scholarly journals Spatiotemporal Heterogeneity in the Distribution of Chikungunya and Zika Virus Case Incidences and Risk Factors During Their Epidemics in Barranquilla, Colombia, between 2014 and 2016: An Ecological Study

2019 ◽  
Author(s):  
Thomas C. McHale ◽  
Claudia M. Romero-Vivas ◽  
Claudio Fronterre ◽  
Pedro Arango-Padilla ◽  
Andrew K. Falconar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Zika Virus ◽  
Northern Region ◽  
Explanatory Variables ◽  
Incidence Data ◽  
Life Years ◽  
Central Regions ◽  
Incidence Risk ◽  
Potential Risk Factors ◽  
Spatiotemporal Heterogeneity

Chikungunya virus (CHIKV) and Zika virus (ZIKV) have recently emerged as global infections with consequential disability adjusted life years (DALYs) and economic burden. This study aimed to explore the spatiotemporal heterogeneity in the occurrence of CHIKV and ZIKV outbreaks throughout Barranquilla, Colombia during 2014 and 2016 and explored the potential for clustering. Incidence data were fitted using multiple Bayesian Poisson models based on a suite of explanatory variables as potential risk factors and multiple options for random effects. A best fit model was used to analyse the case incidence risk for both epidemics to identify any risk factors during their epidemics. Neighbourhoods in the northern region of Barranquilla were hotspots for the outbreaks of both CHIKV and ZIKV. Additional hotspots occurred in the south-western and central regions of the CHIKV and ZIKV outbreaks, respectively. Multivariate conditional autoregressive models strongly identified higher socioeconomic strata (SES) and residing in detached houses as risk factors for ZIKV case incidences. These novel findings challenge the belief that these infections are driven by social vulnerability and merits further study both in Barranquilla and throughout the tropical and subtropical regions of the world. 

scholarly journals Spatiotemporal Heterogeneity in the Distribution of Chikungunya and Zika Virus Case Incidences and Risk Factors during their Epidemics in Barranquilla, Colombia, between 2014 and 2016: An Ecological Study.

2019 ◽  
Author(s):  
Thomas C McHale ◽  
Claudia M Romero-Vivas ◽  
Claudio Fronterre ◽  
Pedro Arango-Padilla ◽  
Andrew K Falconar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Zika Virus ◽  
Northern Region ◽  
Explanatory Variables ◽  
Incidence Data ◽  
Life Years ◽  
Central Regions ◽  
Incidence Risk ◽  
Potential Risk Factors ◽  
Spatiotemporal Heterogeneity

Chikungunya virus (CHIKV) and Zika virus (ZIKV) have recently emerged as global infections with consequential disability adjusted life years (DALYs) and economic burden. This study aimed to explore the spatiotemporal heterogeneity in the occurrence of CHIKV and ZIKV outbreaks throughout Barranquilla, Colombia during 2014 and 2016 and explored the potential for clustering. Incidence data were fitted using multiple Bayesian Poisson models based on a suite of explanatory variables as potential risk factors and multiple options for random effects. A best fit model was used to analyse the case incidence risk for both epidemics to identify any risk factors during their epidemics. Neighbourhoods in the northern region of Barranquilla were hotspots for the outbreaks of both CHIKV and ZIKV. Additional hotspots occurred in the south-western and central regions of the CHIKV and ZIKV outbreaks, respectively. Multivariate conditional autoregressive models strongly identified higher socioeconomic strata (SES) and residing in detached houses as risk factors for ZIKV case incidences. These novel findings challenge the belief that these infections are driven by social vulnerability and merits further study both in Barranquilla and throughout the tropical and subtropical regions of the world.

scholarly journals Spatiotemporal Heterogeneity in the Distribution of Chikungunya and Zika Virus Case Incidences during their 2014 to 2016 Epidemics in Barranquilla, Colombia

2019 ◽  
Vol 16 (10) ◽  
pp. 1759 ◽  
Author(s):  
Thomas C. McHale ◽  
Claudia M. Romero-Vivas ◽  
Claudio Fronterre ◽  
Pedro Arango-Padilla ◽  
Naomi R. Waterlow ◽  
...  
Keyword(s):  
Risk Factors ◽  
Zika Virus ◽  
Northern Region ◽  
Explanatory Variables ◽  
Incidence Data ◽  
Poisson Models ◽  
Potential Risk Factors ◽  
Conditional Autoregressive ◽  
Spatiotemporal Heterogeneity ◽  
Conditional Autoregressive Models

