scholarly journals Cross-Sectional Household Transmission Study of Cryptosporidium Shows that C. Hominis Infections are A Key Risk Factor for Spread.

2021 ◽  
Author(s):  
Caoimhe McKerr ◽  
Rachel M Chalmers ◽  
Kristin Elwin ◽  
Heather Jones ◽  
Roberto Vivancos ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Index Case ◽  
Secondary Infection ◽  
Transmission Risk ◽  
Cross Sectional ◽  
England And Wales ◽  
Infected People ◽  
North West ◽  
Household Transmission

Abstract BackgroundInfection with the Cryptosporidium parasite causes over 4,000 cases of diagnosed illness (cryptosporidiosis) in England and Wales each year. The incidence of sporadic disease has not been sufficiently established, and how frequently this arises from contact with other infected people is not well documented.This project aimed to explore potential transmission in the home and attempt to identify asymptomatic infections, which might play a role in transmission. Risk factors and characteristics associated with spread of infection in the home were described including any differences between Cryptosporidium species.MethodsThe study identified cryptosporidiosis cases from North West England and Wales over a year and invited them and their household to take part. Each household was sent a study pack containing study information and a questionnaire, and stool sample kits to provide samples from consenting household members. Cryptosporidium-positive stool samples, identified by immunofluorescence microscopy, were characterised using molecular methods to help describe any patterns of transmission. Characteristics of households with and without additional cases were described, and compared using odds ratios (OR) and a multivariable logistic regression identified independent risk factors for household transmission. Data collection ran for one year, beginning in September 2018 with an initial pilot phase. ResultsWe enrolled 128 index cases and their households.Additional illness occurred in over a quarter of homes, each reporting an average of two additional cases. The majority of these were undiagnosed and unreported to surveillance. This burden was even greater in households where the index case was infected with C. hominis versus C. parvum, or the index case was under five years old, with mums and siblings most at risk of secondary infection. Only having an index case of C. hominis was independently associated with transmission in the multivariable model (OR= 4.46; p=0.01).ConclusionsCryptosporidium was a considerable burden in the home. At-risk homes were those where the index was less than five years old and/or infected with C. hominis. Of particular risk were female caregivers and siblings. Hygiene advice should be specifically directed here.This work provides evidence for humans as sources of C. hominis infection and that person-person is a key pathway. We recommend that all stools submitted for the investigation of gastrointestinal pathogens are tested for Cryptosporidium to better capture cases, inclusion of speciation data in routine surveillance, and the consideration of specific clinical advice on prevention for high-risk homes.

scholarly journals Cross-sectional investigation of household transmission ofCryptosporidiumin England and Wales: the epiCrypt study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026116 ◽  
Author(s):  
Caoimhe McKerr ◽  
Rachel M Chalmers ◽  
Roberto Vivancos ◽  
Sarah J O’Brien ◽  
Julie Mugarza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transmission Risk ◽  
Advisory Group ◽  
Cross Sectional ◽  
England And Wales ◽  
Infected People ◽  
North West ◽  
Secondary Spread ◽  
The North ◽  
Sporadic Disease

