A Multivariate Analysis on the Assessment of Risk Factors Associated with Infections and Transmission of Schistosomiasis Haematobium in Some Selected Areas of North-Western, Nigeria

2015 ◽  
Vol 4 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Kabiru Mohammed ◽  
Mohamed R. Abdullah ◽  
E. I Ikeh ◽  
Aziah Ismail ◽  
Julia Omar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Factors Associated ◽  
North Western

scholarly journals Seroprevalence and risk factors for HIV, HCV, HBV and syphilis among blood donors in Mali

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Aude Jary ◽  
Sidi Dienta ◽  
Valentin Leducq ◽  
Quentin Le Hingrat ◽  
Mahamadou Cisse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Marital Status ◽  
Blood Donation ◽  
Education Level ◽  
Male Gender ◽  
Hcv Infection ◽  
Hbv Infection ◽  
Factors Associated ◽  
Hcv Prevalence

Abstract Background HIV, HBV and HCV remain a global public health concern especially in Africa. Prevalence of these infections is changing and identification of risk factors associated with each infection in Mali is needed to improve medical care. Methods We conducted a cross-sectional study of all individuals donating blood (n = 8207) in 2018 to the blood bank at university hospital in Bamako, Mali, to assess prevalence and risks factors associated with HIV, HBV, HCV and syphilis infections. Results HIV-seroprevalence was 2.16% and significantly increased with age, being married and decreasing education level. In multivariate analysis, after adjustements with age, marital status and geographical setting, only education level was associated with HIV-infection (OR, 1.54 [95% CI, 1.15–2.07], p = 0.016). HBsAg prevalence was 14.78% and significantly increased with to be male gender. In multivariate analysis, adjusting for age, marital status and type of blood donation, education level (OR, 1.17 [95%CI, 1.05–1.31], p = 0.02) and male gender (OR, 1.37 [95%CI, 1.14–1.65], p = 0.005) were associated with HBV-infection. HCV-prevalence was 2.32% and significantly increased with living outside Bamako. In multivariate analysis, adjusting for gender, age and education level, living outside Bamako was associated with HCV-infection (OR, 1.83 [95% CI, 1.41–2.35], p < 0.001). Syphilis seroprevalence was very low (0.04%) with only 3 individuals infected. Contrary to a prior study, blood donation type was not, after adjustments, an independent risk factor for each infection. Conclusions Overall, HIV and HBV infection was higher in individuals with a lower level of education, HBV infection was higher in men, and HCV infection was higher in people living outside of Bamako. Compared to studies performed in 1999, 2002 and 2007 in the same population, we found that HIV and HCV prevalence have decreased in the last two decades whereas HBV prevalence has remained stable. Our finding will help guide infection prevention and treatment programs in Mali.

Risk Factors Associated with Hospital-Acquired Venous Thromboembolism in the Pediatric Intensive Care Unit

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2313-2313
Author(s):  
Minh Q Tran ◽  
Steven L Shein ◽  
Hong Li ◽  
Sanjay P Ahuja
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Multivariate Analysis ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Odds Ratio ◽  
Pediatric Intensive Care ◽  
Primary Diagnosis ◽  
Factors Associated ◽  
Hospital Acquired

