
Azin Niazi ◽  
Melissa Parker ◽  
Anne Sneddon ◽  
Violeta Lopez ◽  
...  
Keyword(s):  
Online Survey ◽  
Age Of Onset ◽  
Diagnostic Delay ◽  
Delayed Diagnosis ◽  
Cross Sectional Study ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Associated Symptoms ◽  
Surgical Treatments

Abstract Background: Endometriosis is found in women of all ethnic and social groups with a prevalence of around 10%. However, data on diagnostic-delay and associated symptoms are limited. The aim of this study was to determine the endometriosis-associated symptoms and diagnosis-delay through an online survey. Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered and analyzed using STATA (version 14/1). A total of 903 responders completed an online survey from September 2013 to October 2015.Results: Total participants of 903, 71.10% Australians (were born in Australia) and 28.90% Non-Australian (were not born in Australia), with self-reported diagnosis of endometriosis was confirmed by surgery in 86.5% of participants completed the online survey. Delay in diagnosis was 8.1±6.2 years. There was no difference between age range (p = 0.35), mean age of onset of the first symptoms (p = 0.93), and delay in diagnosis (p = 0.11) in both groups. Most common endometriosis-related symptoms that all responders had experienced in their lifetime were period pain 98.11%, fatigue 94.01%, bloating 90.69%, ovulation pain 88.70%, pelvic pain 87.26%, pain during before/after sexual activity 82.72% and heavy bleeding 82.17% and delayed fertility 37.98%. Treatments used in affected women included: pain killers 96.01% (n=867), hormonal medication 84.71% and surgical treatments 84.49 %. Rate of miscarriage or stillbirth was 13.4% and hysterectomy because of endometriosis was 9.6%. Conclusions: Vast similarities in demographics and endometriosis-associated symptoms among the Australian and non-Australian women with endometriosis support the universality of the disease characteristics. Delay in diagnosis of endometriosis is a problem and the reasons for delayed diagnosis must be better understood to try to shorten this delay. Except for pain, endometriosis patients suffer from a variety of symptoms and treatment must take into account the most prominent symptoms.

scholarly journals Delayed Diagnosis of Hidradenitis Suppurativa and Its Effect on Patients and Healthcare System

Dermatology ◽  
2020 ◽  
Vol 236 (5) ◽  
pp. 421-430 ◽  
Author(s):  
Georgios Kokolakis ◽  
Kerstin Wolk ◽  
Sylke Schneider-Burrus ◽  
Stefanie Kalus ◽  
Sebastian Barbus ◽  
...  
Keyword(s):  
Healthcare System ◽  
Inflammatory Disease ◽  
Hidradenitis Suppurativa ◽  
Severe Disease ◽  
Delayed Diagnosis ◽  
Chronic Inflammatory Disease ◽  
Purulent Discharge ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Delay In Diagnosis

Background: Hidradenitis suppurativa (HS) is a neglected chronic inflammatory disease with long delay in diagnosis. Besides pain, purulent discharge, and destruction of skin architecture, HS patients experience metabolic, musculoskeletal, and psychological disorders. Objectives: To determine the delay in HS diagnosis and its consequences for patients and the healthcare system. Methods: This was a prospective, multicenter, epidemiologic, non-interventional cross-sectional trial carried out in Germany and based on self-reported questionnaires and medical examinations performed by dermatologists. In total, data of 394 adult HS patients were evaluated. Results: The average duration from manifestation of first symptoms until HS diagnosis was 10.0 ± 9.6 (mean ± SD) years. During this time, HS patients consulted on average more than 3 different physicians – most frequently general practitioners, dermatologists, surgeons, gynecologists – and faced more than 3 misdiagnoses. Diagnosis delay was longer in younger and non-smoking patients. In most cases, HS was correctly diagnosed by dermatologists. The longer the delay of diagnosis, the greater the disease severity at diagnosis. Delayed HS diagnosis was also associated with an increased number of surgically treated sites, concomitant diseases, and days of work missed. Conclusion: This study demonstrates an enormous delay in the diagnosis of HS, which results in more severe disease. It also shows for the first time that a delay in diagnosis of a chronic inflammatory disease leads to a higher number of concomitant systemic disorders. In addition to the impaired health status, delayed diagnosis of HS was associated with impairment of the professional life of affected people.

scholarly journals Prevalence of Middle Ear Infections and Associated Risk Factors in Children under 5 Years in Gasabo District of Kigali City, Rwanda

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Kaitesi Batamuliza Mukara ◽  
Richard J. Lilford ◽  
Debara Lyn Tucci ◽  
Peter Waiswa
Keyword(s):  
Middle Ear ◽  
Health Workers ◽  
Public Health Problem ◽  
Urban Setting ◽  
Care Seeking ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Ear Infection ◽  
Delay In Diagnosis ◽  
Ear Infections