Chikungunya virus (CHIKV) and Zika virus (ZIKV) have recently emerged as globally important infections. This study aimed to explore the spatiotemporal heterogeneity in the occurrence of CHIKV and ZIKV outbreaks throughout the major international seaport city of Barranquilla, Colombia in 2014 and 2016 and the potential for clustering. Incidence data were fitted using multiple Bayesian Poisson models based on multiple explanatory variables as potential risk factors identified from other studies and options for random effects. A best fit model was used to analyse their case incidence risks and identify any risk factors during their epidemics. Neighbourhoods in the northern region were hotspots for both CHIKV and ZIKV outbreaks. Additional hotspots occurred in the southwestern and some eastern/southeastern areas during their outbreaks containing part of, or immediately adjacent to, the major circular city road with its import/export cargo warehouses and harbour area. Multivariate conditional autoregressive models strongly identified higher socioeconomic strata and living in a neighbourhood near a major road as risk factors for ZIKV case incidences. These findings will help to appropriately focus vector control efforts but also challenge the belief that these infections are driven by social vulnerability and merit further study both in Barranquilla and throughout the world’s tropical and subtropical regions.

scholarly journals Influence of socio-economic status on Shiga toxin-producing Escherichia coli (STEC) infection incidence, risk factors and clinical features

2019 ◽  
Vol 147 ◽  
Author(s):  
N. L. Adams ◽  
L. Byrne ◽  
T. C. Rose ◽  
G. K. Adak ◽  
C. Jenkins ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Shiga Toxin ◽  
Economic Status ◽  
Care Seeking ◽  
Socio Economic Status ◽  
Accident And Emergency ◽  
Incidence Risk ◽  
Potential Risk Factors

Abstract Shiga toxin-producing Escherichia coli (STEC) infection can cause serious illness including haemolytic uraemic syndrome. The role of socio-economic status (SES) in differential clinical presentation and exposure to potential risk factors amongst STEC cases has not previously been reported in England. We conducted an observational study using a dataset of all STEC cases identified in England, 2010–2015. Odds ratios for clinical characteristics of cases and foodborne, waterborne and environmental risk factors were estimated using logistic regression, stratified by SES, adjusting for baseline demographic factors. Incidence was higher in the highest SES group compared to the lowest (RR 1.54, 95% CI 1.19–2.00). Odds of Accident and Emergency attendance (OR 1.35, 95% CI 1.10–1.75) and hospitalisation (OR 1.71, 95% CI 1.36–2.15) because of illness were higher in the most disadvantaged compared to the least, suggesting potential lower ascertainment of milder cases or delayed care-seeking behaviour in disadvantaged groups. Advantaged individuals were significantly more likely to report salad/fruit/vegetable/herb consumption (OR 1.59, 95% CI 1.16–2.17), non-UK or UK travel (OR 1.76, 95% CI 1.40–2.27; OR 1.85, 95% CI 1.35–2.56) and environmental exposures (walking in a paddock, OR 1.82, 95% CI 1.22–2.70; soil contact, OR 1.52, 95% CI 2.13–1.09) suggesting other unmeasured risks, such as person-to-person transmission, could be more important in the most disadvantaged group.

Etoposide and etoposide phosphate hypersensitivity in children: Incidence, risk factors, and prevention strategies

2019 ◽  
Vol 26 (2) ◽  
pp. 397-405
Author(s):  
Winifred M Stockton ◽  
Theresa Nguyen ◽  
Lishi Zhang ◽  
Thomas C Dowling
Keyword(s):  
Risk Factors ◽  
Potential Risk ◽  
Infusion Rate ◽  
Pediatric Patients ◽  
Primary Objective ◽  
Etoposide Phosphate ◽  
Dose Infusion ◽  
Incidence Risk ◽  
Potential Risk Factors ◽  
Rate Infusion

