scholarly journals Risk Factors of Influenza-Associated Respiratory Illnesses Reported to a Sentinel Hospital of Lahore, Pakistan: 2015-2016

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Saima Hasan ◽  
Muhammad Iqbal ◽  
Richard J. Webby ◽  
Jennifer DeBeauchamp ◽  
Hamad Bin Rashid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Influenza A ◽  
Epidemiological Data ◽  
Respiratory Illness ◽  
Sentinel Site ◽  
Risk Markers ◽  
Respiratory Illnesses ◽  
Final Multivariable Model ◽  
Potential Risk Factors ◽  
And Gender

Epidemiological data about determinants of influenza A virus (IAV) in the Pakistani population is scarce. We aimed to conduct a prospective hospital-based active surveillance study from October 2015 to May 2016 to identify potential risk factors associated with IAV infection among patients with influenza-like illness (ILI) and severe acute respiratory illness (SARI). Surveillance was conducted in Lahore General Hospital, selected as a sentinel site in Lahore District, Pakistan. Nasal/throat samples were collected along with epidemiological and clinical data from enrolled patients. Real-time reverse-transcription polymerase chain reaction (rRT-PCR) was performed to identify IAV and its subtypes (H1N1pdm09, H3N2). Data were analyzed to determine risk factors and risk markers associated with IAV infections. A total of 311 suspected ILI and SARI cases were enrolled in the study, and among these 50 were IAV-positive. Of these 50 confirmed cases of IAV, 14 were subtyped as H1N1pdm09 and 15 were H3N2; the remaining 21 were untyped. A final multivariable model identified four independent risk factors/markers for IAV infection: exposure history to ILI patients within last 7 days and gender being male were identified as risk factors of IAV infection, while use of antibiotics prior to hospital consultation and presence of fever were identified as risk markers. We concluded that adopting nonpharmaceutical interventions like hand hygiene, masks, social distancing, and where possible, avoiding identified risk factors could decrease the risk of IAV infection and may prevent imminent outbreaks of IAV in the community.

Skin Integrity in Critically Ill and Injured Children

2007 ◽  
Vol 16 (6) ◽  
pp. 568-574 ◽  
Author(s):  
Christine A. Schindler ◽  
Theresa A. Mikhailov ◽  
Kay Fischer ◽  
Gloria Lukasiewicz ◽  
Evelyn M. Kuhn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Ventilatory Support ◽  
Pediatric Intensive Care ◽  
Cost Of Care ◽  
Respiratory Illnesses ◽  
Skin Breakdown ◽  
Potential Risk Factors

Background Skin breakdown increases the cost of care, may lead to increased morbidity, and has negative psychosocial implications because of secondary scarring or alopecia. The scope of this problem has not been widely studied in critically ill and injured children. Objectives To determine the incidence of skin breakdown in critically ill and injured children and to compare the characteristics of patients who experience skin breakdown with those of patients who do not. Methods Admission and follow-up data for a 15-week period were collected retrospectively on children admitted to a large pediatric intensive care unit. The incidence of skin breakdown was calculated. The risk for skin breakdown associated with potential risk factors (relative risk) and 95% confidence intervals were determined. Results The sample consisted of 401 distinct stays in the intensive care unit for 373 patients. During the 401 stays, skin breakdown occurred in 34 (8.5%), redness in 25 (6.2%), and breakdown and redness in 13 (3.2%); the overall incidence was 18%. Patients who had skin breakdown or redness were younger, had longer stays, and were more likely to have respiratory illnesses and require mechanical ventilatory support than those who did not. Patients who had skin breakdown or redness had a higher risk of mortality than those who did not. Conclusions Risk factors for skin breakdown were similar to those previously reported. Compared with children of other ages, children 2 years or younger are at higher risk for skin breakdown.

scholarly journals Integrating patient and whole genome sequencing data to provide insights into the epidemiology of seasonal influenza A(H3N2) viruses

