scholarly journals Leprosy and cutaneous leishmaniasis affecting the same individuals: A retrospective cohort analysis in a hyperendemic area in Brazil

2021 ◽  
Vol 15 (12) ◽  
pp. e0010035
Author(s):  
Amanda Gabriela de Carvalho ◽  
Anuj Tiwari ◽  
João Gabriel Guimarães Luz ◽  
Daan Nieboer ◽  
Peter Steinmann ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Retrospective Cohort ◽  
Neglected Tropical Diseases ◽  
Cox Model ◽  
Cohort Analysis ◽  
Mato Grosso ◽  
The North ◽  
Number Of Patients ◽  
Demographic Risk ◽  
National Reporting System

Background Leprosy and cutaneous leishmaniasis (CL) are neglected tropical diseases (NTDs) affecting the skin. Their control is challenging but the integration of skin NTDs control programs is recommended to improve timely detection and treatment. However, little is known about the occurrence of leprosy and CL in the same individuals, and what are the characteristics of such patients. This study aimed to identify and characterize patients diagnosed with both leprosy and CL (i.e., outcome) in the hyperendemic state of Mato Grosso, Brazil. Also, we investigated the demographic risk factors associated with the period between the diagnosis of both diseases. Methodology/principal findings A retrospective cohort study was conducted with patients diagnosed between 2008 and 2017. From the leprosy (n = 28,204) and CL (n = 24,771) databases of the national reporting system, 414 (0.8%; 414/52,561) patients presenting both diseases were identified through a probabilistic linkage procedure. This observed number was much higher than the number of patients that would be expected by chance alone (n = 22). The spatial distribution of patients presenting the outcome was concentrated in the North and Northeast mesoregions of the state. Through survival analysis, we detected that the probability of a patient developing both diseases increased over time from 0.2% in the first year to 1.0% within seven years. Further, using a Cox model we identified male sex (HR: 2.3; 95% CI: 1.7–2.9) and low schooling level (HR: 1.5; 95% CI: 1.2–1.9) as positively associated with the outcome. Furthermore, the hazard of developing the outcome was higher among individuals aged 40–55 years. Conclusions/significance Leprosy and CL are affecting the same individuals in the area. Integration of control policies for both diseases will help to efficiently cover such patients. Measures should be focused on timely diagnosis by following-up patients diagnosed with CL, active case detection, and training of health professionals.

scholarly journals Spatial–temporal pattern of cutaneous leishmaniasis in Brazil

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Tatiana P. Portella ◽  
Roberto A. Kraenkel
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Neglected Tropical Diseases ◽  
Temporal Trends ◽  
Control Measures ◽  
World Health ◽  
Trend Test ◽  
Future Research ◽  
Spatial And Temporal Variability ◽  
Mato Grosso ◽  
The World

Abstract Background Cutaneous leishmaniasis (CL) is a vector-borne disease classified by the World Health Organization as one of the most neglected tropical diseases. Brazil has the highest incidence of CL in America and is one of the ten countries in the world with the highest number of cases. Understanding the spatiotemporal dynamics of CL is essential to provide guidelines for public health policies in Brazil. In the present study we used a spatial and temporal statistical approach to evaluate the dynamics of CL in Brazil. Methods We used data of cutaneous leishmaniasis cases provided by the Ministry of Health of Brazil from 2001 to 2017. We calculated incidence rates and used the Mann–Kendall trend test to evaluate the temporal trend of CL in each municipality. In addition, we used Kuldorff scan method to identify spatiotemporal clusters and emerging hotspots test to evaluate hotspot areas and their temporal trends. Results We found a general decrease in the number of CL cases in Brazil (from 15.3 to 8.4 cases per 100 000 habitants), although 3.2% of municipalities still have an increasing tendency of CL incidence and 72.5% showed no tendency at all. The scan analysis identified a primary cluster in northern and central regions and 21 secondary clusters located mainly in south and southeast regions. The emerging hotspots analysis detected a high spatial and temporal variability of hotspots inside the main cluster area, diminishing hotspots in eastern Amazon and permanent, emerging, and new hotspots in the states of Amapá and parts of Pará, Roraima, Acre and Mato Grosso. The central coast the state of Bahia is one of the most critical areas due to the detection of a cluster of the highest rank in a secondary cluster, and because it is the only area identified as an intensifying hotspot. Conclusions Using a combination of statistical methods we were able to detect areas of higher incidence of CL and understand how it changed over time. We suggest that these areas, especially those identified as permanent, new, emerging and intensifying hotspots, should be targeted for future research, surveillance, and implementation of vector control measures. Graphic abstract

scholarly journals Hyperendemicity, heterogeneity and spatial overlap of leprosy and cutaneous leishmaniasis in the southern Amazon region of Brazil