IntroductionInfection with theCryptosporidiumparasite causes over 4000 cases of diagnosed illness (cryptosporidiosis) in England and Wales each year. Risk factors are often estimated from outbreak investigations, and in the UK include ingestion of contaminated water and food, farm/animal contact and person-to-person spread in institutions. However, reported outbreaks only represent about 10% of cases and the transmission routes for sporadic disease may not be the same. Contact with other people has been highlighted as a factor in the transmission ofCryptosporidium, but the incidence of sporadic disease has not been sufficiently established, and how frequently this arises from contact with other infected people is not well documented. This project will estimate the amount of secondary spread that occurs in the home and potentially identify asymptomatic infections which might have a role in transmission. Risk factors and characteristics associated with secondary spread will be described including any differences in transmission betweenCryptosporidiumspecies.Methods and analysisThe study will prospectively identify cryptosporidiosis cases from North West England and Wales over 1 year and invite them and their household to take part. Each household will complete a questionnaire and each household member will be asked to provide a stool sample. Clinical, demographic and home variables will be described, and further analyses undertaken to investigate associations with secondary spread in the home.Cryptosporidium-positive stool samples, identified by immunofluorescence microscopy, will be characterised using molecular methods to describe patterns of transmission. Data collection is expected to take 1 year, beginning in September 2018.Ethics and disseminationThe study has been approved by the North West–Liverpool East NHS Research Ethics Committee (Reference: 18/NW/0300) and the Confidentiality and Advisory Group (Reference 18/CAG/0084). Outputs will include scientific conferences and peer-reviewed publications. In addition, a short, lay report of findings will be produced for participants, who can opt to receive this when they take part.Trial registration numberCPMS ID: 39458.

scholarly journals Household SARS-CoV-2 transmission and children: a network prospective study

2021 ◽  
Author(s):  
Antoni Soriano-Arandes ◽  
Anna Gatell ◽  
Pepe Serrano ◽  
Mireia Biosca ◽  
Ferran Campillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Index Case ◽  
Viral Transmission ◽  
Transmission Risk ◽  
School Interventions ◽  
Household Transmission ◽  
Household Members ◽  
School Period ◽  
Index Cases

Abstract Background The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. Here, we describe the epidemiological and clinical characteristics of children with COVID-19 in Catalonia (Spain) and investigate the dynamics of household transmission. Methods Prospective, observational, multicenter study performed during summer and school periods (1 July-31 October, 2020), in which epidemiological and clinical features, and viral transmission dynamics were analyzed in COVID-19 patients <16 years. A pediatric index case was established when a child was the first individual infected within a household. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infections. Results The study included 1040 COVID-19 patients <16 years. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (p=0.02), and when compared to adults (p=0.006). No individual or environmental risk factors associated with the SAR were identified. Conclusions Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.

Hawaii's Healthy Start Program of Home Visiting for At-Risk Families: Evaluation of Family Identification, Family Engagement, and Service Delivery

PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_2) ◽  
pp. 250-259 ◽  
Author(s):  
Anne Duggan ◽  
Amy Windham ◽  
Elizabeth McFarlane ◽  
Loretta Fuddy ◽  
LCSW, MPH ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Early Identification ◽  
Home Visiting ◽  
Family Engagement ◽  
Cross Sectional Study ◽  
Family Characteristics ◽  
Sectional Study ◽  
Cross Sectional ◽  
Healthy Start Program

Objective. To describe family identification, family engagement, and service delivery in a statewide home visiting program for at-risk families of newborns. Setting. Six target communities of Hawaii's Healthy Start Program (HSP), which incorporates 1) early identification of at-risk families of newborns via population-based screening and assessment, and 2) paraprofessionalhome visiting to improve family functioning, promote child health and development, and prevent child maltreatment. Design. Cross-sectional study: describes early identification process and family characteristics associated with initial enrollment. Longitudinal study: describes home visiting process and characteristics associated with continued participation. Subjects. Cross-sectional study: civilian births in 6 communities (n = 6553). Longitudinal study: at-risk families in the intervention group of a randomized trial of the HSP (n = 373). Measures. Process: completeness and timeliness of early identification and home visiting activities; family characteristics: sociodemographics, child abuse risk factors, infant biologic risk. Results. Early identification staff determined risk status for 84% of target families. Families with higher risk scores, young mothers with limited schooling, and families with infants at biologic risk were more likely to enroll in home visiting. Half of those who enrolled were active at 1 year with an average of 22 visits. Families where the father had multiple risk factors and where the mother was substance abusing were more likely to have ≥12 visits; mothers who were unilaterally violent toward the father were less likely. Most families were linked with a medical home; linkage rates for other community resources varied widely by type of service. Half of families overall, but ≥80% of those active at 1 year, received core home visiting services. Performance varied by program site. Conclusions. It is challenging to engage and retain at-risk families in home visiting. Service monitoring must be an integral part of operations.