2017 ◽  
Author(s):  
Emily J. Goldstein ◽  
William T. Harvey ◽  
Gavin S. Wilkie ◽  
Samantha J. Shepherd ◽  
Alasdair R. MacLean ◽  
...  
Keyword(s):  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Influenza A ◽  
Seasonal Influenza ◽  
Epidemiological Data ◽  
Respiratory Illness ◽  
Influenza Surveillance ◽  
Whole Genome Sequencing Data ◽  
Whole Genome ◽  
Sequencing Data

AbstractGenetic surveillance of seasonal influenza is largely focused upon sequencing of the haemagglutinin gene. Consequently, our understanding of the contribution of the remaining seven gene segments to the evolution and epidemiological dynamics of seasonal influenza is relatively limited. The increased availability of next generation sequencing technologies allows rapid and economic whole genome sequencing (WGS). Here, 150 influenza A(H3N2) positive clinical specimens with linked epidemiological data, from the 2014/15 season in Scotland, were sequenced directly using both Sanger sequencing of the HA1 region and WGS using the Illumina MiSeq platform. Sequences generated by both methods were highly consistent and WGS provided on average >90% whole genome coverage. As reported in other European countries during 2014/15, all strains belonged to genetic group 3C, with subgroup 3C.2a predominating. Inter-subgroup reassortants were identified (9%), including three 3C.3 viruses descended from a single reassortment event, which had persisted in the population. Significant phylogenetic associations with cases of severe acute respiratory illness observed herein warrant further investigation. Severe cases were also more likely to be associated with reassortant viruses (odds ratio: 4.4 (1.3-15.5)) and occur later in the season. These results suggest that increased levels of WGS, linked to clinical and epidemiological data, could improve influenza surveillance.

scholarly journals Smoking and alcohol as potential risk factors for changes on masticatory mucosae

2004 ◽  
Vol 51 (2) ◽  
pp. 89-92
Author(s):  
Dubravka Markovic ◽  
Nada Vuckovic ◽  
Bojana Jefic ◽  
Ljiljana Strajnic ◽  
Sinisa Mirkovic
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Alcohol Drinking ◽  
Alveolar Ridge ◽  
Potential Risk Factors ◽  
The Subject ◽  
And Gender

It is assumed that before there are clinically verified signs of irritation, risk factors can cause changes on tissue, which was the subject of our research. The aim of this study was to establish how much ciggarete smoking, alcohol drinking and gender exerted influence on pathohistological changes on clinically healthy masticatory mucosae. Our results were based on anamnestic answers and pathohistological examination of biopsies from edentulous alveolar ridge of clinically healthy masticator mucosae. The sample consisted of 40 patients, of bouth gender. Conclusions are that smokers have, 25% more chance of having pathohistologicaly verified hyperceratosis on masticatory mucosae than nonsmokers. There are no significant differences between sex in correlation with pathohistologicaly verified changes on masticatory mucosae which are caused by smoking. Persons who consume alcohol have a greater chance of having pathohistologicaly verified changes on masticatory mucosae. Persons who smoke ciggaretes and consume alcohol drinks are most likely, 50% and more, to have pathohistologicaly verified hyperceratosis on masticatory mucosae.

scholarly journals Identification of Risk Factors for Invasive Extraintestinal Pathogenic Escherichia coli (ExPEC) Disease

2021 ◽  
Vol 1 (S1) ◽  
pp. s22-s22
Author(s):  
Erik Clarke ◽  
Jeroen Geurtsen ◽  
Bart Spiessens ◽  
Christel Chehoud
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Potential Risk ◽  
Multidrug Resistant ◽  
Older Age ◽  
Gradient Boosting ◽  
Common Data Model ◽  
Potential Risk Factors ◽  
Precise Relationship ◽  
And Gender

