scholarly journals Diphtheria resurgence in Sada'a-Yemen, 2017–2020

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ahmed Abdallah Al-Dar ◽  
Mutahar Al-Qassimi ◽  
Faten Hamid Ezzadeen ◽  
Mohammed Qassime ◽  
Ahmed Mohamed Al murtadha ◽  
...  

Abstract Background Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe the epidemiology of diphtheria by time, place, and person and vaccination status of affected children. Methods A study was conducted in Sada'a governorate by using accumulative line list of diphtheria from November 2017 to September 2020 at electronic Integrated Disease Early Warning System (eIDEWS). The case definition of WHO was adopted. Data was analyzed by Microsoft Excel and Epi info- version 7.2 and multivariable logistic analysis used for identifying significant associated factors. Results 747 cases were met of WHO case definition. The annual peak of cases started during week 31 and weak 49. Males were slightly more than females (51% vs 49%) and about 35% of cases involved children aged 10 to < 15 years. The overall incidence of diphtheria and case fatality rate (CFR) were 69/ 100,000 and 6.4%, respectively. The highest CFR was among age groups under 5 years 11% (P < 0.001) and among females was 8%. Dysphagia and swollen lymph nodes were the predominant symptoms 98%, 92%, respectively. Based on the Vaccination status, the percentage of unvaccinated and unknown were 53% and 41% respectively, with CFR 11% among cases who received one dose. Furthermore, the most case were from Sahar 40% with case fatality rate 8% and the highest CFR was significantly higher among cases in border and ongoing conflict district (P < 0.05). Conclusions The findings highlight that diphtheria is still an ongoing cause of morbidity and mortality among under 5 children in Sada'a that is rising with the low diphtheria immunization coverage. Therefore, concomitant efforts should now focus on improving and monitoring routine immunization across all age groups and healthcare services, especially in borders and continuing conflict districts.

2021 ◽  
Author(s):  
Mohammed Alamad ◽  
Yousef S. Khader, Khader

BACKGROUND As a consequence of war and collapse of health system in Yemen, diphtheria fatal epidemic occurred at the end of 2017 OBJECTIVE This study aims to describe epidemiology of diphtheria in Yemen, determine its incidence and case fatality rate METHODS Data of patients with diphtheria was obtained from the Diphtheria program in a form of line list which were collected on daily basis by electronic Diseases Early Warning System (eDEWS). Probable case was defined as any person suffered from laryngitis or pharyngitis or tonsillitis and adherent membrane of the tonsils, pharynx and/or nose. Confirmed case was defined as probable case that is laboratory-confirmed or linked epidemiologically to laboratory-confirmed case RESULTS A total of 2,243 cases were reported during the period between July 2017 and August 2018. About 49% of cases were males and 51% of cases were females. About 44% of cases were 5 -15 years old. Respiratory tract infection was the predominant symptoms (91%) followed by psedumembrane (81%). Based on the vaccination status, the percentage of partial vaccinated patients, vaccinated, unvaccinated, and unknown were 7%, 31%, 48% and 14%, respectively. The overall incidence of diphtheria was 8 per 100,000 of population. The highest incidence was among age group <15 years (11 per 100,000) and the lowest incidence was among age group of ≥ 15 years (5 per 100,000). The overall case fatality rate (CFR) among all age groups was 5%, being higher (10%) in the age group < 5 years. . Five of difficult to access governorates had double CFR (22%) which were Raymah, Abyan , Sa'ada, Lahj, Al Jawf. CONCLUSIONS : Diphtheria in Yemen in 2017-2018 affected a significant number of people. The majority of patients were partially or not vaccinated. Children ≤ 15 years were more affected with higher fatality among children < five years. Five of difficult to access governorates had double CFR of WHO estimate. To control diphthereia epidemic in Yemn, it is recommended to increase vaccination coverage through campaigns and boosters, increase public health awareness toward diphtheria and strengthen the surveillance system for early detection and immediate response and provide antitoxin for management of severe cases.


2021 ◽  
Vol 9 ◽  
pp. 205031212110083
Author(s):  
Omoleke Semeeh ◽  
Biniam Getachew ◽  
Yusuf Taofik ◽  
Lukman Surajudeen ◽  
Assad Hassan ◽  
...  

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).


2021 ◽  
Vol 34 (1) ◽  
pp. 55-62
Author(s):  
Be Nazir Ahmmad ◽  
Fazlur Rahman ◽  
Naznin Parvin ◽  
Md Shamsul Alam ◽  
Shitangshu Banerjee ◽  
...  