scholarly journals COVID-19 and young Italians: results of a cross-sectional study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Lia ◽  
B Dorelli ◽  
M Marte ◽  
M Chiappetta ◽  
A Faticoni ◽  
...  
Keyword(s):  
At Risk ◽  
High School Students ◽  
Young People ◽  
Online Survey ◽  
Ad Hoc ◽  
School Students ◽  
Cross Sectional ◽  
Infected People ◽  
Knowledge And Attitudes ◽  
The Impact

Abstract Background At the end of 2019, a novel pneumonia-causing Coronavirus called Sars-CoV-2 was first identified in Wuhan, Hubei Province, China. It subsequently spread throughout China and elsewhere, becoming a global health emergency. In February 2020, WHO designated the disease COVID-19, which stands for Coronavirus disease 2019. The aim of this study was to evaluate the impact of the COVID-19 epidemic on the perception of young Italians and to assess their knowledge and attitudes about the disease. Methods An online survey was conducted on 3rd-4th-5th February 2020 with the collaboration of “Skuola.net”, an important Italian Website for students. Young people had the opportunity to participate in the survey by answering an ad hoc questionnaire created to investigate knowledge and attitudes about the new Coronavirus, using a link published on the homepage. Results 5234 responses were received of which 3262 were females and 1972 were males, aged from 11 to 30. 82,4% were students (50,4% high school students) while 17,6% did not attend school or university. Regarding knowledge, 80% of the participants knew that the infection occurs through droplets from infected people; 63% knew that symptoms can appear up to 14 days after exposure; 80% knew that a vaccine has not yet been discovered. Regarding attitudes, 36% admitted that their attitude towards Chinese tourists has significantly worsened; 26% did not buy from Chinese run stores and 24% avoided Chinese restaurants. Conclusions Although most of the participants seem correctly informed about COVID-19, young Italians are at risk of assuming irrational behavior due to psychosis. Key messages The global emergency of COVID-19 needs adequate information to avoid the spread of dangerous psychoses. Young people, usual users of social networks as a means of information, are more at risk of being influenced by fake news and adopting wrong behaviors.

scholarly journals Risk factors associated with development and persistence of long COVID

2021 ◽  
Author(s):  
Yusuke Miyazato ◽  
Shinya Tsuzuki ◽  
Shinichiro Morioka ◽  
Mari Terada ◽  
Satoshi Kutsuna ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Linear Regression Analysis ◽  
Patient Characteristics ◽  
Cross Sectional ◽  
Residual Symptoms ◽  
Factors Associated ◽  
Mild Disease ◽  
Number Of Patients ◽  
Low Body Mass Index

Background Long COVID has been a social concern. Though patient characteristics associated with developing long COVID are partially known, those associated with persisting it have not been identified. Methods We conducted a cross-sectional questionnaire survey of patients after COVID-19 recovery who visited the National Center for Global Health and Medicine between February 2020 and March 2021. Demographic and clinical data, and the presence and duration of long COVID were obtained. We identified factors associated with development and persistence of long COVID using multivariate logistic and linear regression analysis, respectively. Results We analyzed 457 of 526 responses (response rate, 86.9%). The median age was 47 years, and 378 patients (84.4%) had mild disease in acute phase. The number of patients with any symptoms after 6 and 12 months after onset or diagnosis were 120 (26.3%) and 40 (8.8%), respectively. Women were at risk for development of fatigue (OR 2.03, 95% CI 1.31-3.14), dysosmia (OR 1.91, 95% CI 1.24-2.93), dysgeusia (OR 1.56, 95% CI 1.02-2.39), and hair loss (OR 3.00, 95% CI 1.77-5.09), and were at risk for persistence of any symptoms (coefficient 38.0, 95% CI 13.3-62.8). Younger age and low body mass index were risk factors for developing dysosmia (OR 0.96, 95% CI 0.94-0.98, and OR 0.94, 95% CI 0.89-0.99, respectively) and dysgeusia (OR 0.98, 95% CI 0.96-1.00, and OR 0.93, 95% CI 0.88-0.98, respectively). Conclusion We identified risk factors for the persistence as well as development of long COVID. Many patients suffer from long-term residual symptoms, even in mild cases.

