Seroprevalence and risk factors of SARS-CoV-2 infection in an urban informal settlement in Nairobi, Kenya, December 2020

Introduction: Urban informal settlements may be disproportionately affected by the COVID-19 pandemic due to overcrowding and other socioeconomic challenges that make adoption and implementation of public health mitigation measures difficult. We conducted a seroprevalence survey in the Kibera informal settlement, Nairobi, Kenya, to determine the extent of SARS-CoV-2 infection. Methods: Members of randomly selected households from an existing population-based infectious disease surveillance (PBIDS) provided blood specimens between 27th November and 5th December 2020. The specimens were tested for antibodies to the SARS-CoV-2 spike protein. Seroprevalence estimates were weighted by age and sex distribution of the PBIDS population and accounted for household clustering. Multivariable logistic regression was used to identify risk factors for individual seropositivity. Results: Consent was obtained from 523 individuals in 175 households, yielding 511 serum specimens that were tested. The overall weighted seroprevalence was 43.3% (95% CI, 37.4 – 49.5%) and did not vary by sex. Of the sampled households, 122(69.7%) had at least one seropositive individual. The individual seroprevalence increased by age from 7.6% (95% CI, 2.4 – 21.3%) among children (<5 years), 32.7% (95% CI, 22.9 – 44.4%) among children 5 – 9 years, 41.8% (95% CI, 33.0 – 51.1%) for those 10-19 years, and 54.9%(46.2 – 63.3%) for adults (≥20 years). Relative to those from medium-sized households (3 and 4 individuals), participants from large (≥5 persons) households had significantly increased odds of being seropositive, aOR, 1.98(95% CI, 1.17 – 1.58), while those from small-sized households (≤2 individuals) had increased odds but not statistically significant, aOR, 2.31 (95% CI, 0.93 – 5.74). Conclusion: In densely populated urban settings, close to half of the individuals had an infection to SARS-CoV-2 after eight months of the COVID-19 pandemic in Kenya. This highlights the importance to prioritize mitigation measures, including COVID-19 vaccine distribution, in the crowded, low socioeconomic settings.

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Tuberculosis in biologic-naïve patients with rheumatoid arthritis - risk factors and tuberculosis characteristics

The Journal of Rheumatology ◽

10.3899/jrheum.201251 ◽

2021 ◽

pp. jrheum.201251

Author(s):

Johanna Karlsson Sundbaum ◽

Elizabeth V. Arkema ◽

Judith Bruchfeld ◽

Jerker Jonsson ◽

Johan Askling ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Population Based ◽

Rheumatoid Arthritis Risk ◽

Obstructive Pulmonary Disease ◽

Quality Register ◽

National Patient ◽

Latent Tb ◽

The Individual ◽

Control Study

Objective To investigate risk factors and characteristics of active tuberculosis (TB) in biologics-naïve rheumatoid arthritis (RA) patients. Methods Population-based case-control study using the Swedish Rheumatology Quality Register, the National Patient Register and the Tuberculosis Register to identify RA cases with active TB and matched RA controls without TB 2001-2014. Clinical data were obtained from medical records. TB risk was estimated as adjusted (adj) odds ratios (OR) with 95% confidence intervals (CI) using univariate and multivariable logistic regression analyses. Results After validation of diagnoses, the study included 31 RA cases with TB, and 122 matched RA controls. All except three cases had reactivation of latent TB. Pulmonary TB dominated (84%). Ever use of methotrexate was not associated with increased TB risk (adj OR 0.8; 95% CI 0.3-2.0), whereas ever treatment with leflunomide (adj OR 6.0; 95% CI 1.5-24.6), azathioprine (adj OR 3.8; 95% CI 1.1-13.8) and prednisolone (adj OR 2.4 (95% CI 1.0-5.9) was. There were no significant differences of maximum dose of prednisolone, treatment duration with prednisolone before TB, or cumulative dose of prednisolone the year before TB diagnosis between cases and controls. Obstructive pulmonary disease was associated with an increased TB risk (adj OR 3.9; 95% CI 1.4-10.7). Conclusion Several RA-associated factors may contribute to the increased TB risk in biologics-naïve RA patients, making risk of TB activation difficult to predict in the individual patient. To further decrease TB in RA patients, the results suggest that screening for latent TB should also be considered in biologics-naïve patients.