Background: A pathogenic group of invasive extraintestinal pathogenic (ExPEC) Escherichia coli possess the ability to infect normally sterile body sites and cause severe invasive ExPEC disease (IED). ExPEC is a leading cause of bacteremia and sepsis worldwide and is associated with older age and multidrug-resistant infections. Janssen Vaccines & Prevention is developing a novel multivalent glycoconjugate vaccine to prevent IED. We aimed to use an unbiased approach, with no prespecified potential risk factors, using machine-learning models, to screen for and identify IED risk factors for further validation. Methods: We used a patient-level prediction study design to model the probability of a patient developing IED within 14 days to 1 year from a given date based on their prior 2 years of health records. We used the Optum EHR database (~98 million subjects) in the common data model (CDM) format, with health features encoded in the following categories: conditions, procedures, drugs, healthcare visits, recent laboratory measurements, and age and gender. A gradient boosting model (XGBoost) was used with Shapley additive explanation (SHAP) values to identify which features were most important to the model’s decisions and to characterize precisely the relationship between features and outcomes (binary or continuous). Results: Study participants were aged ≥60 years at index with no previously recorded IED. Of ~6,500,000 cases included, ~8,000 had IED during the prediction window. We found that having ≥1 urinary tract infection (UTI) in the retrospective period increased the model’s probability of predicting IED for that patient, with more frequent or more recent UTIs increasing IED prediction chance (Figure 1). Higher age linearly increased the model’s likelihood of predicting that a patient would develop IED. The model also identified ≥1 inpatient or ER visit and laboratory values indicative of renal or immune dysfunction to be correlated with increased IED risk. This methodology is a generalizable approach to screening for potential risk factors for an outcome using EHR databases; it requires little to no prespecification of the health factors or precise relationship between the factors and outcome. Conclusions: Using a new, impartial methodology (with no prespecification), older age and a history of UTIs were key predictive features for IED, factors previously identified through traditional analysis, confirming the validity of the methodology. Novel features, including recent hospitalization, were shown to increase IED risk relative to existing criteria. Our findings may be used to inform the clinical development of preventive strategies.Funding: Janssen Research and DevelopmentDisclosures: None

scholarly journals Sentinel surveillance for influenza A viruses in Lahore District Pakistan in flu season 2015–2016

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Saima Hasan ◽  
Richard J. Webby ◽  
Muhammad Iqbal ◽  
Hamad Bin Rashid ◽  
Mansur-ud-Din Ahmad ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza A ◽  
Descriptive Analysis ◽  
Epidemiological Data ◽  
Respiratory Illness ◽  
Risk Groups ◽  
Global Public Health ◽  
Influenza A Viruses ◽  
Temporal And Spatial Distribution ◽  
Middle Income

Abstract Background Influenza A virus (IAV) remains an important global public health threat with limited epidemiological information available from low-and-middle-income countries. The major objective of this study was to describe the proportions, temporal and spatial distribution, and demographic and clinical characteristics of IAV positive patients with influenza like illness (ILI) and severe acute respiratory illness (SARI) in Lahore, Pakistan. Methods Prospective surveillance was established in a sentinel hospital from October 2015 to May 2016. All eligible outpatients and inpatients with ILI or SARI were enrolled in the study. Nasal and/or throat swabs were collected along with clinico-epidemiological data. Samples were tested by real-time RT-PCR (rRT-PCR) to identify IAV and subtype. The descriptive analysis of data was done in R software. Results Out of 311 enrolled patients, 284 (91.3%) were ILI and 27 (8.7%) were SARI cases. A distinct peak of ILI and SARI activity was observed in February. Fifty individuals (16%) were positive for IAV with peak positivity observed in December. Of 50 IAV, 15 were seasonal H3N2, 14 were H1N1pdm09 and 21 were unable to be typed. The majority of IAV positive cases (98%) presented with current or history of fever, 88% reported cough and 82% reported sore throat. The most common comorbidities in IAV positive cases were hepatitis C (4%), obesity (4%) and tuberculosis (6%). The highest incidence of patients reporting to the hospital was seen three days post symptoms onset (66/311) with 14 of these (14/66) positive for IAV. Conclusion Distinct trends of ILI, SARI and IAV positive cases were observed which can be used to inform public health interventions (vaccinations, hand and respiratory hygiene) at appropriate times among high-risk groups. We suggest sampling from both ILI and SARI patients in routine surveillance as recommended by WHO.