Introduction Etoposide is critical in treating pediatric cancers, although hypersensitivity can be severe and treatment-limiting. Reported rates of hypersensitivity range from 2% to 51%. Hypersensitivity data for etoposide phosphate, a newer product, are lacking. The primary objective of this study was to assess etoposide and etoposide phosphate hypersensitivity incidence. Secondary objectives included evaluation of potential risk factors for hypersensitivity and strategies to prevent recurrence. Methods This retrospective cohort study evaluated pediatric patients who received initial etoposide phosphate or etoposide dose between August 2012 and July 2017. The primary outcome was documentation of hypersensitivity within four months of initial dose. Potential risk factors evaluated included age, allergies, dose, infusion rate, infusion concentration, and premedication. Results Of 246 patients, hypersensitivity reactions occurred in five of 54 patients (9.3%) who received etoposide phosphate and 52 of 192 patients (27.1%) who received etoposide ( p = 0.0061). For etoposide, the mean initial infusion rate was 64.6 ± 40.9 mg/m2/h for patients with hypersensitivity and 49.5 ± 33.4 mg/m2/h without hypersensitivity ( p = 0.0886). Etoposide phosphate rate was not associated with hypersensitivity. Recurrent hypersensitivity occurred in one of nine patients (11.1%) who received etoposide desensitization and one of 38 patients (2.6%) who changed formulation to etoposide phosphate. Conclusions Etoposide was associated with more hypersensitivity than etoposide phosphate in pediatric patients. Etoposide hypersensitivity was associated with higher infusion rates, but not etoposide phosphate. Differences in hypersensitivity incidence and infusion rate influence indicate a formulation-effect. Etoposide hypersensitivity recurrence may be prevented by changing to etoposide phosphate formulation. During etoposide phosphate shortages, etoposide desensitization may prevent recurrent hypersensitivity.

scholarly journals Acute kidney injury after the arterial switch operation: incidence, risk factors, and outcomes

2021 ◽  
pp. 1-6
Author(s):  
Nikki J. Schoenmaker ◽  
Jesse A. Weeda ◽  
Roel L.F. van der Palen ◽  
Mark G. Hazekamp ◽  
Heleen E. Bunker-Wiersma
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Arterial Switch Operation ◽  
Kidney Injury ◽  
Single Centre ◽  
Arterial Switch ◽  
Switch Operation ◽  
Incidence Risk ◽  
Potential Risk Factors

Abstract Background: The aim of this retrospective cohort study was to determine the incidence, potential risk factors, characteristics, and outcomes of acute kidney injury in children following the arterial switch operation for transposition of the great arteries. Methods: Retrospective review of children who underwent ASO between 2000 and 2020 in our tertiary children’s hospital in the Netherlands. Pre-and post-ASO serum creatinine levels were collected. Severe AKI was defined as 100% serum creatinine rise or estimated creatinine clearance <35 ml/min/1.73 m2 according to pRIFLE criteria. Logistic regression was used to adjust for confounders. Results: A total of 242 children were included. Fifty-seven (24%) children developed severe AKI after ASO. Four patients with severe AKI were treated with renal replacement therapy. Children with severe AKI had a longer duration of mechanical ventilation 4.5 (1.0–29) versus 3 (1.0–12) days (p = 0.001), longer PICU stay 7 (2–76) versus 5 (1–70) days, (p = 0.001), higher rate of myocardial infarction 5% versus 0.5% (p = 0.001), sepsis 24% versus 9% (p = 0.002), post-operative pulmonary hypertension 19% versus 6% (p = 0.002), post-operative bleeding 9% versus 3% (p = 0.044), longer time to sternal closure 3 (1–19) versus 2 (1–6) days, (p = 0.009), and a higher mortality rate 9.0% versus 0.5% (p = 0.001) compared to children without severe AKI. Sepsis was a risk factor for developing severe AKI. Conclusions: In this single-centre cohort, 24% of our patients developed severe AKI after ASO, which is associated with increased morbidity, longer PICU stay, and higher mortality.

scholarly journals The Golden Retriever Lifetime Study: establishing an observational cohort study with translational relevance for human health

2015 ◽  
Vol 370 (1673) ◽  
pp. 20140230 ◽  
Author(s):  
Michael K. Guy ◽  
Rodney L. Page ◽  
Wayne A. Jensen ◽  
Patricia N. Olson ◽  
J. David Haworth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Biological Sample ◽  
Disease Incidence ◽  
Historical Context ◽  
Quality Data ◽  
Golden Retriever ◽  
Prospective Longitudinal Study ◽  
Incidence Data ◽  
Potential Risk Factors ◽  
Prospective Longitudinal

The Golden Retriever Lifetime Study (GRLS) is the first prospective longitudinal study attempted in veterinary medicine to identify the major dietary, genetic and environmental risk factors for cancer and other important diseases in dogs. The GRLS is an observational study that will follow a cohort of 3000 purebred Golden Retrievers throughout their lives via annual online questionnaires from the dog owner and annual physical examinations and collection of biological samples by the primary care veterinarian. The field of comparative medicine investigating naturally occurring disorders in pets is specifically relevant to the many diseases that have a genetic basis for disease in both animals and humans, including cancer, blindness, metabolic and behavioural disorders and some neurodegenerative disorders. The opportunity for the GRLS to provide high-quality data for translational comparative medical initiatives in several disease categories is great. In particular, the opportunity to develop a lifetime dataset of lifestyle and activity, environmental exposure and diet history combined with simultaneous annual biological sample sets and detailed health outcomes will provide disease incidence data for this cohort of geographically dispersed dogs and associations with a wide variety of potential risk factors. The GRLS will provide a lifetime historical context, repeated biological sample sets and outcomes necessary to interrogate complex associations between genes and environmental influences and cancer.