scholarly journals Assessment of Knowledge, Attitude and Practices and the analysis of Risk Factors regarding Schistosomiasis Among Fishermen and Boatmen in the Dongting Lake Basin, P.R. China

2020 ◽  
Author(s):  
Zhou Guan ◽  
Si-Min Dai ◽  
Jie Zhou ◽  
Xiao-Bing Ren ◽  
Zhi-Qiang Qin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dongting Lake ◽  
Hunan Province ◽  
Transmission Risk ◽  
Lake Basin ◽  
Molecular Technique ◽  
Cross Sectional Survey ◽  
Water Contact ◽  
Cross Sectional ◽  
Attitudes And Practices

Abstract Background: Fishermen and boatmen are a risk population for contracting schistosomiasis due to their high frequency of water contact in endemic areas of schistosomiasis in the People’s Republic of China (P. R. China). To develop specific interventions towards this population, our present study was designed to assess the knowledge, attitudes and practices (KAPs) towards schistosomiasis of fishermen and boatmen, and to identify the risk factors associated with schistosome infection using molecular technique in the selected area of Hunan Province in P.R. China.Methods: A cross sectional survey was conducted in the Dongting Lake Basin of Yueyang County, Hunan Province, P. R. China. A total of 601 fishermen and boatmen were interviewed between October and November 2017. Information regarding socio-demographic details and KAPs towards schistosomiasis were collected using a standardized questionnaire. Fecal samples of participants were collected and tested by Polymerase Chain Reaction (PCR), and logistic regression analysis was conducted to explore the risk factors related to the positive results of PCR. Results: Of the 601 respondents, over 90% knew schistosomiasis and how the disease was contracted, the intermediate host of schistosomes and preventive methods. The majority of respondents had a positive attitude towards schistosomiasis prevention. However, only 6.66% (40/601) of respondents had installed a latrine on their boats, while 32.61% (196/601) of respondents defecated in the public toilets on shore. In addition, only 4.99% (30/601) respondents protected themselves while exposed to freshwater. The prevalence of schistosomiasis, as determined by PCR, among fishermen and boatmen in Yueyang County was 13.81% (83/601). Age, years of performing the current job, number of times receiving treatment, and whether they were treated in past three years were the main influencing factors of PCR results among this population.Conclusions: Fishermen and boatmen are still at high risk of infection in P.R. China and gaps exist in KAPs towards schistosomiasis in this population group. Chemotherapy, and health education encouraging behavior change in combination with other integrated approaches to decrease the transmission risk in environments should be improved.

scholarly journals Virological Outcomes and Risk Factors for Non-suppression for Routine and Repeat Viral Load Testing After Enhanced Adherence Counselling During Viral Load Testing Scale-up in Zimbabwe: Analytic Cross-sectional Study Using Laboratory Data From 2014 to 2018.

2022 ◽  
Author(s):  
Trudy Tholakele Mhlanga ◽  
Bart K.M Jacobs ◽  
Tom Decroo ◽  
Emma Govere ◽  
Hilda Bara ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Viral Load ◽  
Scale Up ◽  
Cross Sectional Study ◽  
Load Testing ◽  
Sectional Study ◽  
Cross Sectional ◽  
Viral Load Testing ◽  
Adherence Counselling