Abstract Introduction: Venous thromboembolism (VTE) in Pediatric Intensive Care Unit (PICU) patients is associated with central venous catheter (CVC) use. However, risk factors for VTE development in PICU patients with CVCs are not well established. The impact of Hospital-Acquired VTE in the PICU on clinical outcomes needs to be studied in large multicenter databases to identify subjects that may benefit from screening and/or prophylaxis. Method: With IRB approval, the Virtual Pediatric Systems, LLC database was interrogated for children < 18yo admitted between 01/2009-09/2014 who had PICU length of stay (LOS) <1 yr and a CVC present at some point during PICU care. The exact timing of VTE diagnosis was unavailable in the database, so VTE-PICU was defined as an "active" VTE that was not "present at admission". VTE-prior was defined as a VTE that was "resolved," "ongoing" or "present on admission." Variables extracted from the database included demographics, primary diagnosis category, and Pediatric Index of Mortality (PIM2) score. PICU LOS was divided into quintiles. Chi squared and Wilcoxon rank-sum were used to identify variables associated with outcomes, which were then included in multivariate models. Our primary outcome was diagnosis of VTE-PICU and our secondary outcome was PICU mortality. Children with VTE-prior were included in the mortality analyses, but not the VTE-PICU analyses. Data shown as median (IQR) and OR (95% CI). Results: Among 143,524 subjects, the median age was 2.8 (0.47-10.31) years and 55% were male. Almost half (44%) of the subjects were post-operative. The median PIM2 score was -4.11. VTE-prior was observed in 2498 patients (1.78%) and VTE-PICU in 1741 (1.2%). The incidence of VTE-PICU were 852 (1.7%) in patients ≤ 1 year old, 560 (0.9%) in patients 1-12 years old, and 303 (1.1%) in patients ≥ 13 years old (p < 0.0001). In univariate analysis, variables associated with a diagnosis of VTE-PICU were post-operative state, four LOS quintiles (3-7, 7-14, and 14-21 and >21 days) and several primary diagnosis categories: cardiovascular, gastrointestinal, infectious, neurologic, oncologic, genetic, and orthopedic. Multivariate analysis showed increased risk of VTE with cardiovascular diagnosis, infectious disease diagnosis, and LOS > 3 d (Table 1). The odds increased with increasing LOS: 7 d < LOS ≤ 14 d (5.18 [4.27-6.29]), 14 d < LOS ≤ 21 d (7.96 [6.43-9.82]), and LOS > 21 d (20.73 [17.29-24.87]). Mortality rates were 7.1% (VTE-none), 7.2% (VTE-prior), and 10.1% (VTE-PICU) (p < 0.0001). In the multivariate model, VTE-PICU (1.25 [1.05-1.49]) and VTE-prior (1.18 [1.002-1.39]) were associated with death vs. VTE-none. PIM2 score, trauma, and several primary diagnosis categories were also independently associated with death (Table 2). Conclusion: This large, multicenter database study identified several variables that are independently associated with diagnosis of VTE during PICU care of critically ill children with a CVC. Children with primary cardiovascular or infectious diseases, and those with PICU LOS >3 days may represent specific populations that may benefit from VTE screening and/or prophylaxis. Hospital-Acquired VTE in PICU was independently associated with death in our database. Additional analysis of this database, including adding specific diagnoses and secondary diagnoses, may further refine risk factors for Hospital-Acquired VTE among PICU patients with a CVC. Table 1. Multivariate analysis of Factors Associated with VTE-PICU. Factors Odds Ratio 95% Confidence Interval 3d < LOS ≤ 7d vs LOS ≤ 3d 2.19 1.78-2.69 7d < LOS ≤ 14d vs LOS ≤ 3d 5.18 4.27-6.29 14d < LOS ≤ 21d vs LOS ≤ 3d 7.95 6.44-9.82 LOS > 21d vs LOS ≤ 3d 20.73 17.29-24.87 Age 1.00 0.99-1.01 Post-operative 0.89 0.80-0.99 PIM2 Score 1.47 1.01-1.07 Primary Diagnosis: Cardiovascular 1.50 1.31-1.64 Primary Diagnosis: Infectious 1.50 1.27-1.77 Primary Diagnosis: Genetics 0.32 0.13-0.78 Table 2. Multivariate Analysis of Factors Associated with PICU Mortality. Factors Odds Ratio 95% ConfidenceInterval VTE-prior 1.18 1.00-1.39 VTE-PICU 1.25 1.05-1.49 PIM2 Score 2.08 2.05-2.11 Trauma 1.92 1.77-2.07 Post-operative 0.45 0.42-0.47 Primary Diagnosis: Genetic 2.07 1.63-2.63 Primary Diagnosis: Immunologic 2.45 1.51-3.95 Primary Diagnosis: Hematologic 1.63 1.30-2.06 Primary Diagnosis: Metabolic 0.71 0.58-0.87 Primary Diagnosis: Infectious 1.47 1.36-1.59 Primary Diagnosis: Neurologic 1.37 1.27-1.47 Disclosures No relevant conflicts of interest to declare.

scholarly journals Postoperative Venous Thromboembolism in Children Is Increased in Setting of Cancer or Infection

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2391-2391
Author(s):  
Harold J. Leraas ◽  
Jina Kim ◽  
Zhifei Sun ◽  
Uttara P. Nag ◽  
Brian D. Ezekian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Venous Thromboembolism ◽  
Pediatric Patients ◽  
Conflicts Of Interest ◽  
Significant Risk ◽  
The United States ◽  
Improvement Program ◽  
Thrombotic Risk ◽  
Factors Associated