scholarly journals Lyme disease in France: a primary care-based prospective study

2005 ◽  
Vol 133 (5) ◽  
pp. 935-942 ◽  
Author(s):  
L. LETRILLIART ◽  
B. RAGON ◽  
T. HANSLIK ◽  
A. FLAHAULT
Keyword(s):  
Risk Factors ◽  
Lyme Disease ◽  
Prospective Study ◽  
Rural Areas ◽  
Erythema Migrans ◽  
National Level ◽  
Incidence Data ◽  
Clinical Presentations ◽  
Salaried Workers ◽  
Potential Risk Factors

To estimate the incidence of Lyme borreliosis in France, describe its clinical presentations, and assess its potential risk factors, we conducted a nationwide prospective study in the French Sentinelles Network, consisting of 1178 general practitioners (GPs). Of these, 875 (74%), i.e. 1·6% of all French GPs, participated in the study from May 1999 to April 2000. Eighty-six cases of Lyme disease were reported and validated, of which 77 (90%) consisted of erythema migrans. At national level, the incidence was estimated at 9·4/100000 inhabitants. Compared to the French general population, Lyme disease patients were older (P<10−4), more were living in rural areas (P<10−3), and amongst the working population, more were farmers (P<10−3) and fewer, salaried workers (P<0·005). Cervidae density correlated strongly with the estimated regional incidence of Lyme disease (r=0·82). Both incidence data and identified risk factors can help to target measures for its prevention and treatment.

scholarly journals Acute kidney injury: Incidence, risk factors, and outcomes in severe COVID-19 patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251048
Author(s):  
Danilo Candido de Almeida ◽  
Maria do Carmo Pinho Franco ◽  
Davi Rettori Pardo dos Santos ◽  
Marina Colella Santos ◽  
Isabela Soucin Maltoni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
University Hospital ◽  
Injury Incidence ◽  
Vasoactive Drugs ◽  
Reactive Protein ◽  
Incidence Risk ◽  
Potential Risk Factors

Background COVID-19 is a multisystemic disorder that frequently causes acute kidney injury (AKI). However, the precise clinical and biochemical variables associated with AKI progression in patients with severe COVID-19 remain unclear. Methods We performed a retrospective study on 278 hospitalized patients who were admitted to the ward and intensive care unit (ICU) with COVID-19 between March 2020 and June 2020, at the University Hospital, São Paulo, Brazil. Patients aged ≥ 18 years with COVID-19 confirmed on RT-PCR were included. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. We evaluated the incidence of AKI, several clinical variables, medicines used, and outcomes in two sub-groups: COVID-19 patients with AKI (Cov-AKI), and COVID-19 patients without AKI (non-AKI). Univariate and multivariate analyses were performed. Results First, an elevated incidence of AKI (71.2%) was identified, distributed across different stages of the KDIGO criteria. We further observed higher levels of creatinine, C-reactive protein (CRP), leukocytes, neutrophils, monocytes, and neutrophil-to-lymphocyte ratio (NLR) in the Cov-AKI group than in the non-AKI group, at hospital admission. On univariate analysis, Cov-AKI was associated with older age (>62 years), hypertension, CRP, MCV, leucocytes, neutrophils, NLR, combined hydroxychloroquine and azithromycin treatment, use of mechanical ventilation, and vasoactive drugs. Multivariate analysis showed that hypertension and the use of vasoactive drugs were independently associated with a risk of higher AKI in COVID-19 patients. Finally, we preferentially found an altered erythrocyte and leukocyte cellular profile in the Cov-AKI group compared to the non-AKI group, at hospital discharge. Conclusions In our study, the development of AKI in patients with severe COVID-19 was related to inflammatory blood markers and therapy with hydroxychloroquine/azithromycin, with vasopressor requirement and hypertension considered potential risk factors. Thus, attention to the protocol, hypertension, and some blood markers may help assist doctors with decision-making for the management of COVID-19 patients with AKI.