Abstract BackgroundSince the scale-up of routine viral load (VL) testing started in 2016, there is limited evidence on VL suppression rates under programmatic settings and groups at risk of non-suppression. We conducted a study to estimate VL non-suppression (> 1000 copies/ml) and its risk factors using "routine" and "repeat after enhanced adherence counselling" VL results.MethodsWe conducted an analytic cross-sectional study using secondary VL testing data collected between 2014 and 2018 from a centrally located laboratory. We analysed data from routine tests and repeat tests after an individual received enhanced adherence counselling. Our outcome was viral load non-suppression. Bivariable and multivariable logistic regression was performed to identify factors associated with having VL non-suppression for routine and repeat VL.ResultsWe analysed 103 609 VL test results (101 725 routine and 1884 repeat tests results) collected from the country's ten provinces. Of the 101 725 routine and 1884 repeat VL tests, 13.8% and 52.9% were non-suppressed, respectively. Only one in seven (1:7) of the non-suppressed routine VL tests had a repeat test after EAC. For routine VL tests; males (vs females, adjusted odds ratio (aOR)=1.19, [95% CI:1.14-1.24]) and adolescents (vs adults, aOR=3.11, [95%CI:2.9-3.31]) were more at risk of VL non-suppression. The patients who received care at the secondary level (vs primary, aOR=1.21, [95%CI:1.17-1.26]) and tertiary level (vs primary, aOR=1.63, [95%CI:1.44-1.85]) had a higher risk of VL non-suppression compared to the primary level. Those that started ART in 2014-2015 (vs <2010, aOR=0.83, [95%CI:0.79-0.88]) and from 2016 onwards (vs <2010, aOR=0.84, [95%CI:0.79-0.89]) had a lower risk of VL non-suppression. For repeat VL tests; young adults (vs adults, (aOR)=3.48, [95% CI 2.16 -5.83]), adolescents (vs adults, aOR=2.76, [95% CI:2.11-3.72]) and children (vs adults, aOR=1.51, [95%CI:1.03-2.22]) were at risk of VL non-suppression.ConclusionClose to 90% suppression in routine VL shows that Zimbabwe is on track to reach the third UNAIDS target. Strategies to improve the identification of clients with high routine VL results for repeating testing after EAC and ART adherence in subpopulations (men, adolescents and young adolescents) at risk of viral non-suppression should be prioritised.

scholarly journals Influence of cardiovascular risk factors on the occurrence of foot risk, prior to the complementary study with infrared thermography

2019 ◽  
Vol 18 (3) ◽  
pp. 35-57
Author(s):  
Álvaro Astasio Picado ◽  
Elena Escamilla Martínez ◽  
Beatriz Gómez Martín
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
At Risk ◽  
Infrared Thermography ◽  
Diabetic Foot ◽  
Public Health Problem ◽  
Control Group ◽  
Cross Sectional ◽  
Factores De Riesgo ◽  
And Control