Abstract Background: Venous thromboembolism (VTE) is an uncommon but clinically significant postoperative complication in children. Incidence of VTE in pediatric patients ranges from 34-58 per 10,000 hospitalized children1. Due to rarity of these events, there is limited information about the factors predisposing children to VTE after surgery. We queried a national surgical database to identify risks and outcomes associated with VTE in pediatric surgical patients. Methods: The National Surgical Quality Improvement Program-Pediatric (NSQIP) is a prospectively collected database that records pediatric surgical information, surgical approaches, and 30 day patient outcomes. The database was queried for the years 2012-2013 to identify pediatric patients (age < 18) who had received surgical intervention and were diagnosed with postoperative VTE. Because of their separate coding in NSQIP, we defined VTE as including venous thromboembolism, or pulmonary embolism (PE) diagnosed radiographically within 30 days of operation. To reduce non-random differences between patients we used propensity scores based on age, sex, race, BMI, and ASA classification to match patients in a 1:2 ratio using the nearest neighbor method. Using univariate and multivariate analysis, we identified preoperative risk factors associated with VTE. Results: In total, 130 patients were identified who developed VTE postoperatively (VTE n=122, PE n=7, BOTH PE + VTE n= 1) from this database of 114,395 patients. There were 104 patients with VTE that also had complete entries and were subsequently analyzed in this study. Surgical specialties treating patients in this analysis included cardiothoracic surgery, general surgery, neurosurgery, orthopedic surgery, otolaryngology, plastic surgery, and urology. Eighty-one unique operative CPT codes were identified for patients with VTE. Patients who developed VTE had increased operative time, anesthesia time, and total length of stay (all p < 0.001). Multivariate analysis demonstrated that pneumonia (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.3 - 2.29), Central Line Associated Bloodstream Infection (CLABSI) (OR 1.69, 95% CI 1.18 - 2.42), sepsis (OR 1.47, 95% CI 1.18 - 1.82), septic shock (OR 1.36, 95% CI 1.06 - 1.75), and current solid or hematologic malignancy or active treatment of malignancy (OR 1.30, 95% CI 1.08 - 1.58) were all statistically significant risk factors associated with development of VTE (all p < 0.05). Conclusions: Postoperative VTE risk is significantly increased in children with malignancy or severe infections. Further research is needed to understand the mechanism between malignancy, systemic inflammation, and VTE risk in children. These findings may help to identify patients in need of prophylactic treatment in order to reduce postoperative thrombotic risk in pediatric patients. References: 1. Raffini L, Huang YS, Witmer C, Feudtner C. Dramatic increase in venous thromboembolism in children's hospitals in the United States from 2001 to 2007. Pediatrics. 2009;124(4):1001-1008. Disclosures No relevant conflicts of interest to declare.

scholarly journals RSV and exposure to cigarette smoking as risk factors for severe bronchiolitis in a tropical country

2020 ◽  
Author(s):  
Jefferson A. Buendia ◽  
Ranniery Acuña-Cordero
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Cigarette Smoking ◽  
Retrospective Cohort ◽  
Respiratory Effort ◽  
Tropical Country ◽  
Factors Associated ◽  
Confounding Variables ◽  
Binomial Regression ◽  
Current Exposure

Abstract Objetive: This study aims to identify risk factors associated with severe bronchiolitis in children. In a retrospective cohort study, we included all infants younger than two years of age in tertiary centers in Rionegro, Colombia, hospitalized due to bronchiolitis from January 2019 to December 2019. Severe bronchiolitis was defined as rhinorrhea, cough, tachypnea, wheezing, rales, and increased respiratory effort (e.g., grunting, nasal flaring, and intercostal and/or subcostal retraction), with symptoms of severity (e.g., increased respiratory rate, retractions, and oxygen saturation at 90% or lower). To identify factors independently associated with severe bronchiolitis, we used log-binomial regression and estimate prevalences ratio (PR) and adjust for potential confounding variables Results: Of a total of 417 included, 300 (72.12%) have severe bronchiolitis. After modeling and controlling for potential confounders in the multivariate analysis: RSV isolation (PR 1.15 95%CI 1.03–1.29) and current exposure to cigarette smoking (PR 1.19 95%CI 1.04–1.35) were independent predictors of severe bronchiolitis. We concluded that RSV and exposure to cigarette smoking are independent predictors of severe bronchiolitis. These potentially modifiable variables associated with severity should guide future interventions to reduce the morbidity and economic burden of bronchiolitis in our population.

scholarly journals A Study in the Clinical Characteristics of Stenotrophomonas Maltophilia Bacteremia in Hematological Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4631-4631
Author(s):  
Haiyan Bao ◽  
Jia Chen ◽  
Xiaojin Wu ◽  
Xiao Ma ◽  
Chengcheng Fu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Respiratory Failure ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Univariate Analysis ◽  
P Value ◽  
Hematological Diseases ◽  
Factors Associated