scholarly journals Detection of Influenza Virus Infection Using Two PCR Methods

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Richard K. Zimmerman ◽  
Charles R. Rinaldo ◽  
Mary Patricia Nowalk ◽  
G. K. Balasubramani ◽  
Mark G. Thompson ◽  
...  
Keyword(s):  
Influenza A ◽  
Influenza Virus Infection ◽  
Cost Effective ◽  
Respiratory Illness ◽  
Influenza B ◽  
Chi Square ◽  
Respiratory Illnesses ◽  
Comparable Method ◽  
Pcr Method ◽  
Tract Infections

Rapid, accurate, and cost-effective methods to identify the cause of respiratory tract infections are needed to maximize clinical benefit. Outpatients with acute respiratory illness were tested for influenza using a singleplex reverse transcriptase polymerase chain reaction (SRT-PCR) method. A multiplex RT-PCR (MRT-PCR) method tested for influenza and 17 other viruses and was compared with SRT-PCR using chi-square tests. Among 935 patients, 335 (36%) tested positive for influenza A and influenza B using SRT-PCR. Using MRT-PCR, 320 (34.2%) tested positive for influenza A and influenza B. This study supports MRT-PCR as a comparable method for detecting influenza among patients seeking outpatient care for acute respiratory illnesses.

scholarly journals Prevalence, Risk Factors, and Characterization of Multidrug Resistant and ESBL/AmpC Producing Escherichia coli in Healthy Horses in Quebec, Canada, in 2015–2016

Animals ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 523 ◽  
Author(s):  
Maud de Lagarde ◽  
John M. Fairbrother ◽  
Julie Arsenault
Keyword(s):  
Risk Factors ◽  
Healthy Adult ◽  
Epidemiological Data ◽  
Multidrug Resistant ◽  
Facility Management ◽  
E Coli ◽  
Equine Medicine ◽  
Potential Risk Factors ◽  
Amoxicillin Clavulanic Acid

Although antimicrobial resistance is an increasing threat in equine medicine, molecular and epidemiological data remain limited in North America. We assessed the prevalence of, and risk factors for, shedding multidrug-resistant (MDR) and extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase-producing E. coli in healthy horses in Quebec, Canada. We collected fecal samples in 225 healthy adult horses from 32 premises. A questionnaire on facility management and horse medical history was completed for each horse. Indicator (without enrichment) and specific (following enrichment with ceftriaxone) E. coli were isolated and tested for antimicrobial susceptibility. The presence of ESBL/AmpC genes was determined by PCR. The prevalence of isolates that were non-susceptible to antimicrobials and to antimicrobial classes were estimated at the horse and the premises level. Multivariable logistic regression was used to assess potential risk factors for MDR and ESBL/AmpC isolates. The shedding of MDR E. coli was detected in 46.3% of horses. Non-susceptibility was most commonly observed to ampicillin, amoxicillin/clavulanic acid or streptomycin. ESBL/AmpC producing isolates were detected in 7.3% of horses. The most commonly identified ESBL/AmpC gene was blaCTX-M-1, although we also identified blaCMY-2. The number of staff and equestrian event participation were identified as risk factors for shedding MDR isolates. The prevalence of healthy horses harboring MDR or ESBL/AmpC genes isolates in their intestinal microbiota is noteworthy. We identified risk factors which could help to develop guidelines to preclude their spread.

scholarly journals Disease Mapping and Spatial Landscape Characterization of Tuberculosis Ecology in Malaysia