scholarly journals The incidence of very late-onset psychotic disorders: a systematic review and meta-analysis, 1960–2016

2017 ◽  
Vol 48 (11) ◽  
pp. 1775-1786 ◽  
Author(s):  
Jean Stafford ◽  
Robert Howard ◽  
James B. Kirkbride
Keyword(s):  
Risk Factors ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Economic Status ◽  
Meta Analysis ◽  
Incidence Rates ◽  
Affective Psychoses ◽  
Incidence Data ◽  
Potential Risk Factors ◽  
Meta Analyses

A substantial subset of people with psychotic disorders are first diagnosed in old age, yet little is known about the epidemiology of very late-onset schizophrenia-like psychosis. We investigated the incidence of affective and non-affective psychotic disorders in those aged 65 and above, and examined variation related to potential risk factors via systematic literature review. We searched PubMed, PsychInfo, Web of Science and bibliographies and directly contacted authors to obtain citations published between 1960 and 2016 containing (derivable) incidence data. Cases were those diagnosed with non-organic psychotic disorders after age 65. Findings were presented narratively, and random-effects meta-analyses were used to obtain pooled incidence rates. From 5687 citations, 41 met inclusion criteria. The pooled incidence of: affective psychoses was 30.9 per 100 000 person-years at risk (100 kpy) [95% confidence interval (CI) 11.5–83.4; I2 = 0.99], and schizophrenia was 7.5 per 100 kpy (95% CI 6.2–9.1; I2 = 0.99), with some evidence of higher schizophrenia rates in women [odds ratio (OR) = 1.6; 95% CI 1.0–2.5, p = 0.05]. We found narrative evidence of increasing incidence rates of non-affective psychoses with age, and higher rates amongst migrants than baseline populations, but no evidence that incidence varied by study quality or case ascertainment period (quality OR = 1.04; 95% CI 0.74–1.48; time period OR = 1.00; 95% CI 0.95–1.05). Substantial heterogeneity in the incidence of very late-onset schizophrenia-like psychoses was observed. No identified studies examined possible risk factors which may account for such variation, including socio-economic status, sensory impairment, traumatic life events, or social isolation.

Frequency of Postherpetic Neuralgia In Herpes Zoster Patients

2021 ◽  
Vol 15 (6) ◽  
pp. 1305-1308
Author(s):  
A. Malik ◽  
F. F Jang ◽  
M. Moosa ◽  
A. Iqbal ◽  
S. A. A. Hassan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Postherpetic Neuralgia ◽  
Age Group ◽  
Male Population ◽  
Female Population ◽  
Number Of Patients ◽  
Co Morbidity ◽  
Incidence Risk ◽  
Potential Risk Factors

Aim: To estimate the incidence ofpostherpetic neuralgia after being infected by herpes zoster virus. Place and duration of study: This study was conducted in Sharif Medical & Dental College, Lahore from August 2019 to August 2020. Methodology: A number of 126 patients was included in this research who had history of herpes zoster. Demographic information, medical diagnosis, treatment and symptoms were included in the data collected. Patients with unclear diagnosis regarding herpes zoster were not included in this study. From patient’s history, we comprehended the number of patients who developed postherpetic neuralgia after herpes zoster. Severity of pain was judged by the medications prescribed to the patients. Risk factors like age, gender, co-morbidity and localization were also analyzed. We used multivariate logistic regression to analyze potential risk factors. Risk factors were analyzed in order to determine the frequency of postherpetic neuralgia in herpes zoster patients extensively. This gave us a better idea about postherpetic neuralgia occurrence. Results: Percentage of patients developing postherpetic neuralgia after one month of herpes zoster was 12.7% for age group 50-60. For age group 75-85, this percentage increased up to 26.8%. Neuralgia with severe pain persisted from 9 to 12 months. Mostly patients suffered mild to moderate pain up till 8 months. Patients with ophthalmic localization had 7.6% more chance of developing postherpetic neuralgia than the patients with no localization, after one month of herpes zoster. So, did the patients with co-morbidity. Conclusion: As the results show, postherpetic neuralgia in herpes zoster patients is a frequently occurring condition. The incidence of postherpetic neuralgia increases with age. As the age increases, so does the chance of postherpetic neuralgia in herpes zoster patients. Ophthalmic localization and co-morbidity, i.e. diabetes mellitus and rheumatoid arthritis, are also related to high prevalence of postherpetic neuralgia. Female population also tend to get more postherpetic neuralgia than male population does. Keywords: Postherpetic Neuralgia, Herpes Zoster, Incidence, Risk Factors.

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