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Characteristics of Nontuberculous Mycobacterial Infections at a Midwestern Tertiary Hospital: A Retrospective Study of 365 Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa173 ◽

2020 ◽

Vol 7 (6) ◽

Cited By ~ 1

Author(s):

Claire E Hannah ◽

Bradley A Ford ◽

Jina Chung ◽

Dilek Ince ◽

Karolyn A Wanat

Keyword(s):

Risk Factors ◽

Mycobacterium Avium ◽

Disease Surveillance ◽

Mycobacterium Avium Complex ◽

Retrospective Chart Review ◽

Common Species ◽

Tertiary Hospital ◽

Population Based ◽

Clinical Findings ◽

Infection Prevalence

Abstract Background The prevalence of infections due to nontuberculous mycobacteria (NTM) is increasing worldwide, yet little is known about the epidemiology and pathophysiology of these ubiquitous environmental organisms. Pulmonary disease due to Mycobacterium avium complex is most prevalent, but many other NTM species can cause disease in virtually any organ system. As NTM becomes an increasingly common cause of morbidity and mortality, more information is needed about the epidemiology of NTM disease. Methods We conducted a retrospective chart review of all patients with cultures that grew NTM at a Midwestern tertiary hospital from 1996 to 2017. Information on demographics, medical history, clinical findings, treatment, and outcome was obtained from medical records of all NTM isolates. American Thoracic Society/Infectious Diseases Society of America criteria were used to define pulmonary NTM infections. Results We identified 1064 NTM isolates, 365 of which met criteria for NTM infection. Pulmonary cases predominated (185 of 365; 50.7%), followed by skin/soft tissue (56 of 365; 15.3%), disseminated (40 of 365; 11%), and lymphatic (28 of 365; 7.7%) disease. Mycobacterium avium complex was the most common species (184 of 365; 50.4%). Individuals aged >50 years were most affected (207 of 365; 56.7%). Common comorbidities included structural lung disease (116 of 365; 31.8%), use of immunosuppressive medications (78 of 365; 21.4%), malignancy (59 of 365; 16.2%), and human immunodeficiency virus (42 of 365; 11.5%). Conclusions This large cohort provides information on the demographics, risk factors, and disease course of patients with pulmonary and extrapulmonary NTM infections. Most patients had medical comorbidities that resulted in anatomic, genetic, or immunologic risk factors for NTM infection. Further population-based studies and increased disease surveillance are warranted to further characterize NTM infection prevalence and trends.

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Evaluation of individual awareness of diabetes, related risk factors and complications in urban and rural people of Noakhali region, Bangladesh: a population-based study

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v27i1.28069 ◽

2016 ◽

Vol 27 (1) ◽

pp. 8-15

Author(s):

Md Khorshed Alam ◽

Md Ariful Islam ◽

Abhijit Das ◽

Palash Karmakar ◽

Pankaj Chandra Debnath ◽

...

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Significant Risk Factor ◽

Population Based ◽

Cross Sectional Study ◽

Dominant Group ◽

Cross Sectional ◽

Related Risk ◽

Secondary Study ◽

The Individual

This cross-sectional study was conducted to evaluate the individual awareness, related risk factors and complications of diabetes with socio-demographic profiles of the study individuals in Noakhali region, Bangladesh during June to December, 2013. A total 250 participants were selected randomly and data were collected using structured questionnaire. Among the respondents 47.20% were found male and 52.80% were female and majorities (52.00%) of the respondents were urban people. Respondents completed secondary study level or below were the dominant group. 9.20%, 27.20%, 12.80% and 34.40% respondents were agriculturist, businessman and housewives respectively. Women showed better knowledge about overall diabetes (20.00%) and blood glucose level (9.60%), in case of causes, symptoms and management men (12.80%, 23.20% and 18.40% respectively) were found dominant than women (10.00%, 16.00% and 12.00% respectively). It was found that 13.20% respondents were suffering from impaired glucose tolerance and 79.20% had diabetes mellitus where female were more vulnerable than male. Family history was found the significant risk factor (p= 0.016; Ç2 = 5.849) for diabetes (total 62%, male 40.65% and female 59.35%), Other risk factors like age (67.20%), obesity (46.40%), hypercholesterolemia (82.00%), excess triglyceride (78.00%) and hypertension (29.60%) remained insignificant respectively and in every cases female were found more vulnerable than men. Study revealed that knowledge regarding diabetes was not up to the mark to the respondents though it is now one of the most pandemic diseases in the world.Bangladesh J Medicine Jan 2016; 27(1) : 8-15