Introducción: La Diabetes Mellitus es un problema de salud pública. El Pie diabético es una degeneración de la estructura vascular de los pies, cuyos pacientes presentan problemas neurológicos, necesarios de identificar en el menor tiempo posible. Objetivo: El objetivo del estudio es analizar la influencia de los factores de riesgo en la aparición del pie de riesgo, como datos complementarios al estudio mediante termografía infrarroja. Método: Se plantea un estudio descriptivo, transversal y observacional sobre una muestra de 479 sujetos encuadrados en dos grupos, grupo casos (personas con diabetes) y grupo control (personas sin diabetes). El grupo casos compuesto de un total de 277 personas, con una edad media de 63.41 años, [138 hombres (49.8%) y 139 mujeres (50.2%)]. De igual modo para el grupo control, el número consistió en 202 usuarios, con una edad media de 61.92 años, [ 99 hombres (49%) y 103 mujeres (51%)]. La toma de imágenes se ha llevado a cabo con la cámara FLIR E60bx® (FLIR® Company, Boston, USA). El análisis estadístico de los datos obtenidos se ha realizado utilizando el paquete estadístico IBM SPSS Statistics 22.Conclusión: Se puede concluir afirmando que el estudio de los diferentes factores de riesgo es clave en el diagnóstico del pie de riesgo. Se puede establecer con rotundidad que la edad es un condicionante evidente, ya que las edades avanzadas se corresponden con un IMC y perímetro abdominal mayor. Unido al análisis mediante termografía infrarroja en la evaluación del pie de riesgo es útil para el diagnóstico y prevención de zonas comprometidas del pie, evitando así el desencadenante evidente en los daños propios de un pie diabético. Introduction: Diabetes mellitus is a public health problem. The diabetic foot is a degeneration of the vascular structure of the feet, whose patients present neurological problems that need to be identified in the shortest possible time.Objective: The study's objective was to analyse the influence of risk factors in the appearance of the foot at risk as complementary data to the infrared thermography study.Method: A descriptive, cross-sectional, and observational study was proposed for a sample of 479 subjects corresponding to two groups – cases (subjects with diabetes) and control (subjects without diabetes). The cases group comprised 277 subjects, mean age 63.41 years, 138 men (49.8%) and 139 women (50.2%). The control group comprised 202 subjects, mean age 61.92 years, 99 men (49%) and 103 women (51%). Images were taken with an FLIR E60bx® camera (FLIR® Company, Boston, USA). The statistical analysis of the data was carried out using the IBM SPSS Statistics 22 statistical package.Conclusion: It can be concluded that the study of the different risk factors is key to the diagnosis of the foot at risk. It was solidly established that age evidently conditions the risk, since advanced ages corresponded to greater BMI and waist circumference. This type of study, together with the analysis by infrared thermography, is useful for the diagnosis and prevention of compromised areas of the foot, thus avoiding the obvious triggering of the damage typical of a diabetic foot.

Cytomegalovirus (CMV) Shedding in French Day-Care Centers: A Nationwide Study of Epidemiology, Risk Factors, Centers’ Practices, and Parents’ Awareness of CMV

2020 ◽  
Author(s):  
Sophie Alain ◽  
Françoise Garnier-Geoffroy ◽  
Anaïs Labrunie ◽  
Amélie Montané ◽  
Benoit Marin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Load ◽  
Day Care ◽  
Secondary Infection ◽  
High Viral Load ◽  
Cross Sectional ◽  
Day Care Centers ◽  
Nationwide Study ◽  
Serological Status ◽  
History Of

Abstract Background Congenital cytomegalovirus (CMV) remains an important healthcare burden, resulting from primary or secondary infection in pregnant women. Exposure to young children’s saliva is a major risk factor, as prevalence of CMV shedding can reach 34%. Methods This cross-sectional, multicenter, nationwide study was conducted in randomly selected day care centers (DCCs), and complemented with a survey among parents and DCCs. All children aged &gt;3 months were eligible. The study measured the CMV shedding prevalence in children’s saliva and described CMV genotypes epidemiology. The risk factors for CMV shedding and high viral load were evaluated using multivariable models. Results A total of 93 DCCs participated. Among the 1770 enrolled children with evaluable samples, the CMV shedding prevalence was 40% (713/1770, 95% confidence interval, 34.6–46.1), independently associated with children aged between 12 and 18 months, history of CMV infection in ≥1 parents, a mid-level income. Prevalence increased with DCC staff workload and attending children number. Viral load was ≥5 log-copies CMV/mL in 48% (342/713). Risk factors for higher viral load included children aged between 12 and 18 months, and still being breastfed. The most frequent genotype combinations were gB1-gN4c-gH2 (6.9%), gB1-gN2-gH2 (6.3%), gB4a-gN3a-gH1 (6.3%), and gB1-gN3b-gH2 (5,7%). CMV awareness was low in parents: their serological status was unknown by 72% of mothers and 82% of fathers. Only 41% knew something about CMV. Conclusions CMV shedding was independently associated with risk factors related to the children, family and DCC. Some of these risk factors may influence prevention strategies, including through an improved information provided to parents. Clinical Trials Registration NCT01704222.

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