Middle ear infections are common in children, and delay in diagnosis and treatment may result in complications such as delays in speech and language development and deafness. The aim of this study was to determine the prevalence and care seeking behaviour for middle ear infections in children under five years in Kigali city. We conducted a cross-sectional study among 810 children aged 6–59 months in Gasabo district of Kigali city, Rwanda. The prevalence of middle ear infections was 5.8%, of whom 4% had chronic suppurative otitis media. A child was less likely to develop middle ear infections if they lived in an urban setting (OR = 0.52, 95% CI: 0.285–0.958) but more likely to develop middle ear infections if exposed to household smoke (OR = 2.54, 95% CI: 1.18–5.46). Parents were unlikely to know that their child had an ear infection (OR: 0.15, 95% CI: 0.06–0.34). Middle ear infection remains a public health problem in Rwanda but many parents were not aware of its presence in the affected children. There is a need to raise awareness of parents about ear infection and to promote early care seeking from qualified health workers.

scholarly journals Prevalence and Factors associated with Mental health impact of COVID-19 Pandemic in Bangladesh: A survey-based cross-sectional study

2021 ◽  
Author(s):  
Tanvir Abir ◽  
Nazmul Ahsan Kalimullah ◽  
L Osuagwu Uchechukwu ◽  
Dewan Muhammad Nur-A Yazdani ◽  
Taha Husain ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Health Status ◽  
Sore Throat ◽  
Stress Level ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

AbstractBackgroundFeelings of isolation, insecurity, and instability triggered by COVID-19 could have a long-term impact on the mental health status of individuals. This study examined the prevalence and factors associated with the mental health symptoms of anxiety, depression, and stress during the COVID-19 pandemic in Bangladesh.MethodsFrom 1st – 30th April 2020, we used a validated self-administered questionnaire to conduct a cross-sectional study on 10,609 participants through an online survey platform. We assessed mental health status using the Depression, Anxiety, and Stress Scale (DASS-21). The total depression, anxiety, and stress subscale scores were divided into normal, mild, moderate, severe, and multinomial logistic regression was used to examine associated factors.ResultsThe prevalence of depressive symptoms was 15%, 34%, and 15% for mild, moderate, and severe depressive symptoms, respectively. The prevalence of anxiety symptoms was 59% for severe anxiety symptoms, 14% for moderate anxiety symptoms, and 14% for mild anxiety symptoms while, the prevalence for stress levels were 16% for severe stress level, 22% for moderate stress level and 13% for mild stress level. Multivariate analyses revealed that the most consistent factors associated with mild, moderate, and severe of the three mental health subscales (depression, anxiety, and stress) were respondents who lived in Dhaka and Rangpur division, females, those who self-quarantine in the previous 7 days before the survey and those respondents who experienced chills, breathing difficulty, dizziness, and sore throat.ConclusionOur results showed that about 64%, 87%, and 61% experienced depressive symptoms, anxiety symptoms, and levels of stress, respectively. In Bangladesh, there is a need for better mental health support for females especially those that lived in Dhaka and Rangpur division and experienced chills, breathing difficulty, dizziness, and sore throat during COVID-19 and other future pandemics.

scholarly journals Factors associated with delayed diagnosis of migraine: A hospital-based cross-sectional study

2019 ◽  
Vol 8 (6) ◽  
pp. 1925 ◽  
Author(s):  
NirendraKumar Rai ◽  
Ritwa Bitswa ◽  
Ruchi Singh ◽  
AbhijitP Pakhre ◽  
DayaShankar Parauha
Keyword(s):  
Delayed Diagnosis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

scholarly journals Place & Person involved in delivery: Factors leading to delay in diagnosis of Anorectal Malformation in Newborns

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Shazia Perveen ◽  
Sajid Ali ◽  
Abdul Jabbar ◽  
Batool Fatima
Keyword(s):  
Anorectal Malformation ◽  
Delayed Diagnosis ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Paediatric Surgery ◽  
Chi Square ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Creative Commons ◽  
Medical Person

Objective: To determine the frequency of place of delivery and person detecting the anomaly among newborn babies presenting with delayed diagnosis of anorectal malformation (ARM). Methods: This is a Descriptive Cross-Sectional Study, conducted at Department of Paediatric Surgery, National Institute of Child Health (NICH) Karachi, from February 19, 2019 to August 18, 2019. All patients with ARM who were diagnosed beyond two hours of life (Delayed diagnosis) were included in the study. Chi square test was applied for comparison of categorical variables. Results: Total 110 patients were enrolled in this study. Nineteen (17.3%) patients were delivered at home, while 91 (82.7%) were delivered at the hospital. The first person detecting the anomaly was grandmother (n=25) or a non-medical person in 58 patients (52.7%), 52 were diagnosed by a medical personal either primarily in 31 cases (28.2%) or secondarily by a neonatologist in 21 cases (19.1%). Conclusion: It is concluded that Non-medical person detected ARM mainly despite the babies being delivered mostly at the hospital, indicating the need for meticulous neonatal examination. doi: https://doi.org/10.12669/pjms.38.1.4156 How to cite this:Perveen S, Ali S, Jabbar A, Fatima B. Place & Person involved in delivery: Factors leading to delay in diagnosis of Anorectal Malformation in Newborns. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4156 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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