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Amanda Gabriela De Carvalho ◽  
João Gabriel Guimarães Luz ◽  
João Victor Leite Dias ◽  
Anuj Tiwari ◽  
Peter Steinmann ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Spatial Autocorrelation ◽  
Cutaneous Leishmaniasis ◽  
Urban Areas ◽  
Neglected Tropical Diseases ◽  
Scan Statistics ◽  
Moran’S I ◽  
Moran's I ◽  
Mato Grosso ◽  
Global And Local

Neglected tropical diseases characterized by skin lesions are highly endemic in the state of Mato Grosso, Brazil. We analyzed the spatial distribution of leprosy and Cutaneous Leishmaniasis (CL) and identified the degree of overlap in their distribution. All new cases of leprosy and CL reported between 2008 and 2017 through the national reporting system were included in the study. Scan statistics together with univariate Global and Local Moran’s I were employed to identify clusters and spatial autocorrelation for each disease, with the spatial correlation between leprosy and CL measured by bivariate Global and Local Moran’s I. Finally, we evaluated the demographic characteristics of the patients. The number of leprosy (N = 28,204) and CL (N = 24,771) cases in Mato Grosso and the highly smoothed detection coefficients indicated hyperendemicity and spatial distribution heterogeneity. Scan statistics demonstrated overlap of high-risk clusters for leprosy (RR = 2.0; p <0.001) and CL (RR = 4.0; p <0.001) in the North and Northeast mesoregions. Global Moran’s I revealed a spatial autocorrelation for leprosy (0.228; p = 0.001) and CL (0.311; p = 0.001) and a correlation between them (0.164; p = 0.001). Both diseases were found to be concentrated in urban areas among men aged 31-60 years, of brown-skinned ethnicity and with a low educational level. Our findings indicate a need for developing integrated and spatially as well as socio-demographically targeted public health policies.

scholarly journals Impact of the COVID-19 Pandemic on Acute General Surgical Admissions in a District General Hospital in the United Kingdom: A Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Rory Callan ◽  
Nazrin Assaf ◽  
Katharine Bevan
Keyword(s):  
General Hospital ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Substantial Reduction ◽  
District General Hospital ◽  
Similar Proportion ◽  
Surgical Team ◽  
Number Of Patients ◽  
Medical Teams ◽  
The Impact

The COVID-19 pandemic of 2020 has greatly impacted healthcare systems and society more generally around the world. The management of patients infected with SARS-CoV-2 has primarily impacted emergency departments, medical teams, and intensive care units. However, the impact on health systems as a whole, including surgical specialties, has been wide ranging. We aimed to establish the impact of the COVID-19 pandemic and associated lockdown on the number and characteristics of general surgical patients reviewed and/or admitted by the surgical team within a district general hospital. We performed a retrospective cohort analysis of patients admitted in the 2-week period from start of the lockdown (Monday 23rd March 2020 to 5th April 2020), and the same period 1 year earlier (Monday 25th March 2019 to 7th April 2019). Number of patients reviewed and admitted were compared between the two cohorts. Data including diagnosis, operation/procedural interventions, and length of stay were analysed. The overall number of patients reviewed and admitted by the surgical team was substantially lower during the period of lockdown (61 vs 126). Of the patients seen during lockdown, a smaller proportion were admitted to hospital after initial surgical review (59% vs 77%, p<0.05). Interventional/operative procedures were performed in a similar proportion of patients in both cohorts (31%). Our data show that there has been a substantial reduction in the number of patients being referred to and admitted by the general surgical team at our centre during the COVID-19 pandemic. Explanations for this include reduced attendance due to risk perception of the patients, the impact of lockdown messages and advice regarding self-isolation, as well as an increased threshold for patient admission during the COVID-19 pandemic. Key learning points include the possible benefits of a reduction in admission to hospital of patients with nonurgent conditions.

scholarly journals Geographical accessibility to the supply of antiophidic sera in Brazil: Timely access possibilities

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0260326
Author(s):  
Ricardo Antunes Dantas de Oliveira ◽  
Diego Ricardo Xavier Silva ◽  
Maurício Gonçalves e Silva
Keyword(s):  
Population Distribution ◽  
Neglected Tropical Diseases ◽  
Transportation Network ◽  
Health Facilities ◽  
Mato Grosso ◽  
The North ◽  
Timely Access ◽  
Public Health Information ◽  
Commuting Time ◽  
Geographical Accessibility