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Diet, Physical Activity, Obesity, and Breastfeeding: How French People Perceive Factors Associated with Cancer Risk

Nutrients ◽

10.3390/nu11102491 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2491 ◽

Cited By ~ 1

Author(s):

Lamore ◽

Ducrot ◽

Latino-Martel ◽

Soler ◽

Foucaud

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cancer Risk ◽

Population Based ◽

Nutritional Risk ◽

French Population ◽

Cancer Risk Factors ◽

Beneficial Effects ◽

Individual Perception ◽

The Individual

The French Cancer Barometer, a population-based-survey, is carried out every five years and is, to date, one of the few national studies conducted to investigate individual perception linked to cancer risk factors. The aims of the present study were to describe the perceptions of the French population in 2015 and to assess their evolution over a 5-year period (2010–2015). The French Cancer Barometer surveyed a randomly selected sample of participants aged 15–75 years (n = 3345 in 2010) and 15–85 years (n = 3764 in 2015), representative of the French population. Questions were on perception of diet, physical activity, obesity, and breastfeeding as cancer risk factors. In 2015, nutritional/activity factors were perceived as having an important role in cancer development for the majority of those surveyed (diet (90.8%), obesity (76%), and physical activity (70%)) with the exception being breastfeeding (34%). However, there was a moderate perception of the risks of red meat (43%) and salt or salty food (55%) consumption. Perceptions of nutritional risk factors were mostly associated with age and education level. Interestingly, there was a greater perception of nutritional risk factors in 2015 compared to 2010, and the participants’ opinions were also stronger. Efforts should be made on individuals with lower educational level and to promote the beneficial effects of breastfeeding. However, to impact food behavior, measures are needed at the environmental level and not only at the individual one.

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Single spies and battalions: the clinical epidemiology of mental disorders

Psychological Medicine ◽

10.1017/s0033291700026362 ◽

1993 ◽

Vol 23 (4) ◽

pp. 891-907 ◽

Cited By ~ 6

Author(s):

Brian Cooper

Keyword(s):

Risk Factors ◽

Mental Disorders ◽

Mental Disorder ◽

Local Community ◽

Clinical Epidemiology ◽

Relevant Literature ◽

Population Based ◽

Starting Point ◽

Clinical Thinking ◽

The Individual

SynopsisClinical epidemiology, a term that has been variously defined, is used here to refer to a discipline which, commencing with examination and diagnosis of the individual patient who presents in medical practice, proceeds to study the occurrence of similar, possibly connected cases in the local community, and in so doing may provide hypotheses for population-based studies of disease and its risk factors. While the relevance of this discipline to the modern practice of clinical psychiatry remains largely unexplored, its importance in the search for causes of mental disorder is attested by many instances, both historical and more recent, in which the spread or clustering of psychiatric syndromes in populations could be related to nutritional deficiency, infectious disease, the presence of environmental neurotoxins, the social communication of psychopathology or the transmission of abnormal, harmful behaviour patterns within family groups. Observations made in clinical practice have repeatedly served as the starting point for epidemiological investigation of mental disorders, while conversely epidemiological findings have influenced clinical thinking about their classification, diagnosis, prognosis and morbid risk. A review of the relevant literature underlines the need for a keener awareness of environmental risk factors and a fundamentally epidemiological frame of reference in trying to grapple with the aetiological problems of mental disorder.

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Primary prevention of cardiovascular disease: focus on improving behavioral risk factors

Russian Journal of Cardiology ◽

10.15829/1560-4071-2021-4278 ◽

2021 ◽

Vol 26 (3S) ◽

pp. 4278

Author(s):

V. S. Chulkov ◽

E. S. Gavrilova ◽

Vl. S. Chulkov ◽

E. D. Pankova ◽

E. A. Lenets ◽

...

Keyword(s):

Risk Factors ◽

Primary Prevention ◽

Healthy Lifestyle ◽

Cardiovascular Prevention ◽

Population Based ◽

Behavioral Risk Factors ◽

Behavioral Risk ◽

Behavioral Alterations ◽

Cvd Risk ◽

The Individual

Public health strategies for the detection, prevention and treatment of cardiovascular diseases (CVDs) can be implemented at many levels as follows: from individual behavioral alterations to population-based strategies that affect different national and cultural communities. Despite the fact that the priority of primary prevention is treating hypertension and hyperlipidemia, great importance is given to improving behavioral and biological risk factors. Dietary modification, exercise and smoking cessation are specific interventions that can be targeted to reduce CVD risk at both the individual and population levels. Following a healthy lifestyle can potentially change factors such as overweight/obesity, hyperlipidemia, type 2 diabetes, and hypertension. The aim of this review was to present and summarize new data on the primary cardiovascular prevention with a focus on improving behavioral risk factors considered in the current guidelines.