Background: Rajshahi medical college hospital is a tertiary care teaching and referral center in the North-West part of Bangladesh. To assess the epidemiological trend in hospital admission, including morbidity and mortality pattern of illness in the pediatric population, it needs to develop effective health care planning, appropriate resource allocation, and integration of existing health care service facilities. Objective: To evaluate the diseases and deaths of children admitted in the department of pediatrics, Rajshahi medical college hospital, Rajshahi. Materials and methods: This is a retrospective study. The collected case records of all patients admitted in the department of pediatrics from 1st January 2017 to 31st December 2019 (3 years) were analyzed.  Result: A total of 62000 children were admitted during the mentioned study period. All the patients were distributed into three age groups infant, under five, and more than five, contributing 22%, 27.5%, and 19%, respectively. Acute watery diarrhea (21%), hereditary hemolytic anemia (18%), bronchopneumonia (10.4%), acute gastritis (9.4%), and acute bronchiolitis and wheezy child (7.17%) were the top five diseases in each of the three years of admission. Among the total admitted patients, 1003 (1.61%) patients died. Infant, under five, and more than five age groups constitute 61.3%, 28.1%, and 15.1%, respectively. Encephalitis and fulminant hepatic failure found the top two diseases causing death with a case fatality rate was 61% and 43%, respectively. The next highest case fatality rate was found in acute leukemia (15%). Other common causes of death include meningitis, cerebral palsy with complications (7.5%), bronchopneumonia with complications (3.8%). Conclusion: An admission-related comprehensive evaluation of this study will help to understand the diseases and death patterns of a hospital, leading to the development of more effective planning and case management strategies. TAJ 2021; 34: No-1: 55-62


Author(s):  
S. Kumar ◽  
R. Gupta ◽  
N. Jindal and Y.C. Bangar

The study was conducted on 106 E. coli isolates to determine the phylogenetic group, serotype and carriage of Class 1 integrons in isolates and ascertain their association along with other parameters with vital disease measures in broiler flocks affected with colibacillosis. Out of 32 isolates of which “O” antigen was characterized, serogroup O2 comprising of 12 (37.5%) isolates was most prevalent in the present study. Most of the isolates (85/106; 80.19%) belonged to phylogenetic group B2. Mean apparent morbidity, mortality and case fatality rate (CFR) were 3.77%, 2.32% and 61.49%, respectively. There was significant difference in number of outbreaks reported in different age groups (p less than 0.0001). Also, there was significant association between phylogenetic group and age of outbreak due to E. coli (p=0.024). Comparatively, no significant association was observed between age of outbreaks and serotypes (p=0.980). There was significant association between various disease measures and E. coli isolates affiliated to various phylogenetic groups and serotypes. All the measures (apparent morbidity, mortality and CFR) of disease were highest in outbreaks due to isolates of phylogenetic group B2 and serogroup O20. However, the measures were not significantly affected by the presence of integrons in the E. coli.


PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1035-1040
Author(s):  
Linda Quan ◽  
Edmond J. Gore ◽  
Kim Wentz ◽  
Jill Allen ◽  
Alvin H. Novack

The factors associated with submersion events among &lt;20-year-old persons that occurred in King County from 1974 to 1983 were studied to focus prevention efforts. Near-drowning (n = 103) and drowning (n = 96) victims were identified from medical examiners' reports, paramedics' reports, and hospital discharge registers. Annual incidence was 5.5; the mortality rate was 2.6 per 100,000 children. Although preschool-aged children had the largest incidence (12.8), followed by older adolescents (4.9), adolescents had the largest case fatality rate, 77%. Lake and river victims had the largest incidence, mortality, and case fatality rate; swimming pools, the smallest case fatality rate (25%). A total of 89% of all victims had absent or no supervision; victims supervised by lifeguards had a 42% case fatality rate. Prior seizures were part of the history of 7.5% of all victims; 25% of fatal submersions by adolescents were associated with alcohol. Bathtub submersions were associated with child abuse in three of 16 preschool-aged children and epilepsy in four of five older children. Certain age groups and sites combined had the greatest incidence: preschool-aged children in swimming pools, infants in bathtubs, teenagers in lakes and rivers. Incidence decreased in public and semipublic pools coincident with fencing regulations. These findings suggest prevention strategies: extending fencing requirements to private pools, discouraging alcohol consumption during water sports, changing bathing practices of epileptics, and improving lifeguard efficacy.