Snakebite accidents are considered category A neglected tropical diseases. Brazil stands out for snakebite accidents, mainly in the Amazon region. The best possible care after snakebite accidents is to obtain antiophidic sera on time. And the maximum ideal time to reach it is about 2 hours after an accident. Based on public health information and using a tool to analyze geographical accessibility, we evaluate the possibility of reaching Brazilian serum-providing health facilities from the relationship between population distribution and commuting time. In this exploratory descriptive study, the geographic accessibility of Brazilian population to health facilities that supply antiophidic serum is evaluated through a methodology that articulates several issues that influence the commuting time to health units (ACCESSMOD): population and facilities’ distribution, transportation network and means, relief and land use, which were obtained in Brazilian and international sources. The relative importance of the population without the possibility of reaching a facility in two hours is highlighted for Macro-Regions, States and municipalities. About nine million people live in locations more than two hours away from serum-providing facilities, with relevant variations between regions, states, and municipalities. States like Mato Grosso, Pará and Maranhão had the most important participation of population with reaching time problems to those units. The most significant gaps are found in areas with a dispersed population and sometimes characterized by a high incidence of snakebites, such as in the North of the country, especially in the Northeastern Pará state. Even using a 2010 population distribution information, because of the 2020 Census postponement, the tendencies and characteristics analyzed reveal challenging situations over the country. The growing availability of serum-providing health facilities, the enhanced possibilities of transporting accident victims, and even the availability of sera in other types of establishments are actions that would allow expanding the possibilities of access to serum supply.

A Synopsis of Dicliptera (Acanthaceae) in Brazil, with the Description of Two New Species

2020 ◽  
Vol 45 (2) ◽  
pp. 340-348
Author(s):  
James Lucas da Costa-Lima ◽  
Earl Celestino de Oliveira Chagas
Keyword(s):  
New Species ◽  
South America ◽  
The State ◽  
Northeastern Brazil ◽  
Mato Grosso ◽  
The North ◽  
New Synonyms ◽  
Two New Species ◽  
Mato Grosso Do Sul ◽  
A New Species

Abstract—A synopsis of Dicliptera (Acanthaceae) for Brazil is presented. Six species are recognized: Dicliptera ciliaris, D. sexangularis, and D. squarrosa, widely distributed in South America; D. purpurascens, which ranges from the North Region of Brazil (in the state of Acre) to eastern Bolivia; D. gracilirama, a new species from the Atlantic Forest of northeastern Brazil; and D. granchaquenha, a new species recorded in dry and semideciduous forests in Bolivia and western Brazil, in the state of Mato Grosso do Sul. Furthermore, we propose new synonyms and designate lectotypes for eleven names. An identification key to the six accepted Dicliptera species in Brazil is provided.

Are perceptual disorder signs in diplegic cerebral palsied children stable over time? A retrospective cohort analysis

2020 ◽  
Vol 72 (2) ◽  
Author(s):  
Silvia Alboresi ◽  
Alice Sghedoni ◽  
Giulia Borelli ◽  
Stefania Costi ◽  
Laura Beccani ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Retrospective Cohort Analysis ◽  
Over Time

An Analysis of Dental Implants Survival and Success

2018 ◽  
Vol 69 (9) ◽  
pp. 2465-2466
Author(s):  
Iustin Olariu ◽  
Roxana Radu ◽  
Teodora Olariu ◽  
Andrada Christine Serafim ◽  
Ramona Amina Popovici ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Medical History ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Demographic Data ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Health Related

Osseointegration of a dental implant may encounter a variety of problems caused by various factors, as prior health-related problems, patients� habits and the technique of the implant inserting. Retrospective cohort study of 70 patients who received implants between January 2011- April 2016 in one dental unit, with Kaplan-Meier method to calculate the probability of implants�s survival at 60 months. The analysis included demographic data, age, gender, medical history, behavior risk factors, type and location of the implant. For this cohort the implants�survival for the first 6 months was 92.86% compared to the number of patients and 97.56% compared to the number of total implants performed, with a cumulative failure rate of 2.43% after 60 months. Failures were focused exclusively on posterior mandible implants, on the percentage of 6.17%, odds ratio (OR) for these failures being 16.76 (P = 0.05) compared with other localisations of implants, exclusively in men with median age of 42 years.

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