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Non-communicable disease care and physical activity promotion in India: analysis of recent policies, guidelines and workplans

Family Medicine and Community Health ◽

10.1136/fmch-2019-000206 ◽

2020 ◽

Vol 8 (2) ◽

pp. e000206

Author(s):

Satyajit Mohanty ◽

Epari Venkatarao ◽

Sandul Yasobant

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Risk Factor ◽

Physical Activity Promotion ◽

Population Based ◽

Care Model ◽

Policy Documents ◽

Activity Promotion ◽

Care Models ◽

The Individual

Burden statements on non-communicable diseases (NCDs) across the globe suggest that they pose a constant threat to human development. There are two different types of NCD interventions: population-based interventions addressing NCD risk factors and individual-based interventions addressing NCDs in the primary care setting. Most of the individual-based interventions are based on NCD-care models, as opposed to population-based interventions targeting risk factors through independent vertical programmes. We explored the relevant Indian policy documents including the recent National Health Policy 2017, to get an overview of the Indian NCD-care model and to find out how physical activity (PA) promotion stands in the year 2019 in the current policy documents on NCDs. We conducted a review with two perspectives; first to capture the NCD-care models and second to document the PA promotion and its integration in the current NCD-care model specific to the Indian context. Indian NCD programme is an evolving healthcare programme with a definite NCD-care model, where the individual-based and population-based care are thoroughly linked. Despite having good NCD-care policy and methodical planning, PA promotion seems to be lacking in the policy perspective and currently physical inactivity as a risk factor is not considered seriously. The structure of the NCD-care model should be detailed and strengthened by incorporating lessons from other successful NCD models from across the globe. Indian NCD model must provide sufficient scope of interfacing individual care to that of population-based risk factor strategies like physical activity promotion.

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Shigellosis outbreak among MSM living with HIV: a case–control study in Taiwan, 2015–2016

Sexually Transmitted Infections ◽

10.1136/sextrans-2017-053410 ◽

2018 ◽

Vol 95 (1) ◽

pp. 67-70 ◽

Cited By ~ 8

Author(s):

Hao-Hsin Wu ◽

Yi-Ting Shen ◽

Chien-Shun Chiou ◽

Chi-Tai Fang ◽

Yi-Chun Lo

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Disease Surveillance ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Health Concern ◽

Crystal Methamphetamine ◽

Living With Hiv ◽

Control Study

ObjectivesOutbreaks of shigellosis among men who have sex with men (MSM) have been reported since the late 1990s. HIV infection is an important risk factor. Since 2014, the global shigellosis epidemic has intensified. Whether chemsex (the use of crystal methamphetamine, γ-hydroxybutyrate or mephedrone to enhance sex) is a new risk factor has not been previously examined.MethodsWe conducted a population-based, case–control study in Taiwan. Acute shigellosis cases diagnosed during the 2015 outbreak among MSM living with HIV were compared with those without shigellosis. CD4+ counts, plasma viral load (pVL), gonorrhoea, syphilis and amoebiasis records were obtained from the Notifiable Disease Surveillance System database. We invited cases/controls to provide information on illicit drug use and sexual behaviours, using a structured questionnaire.ResultsSeventy-five shigellosis cases were compared with 225 controls. High pVL (>100 000 copies/mL; adjusted OR (aOR): 4.9, 95% CI 1.4 to 16.9), gonorrhoea (aOR: 29.4, 95% CI 2.3 to 340.2) and syphilis (aOR: 4.3, 95% CI 1.6 to 11.6) were independent risk factors of shigellosis. Twenty shigellosis cases and 59 controls completed the questionnaire. Oral-to-anal sex (aOR: 15.5, 95% CI 3.6 to 66.7), chemsex (aOR: 5.6, 95% CI 1.4 to 22.7) and poppers use (aOR: 10.9, 95% CI 1.9 to 64.2) within 12 months were independent behavioural risk factors of shigellosis.ConclusionsChemsex is a new risk factor for shigellosis among MSM living with HIV, as identified in the 2015–2016 outbreak. Additional risk factors include poppers use, sexual risk behaviours and high pVL. Further studies on chemsex among MSM, which is a rising public health concern, are urgently required.

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