2017 ◽  
Vol 18 (11-12) ◽  
pp. 319
Author(s):  
W.A.F.J. Tumbelaka ◽  
Sunoto Sunoto

Diarrheal diseases still constitute one of the major causes of morbidity and mortality in Indonesian children. The ertiology is multi-complex as in other developing countries. In 1974 a National Seminar on Rehydration was held in Jakarta and a rehydration program started with a standardized treatment of Ringer's Lactate and oral rehydration (ROSE SYSTEM). As a result the case fatality rate of diarrheal diseases has been dramatically reduced for for gastroenteritis and cholera.


2021 ◽  
Vol 9 (9) ◽  
pp. 1991
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Jara Llenas-García ◽  
Hector Pinargote-Celorio ◽  
Veronica Sánchez-García ◽  
Philip Wikman-Jorgensen ◽  
...  

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.


2020 ◽  
Vol 1 (10) ◽  
pp. 39-44
Author(s):  
K. A. Nogoibaeva ◽  
S. T. Tobokalova ◽  
K. T. Kasymbekova ◽  
S. I. Umarova

The purpose of the study is to research the morbidity, mortality and case fatality rate y of chronic viral hepatitis B without and with a delta agent from 2010–2017. in Kyrgyzstan.Materials and methods: analyzed state reporting forms No. 12 “Report on morbidity and preventive work (family medicine center, dispensary)” and “C51 — Distribution of deaths by sex, age groups and causes of death” from 2010–2017. Data processed by Microsoft Office Excel.Results: In the country from 2010–2017 3292 cases of chronic viral hepatitis B were detected, 1738 patients of them verified an independent course (СhHBV), and 1,554 patients combined with a delta agent (СhHDV), while the incidence did not have a statistically significant difference (3.80/0000, 95% CI 2.4–4.0 and 3.40/0000, 95% CI 2.2–3.4, СhHBV and СhHDV, respectively) were 20 times lower compared to the HBV Carrier (60 40/0000). There was no statistically significant difference between the cumulative morbidity, mortality, case fatality rate and the proportion of deaths in СhHBV and СhHDV. The death rate СhHBV increased by 4.7 times (0.090/0000 and 0.410/0000), case fatality rate — by 11.8 times (1355.00/0000 and 16025.60/0000) amid a decrease the incidence is 2.5 times (6.40/0000 and 2.50/0000) from 2014 to 2017, respectively. At СhHDV, the mortality rate was also increased by 4.7 times (0.030/0000 and 0.160/0000), case fatality rate — by 32.3 times (793.70/0000 and 25641.80/0000) against the background of a decrease in incidence by 6.9 times (4.40/0000 and 0.60/0000) from 2014 to 2017, respectively.Conclusion: In Kyrgyzstan from 2010–2017, relatively low detectability of chronic forms of HBV infection with and without delta agent was found, compared with the “HBV carrier”. There has been an increase in mortality and case fatality rate over the past 4 years, with a sharp rise in 2017 against the background of a downward trend in the incidence of СhHBV and СhHDV.


1994 ◽  
Vol 112 (1) ◽  
pp. 115-124 ◽  
Author(s):  
R. J. P. M. Scholten ◽  
H. A. Bijlmer ◽  
H. A. Valkenburg ◽  
J. Dankert

SummaryTo investigate the joint association of patient and strain characteristics with the outcome of meningococcal disease (MD), data were collected on 563 consecutive cases of MD reported between 1989 and 1990 in The Netherlands. The meningococcal isolates were characterized with regard to their surface characteristics. Sequelae occurred in 8.5% of the patients, and were only associated with the presence of bacteraemia. The case-fatality rate was 7.7%. Infants aged ≤ 5 months and patients in the age-groups of 10–19 years and ≥ 50 years had an increased risk for a fatal outcome compared with children from 6 months to 9 years old (Odds Ratios [ORs]: 5.1, 3.4 and 9.8, respectively). The OR for females versus males was 2.3. The ORs for patients with bacteraemia, or a combination of bacteraemia and meningitis, compared with meningitic patients, were 2.3 and 3.1. Meningococcal strain characteristics did not influence the case-fatality rate substantially. In conclusion, host factors were found to be determinants for a fatal outcome of MD in The Netherlands from 1989 to 1990.


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