2019 ◽  
Vol 1 ◽  
pp. 1-2 ◽  
Author(s):  
Abdul Rauf Abdul Rasam ◽  
Noresah Mohd Shariff
Keyword(s):  
Risk Factors ◽  
Human Mobility ◽  
Random Medium ◽  
Disease Mapping ◽  
Central Zone ◽  
Epidemiological Data ◽  
Geographical Information ◽  
Disease Pattern ◽  
Potential Risk Factors ◽  
Northern Zone

<p><strong>Abstract.</strong> This paper analyses the pattern distribution and influential risk factors of tuberculosis (TB) at 47 Sections of Shah Alam, Malaysia using spatial epidemiological (SE) approach. Quantifying environmental risk factors of the disease pattern can be a challenging task due to spatial environmental and transmission process, whereby each area may have its own unique risk factors and dynamics. A conceptual framework of spatial epidemiological data analysis (Pfieffer et al. 2008), and geographical information system (GIS) method (Chang 2011) are mainly adapted in this research method. Disease mapping of the 3-year datasets (2013 to 2015) was created using GIS analysis and satellite remote sensed land used in identifying the clustering areas of TB pattern. Meanwhile, the potential risk factors of TB in the clustering areas were assessed using spatial landscape ecology through site observation.</p><p>Figure 1 shows the spatial pattern of TB cases in the study area as a random medium, revealing that TB distribution is well distributed in the area. However, there is also some clustering concentration at the northern zone (Section U17 to Section U20) and some in U5 and U13, while in the central zone, the majority cases are concentrated at Section S7, S17, S18, S19 and S24. Section S27 and S28 are also indicated as high-case areas in the southern zone. It is interesting to note that in the recent years (2015), the disease was a little dispersed and scattered to the northern area especially in U13, U10, U15 and U17 due to the new township area, physical development and human mobility (Nava-Aguilera et al., 2011; Prussing et al., 2013). Furthermore, every zone or section may have its own risk factors; hence, there is a need for specific investigation to be conducted in a smaller area.</p>

scholarly journals Toxoplasma gondii infection in children with lymphoma in Eastern China: seroprevalence, risk factors and case–control studies

2019 ◽  
Vol 147 ◽  
Author(s):  
Yuhe Duan ◽  
Yunlai Zhi ◽  
Yusheng Liu ◽  
Na Zhou ◽  
Fujiang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Toxoplasma Gondii ◽  
Eastern China ◽  
Epidemiological Data ◽  
Multivariable Logistic Regression Analysis ◽  
Healthy Children ◽  
Healthy Controls ◽  
Case Control Studies ◽  
And Gender ◽  
Toxoplasma Gondii Infection

Abstract Epidemiological data for Toxoplasma gondii regarding malignancy have gained increasing attention; however, the information about T. gondii infection among children with malignant lymphoma (ML) in China is unclear. Therefore, 314 children with lymphoma and 314 healthy children, age- and gender-matched, were recruited to estimate the seroprevalence of T. gondii in the participants and identify the risk factors of infection. Blood samples from all participants were collected and examined for T. gondii IgG and IgM antibodies using ELISA. The results showed that the overall seroprevalence of T. gondii antibodies (including IgG and/or IgM) in ML patients and healthy controls was 19.8% and 9.9%, respectively. Contact with the cats, consumption of oysters and history of chemotherapy were estimated to be the risk factors for T. gondii infection in children with lymphoma by multivariable logistic regression analysis, whereas in healthy children, contact with cats and consumption of oysters were the risk factors. Moreover, among various histological types of lymphoma, individuals with NK/T-cell lymphoma, B-small lymphocytic lymphoma, marginal zone B-lymphoma and Hodgkin's lymphoma had a higher seroprevalence than healthy controls (P < 0.05). These findings indicated the high prevalence of T. gondii infection in children with lymphoma, and hence, efforts should be performed to evaluate the effect of the infection further in lymphoma patients.

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