Abstract Introduction: Stenotrophomonas maltophilia is an important nosocomial pathogen, particularly in immunocompromised patients, especially in patients with hematologic diseases. Methods: We reviewed the clinical characteristics and prognosis of patients with S. maltophilia bacteremia over a five-year period from January 2010 to December 2014. Species identification was performed using the automated Vitek 2 compact system (bioMe rieux). Results: The incidence of S. maltophilia bacteremia was 25.1 per 10 000 admissions in our study. Thirty-four patients (median age: 34 years; 64.7% males) with S. maltophilia bacteremia were analyzed. The S. maltophilia bacteremia related 30-day mortality was 44.1%. Risk factors associated with mortality in patients with S. maltophilia infection in the univariate and multivariate analysis were represented in Tables I and II. In the univariate analysis, risk factors included T>39.0¡æ, septic shock, respiratory failure and non-remission after treatment for primary hematological diseases (P <0.05). In the multivariate analysis, respiratory failure and non-remission status after treatment forhematological diseases were independent prognostic factors for mortality. In vitro susceptibility was higher to ciprofloxacin(82.4%), ceftazidime(70.6%), sulbactam and cefoperazone(58.8%), which was shown in Table III. Conclusion: Combination regimens with ciprofloxacin and ceftazidime, or sulbactam and cefoperazone could be alternative treatment. Novel antibiotics are required for treatment of S. maltophilia infection, as well as infection control practices of environmental reserves, rapid detection of pathogens, risk stratification strategy and appropriate treatment for primary hematologic malignancies, which might conjointly contribute to better survival outcome of S. maltophilia bacteremia. Univariate analysis of prognostic factors associated with mortality from S. maltophilia bacteremia Table 1. Factor Mortality HR 95%CI P-value Withfactor Withoutfactor T>39.0¡æ 75% 16.7% 2.490 1.318-4.704 0.005 Septic shock 90.0% 25.0% 2.544 1.473-4.393 0.001 Respiratory failure 100% 20.8% 4.672 2.366-9.225 0.000 Treatment outcome for hematological diseases Remission 10.0% 85.7% 0.247 0.116-0.526 0.000 HR, hazard ratio; CI, confidence interval; HSCT, Hematopoietic stem cell transplantation Table 2. Multivariate analysis of prognostic factors associated with mortality from S. maltophilia bacteremia Factor HR 95%CI P-value Respiratory failure 2.688 1.297-5.569 0.008 Remission after treatment for hematological diseases 0.367 0.153-0.879 0.025 HR, hazard ratio; CI, confidence interval Table 3. Susceptibility pattern of the 34 patients with Stenotrophomonas maltophilia bacteremia Antimicrobial agents S (%) I (%) Ceftazidime 24(70.6%) 1(2.9%) Cefoperazone 19(44.1%) 6(17.6%) Sulbactam and Cefoperazone 20(58.8%) 5(14.7%) Piperacillin 7(20.6%) 6(17.6%) Piperacillin-Tazobactam 11(32.3%) 7(20.6%) Amikacin 6(17.6%) 0(0%) Ciprofloxacin 28(82.4%) 1(2.9%) S, susceptible; I, intermediately susceptible. Disclosures No relevant conflicts of interest to declare.

Septic Dermatitis of the Neonatal Scalp and Maternal Endomyometritis with Intrapartum Internal Fetal Monitoring

PEDIATRICS ◽  
1984 ◽  
Vol 74 (1) ◽  
pp. 81-85
Author(s):  
Marilyn M. Wagener ◽  
Russell Rule Rycheck ◽  
Robert B. Yee ◽  
Joanne F. McVay ◽  
Carol L. Buffenmyer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Significant Risk ◽  
Fetal Monitoring ◽  
Maternal Diabetes ◽  
Factors Associated ◽  
Increased Risk ◽  
Fetal Scalp ◽  
Pressure Catheter ◽  
Fetal Scalp Blood Sampling

During a 3-month period, 1,062 mother-infant pairs were studied for infections following internal fetal monitoring during labor. Six infants (0.56%) developed septic scalp dermatitis at the site of the spiral electrode application. Factors associated with septic scalp dermatitis included the number of vaginal examinations, the use of an intrauterine pressure catheter or of more than one spiral electrode, and fetal scalp blood sampling. Maternal diabetes and endomyometritis were also associated with an increased risk of scalp infection. The duration of spiral electrode use and duration of ruptured membranes were not significant risk factors. Endomyometritis was documented in 41 mothers, an overall incidence of 3.9%. In women whose babies were delivered by cesarean section, the incidence of endomyometritis was 28/117 (23.9%). Using multivariate analysis by logistic regression, endomyometritis was associated with the number of vaginal examinations during labor but not with the duration of internal monitoring, duration of labor, or duration of ruptured membranes.

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