scholarly journals Outbreak Investigation of a Multipathogen Foodborne Disease in a Training Institute in Rabat, Morocco: Case-Control Study

10.2196/14227 ◽  
2019 ◽  
Vol 5 (3) ◽  
pp. e14227
Author(s):  
Houda Moumni Abdou ◽  
Ilham Dahbi ◽  
Mohammed Akrim ◽  
Fatima Zahra Meski ◽  
Yousef Khader ◽  
...  
Keyword(s):  
Case Control Study ◽  
Multivariable Analysis ◽  
Disease Outbreak ◽  
Case Control ◽  
Control Measures ◽  
Common Source ◽  
Foodborne Disease ◽  
Hygiene Measures ◽  
Training Institute ◽  
Control Study

Background On June 18, 2017, the public health service was alerted about 43 students in the training institute in Rabat who were admitted to the emergency room for acute gastroenteritis following the uptake of a meal a day before. Objective This study aimed to investigate the foodborne disease outbreak by confirming the outbreak, identifying the source of contamination, and recommending control measures. Methods We conducted a case-control study. Cases and controls were selected in a ratio of 1:1. We defined a case as any member of the training institute who attended the Ramadan buffet in the institute’s restaurant and who had presented, in the weekend of June 16 to 20, 2017, symptoms of diarrhea or vomiting with at least one of the following signs: abdominal pain, fever, headache, nausea, and dizziness. A control was defined as anyone who attended the Ramadan buffet in the institute’s restaurant but had not presented any symptoms from June 16 to 20, 2017. We conducted a bivariate and multivariable analysis. Stools of ill students were collected, and a food specimen was collected for bacterial testing. Results A total of 50 cases and 50 controls were selected. Among the cases, males were predominant (43/50, 86%); the median age was 21 years. A total of 47 cases sought medical care. There were no hospitalizations and no deaths. The episode was short with an estimated average incubation period of 9 hours. The epidemic curve oriented toward a common source of contamination. Among food items, briwates were strongly associated with the illness with an odd ratio of 14.23 (95% CI 5.04-40.04; P<.001). Laboratory testing of briwates showed presence of Escherichia coli O157 and Staphylococcus aureus. Conclusions This foodborne disease outbreak was likely caused by briwates that was contaminated with S aureus and E coli. We recommended strengthening hygiene measures. Food handling techniques should be taught as part of continuous professional development for food handlers.

scholarly journals Outbreak Investigation of a Multipathogen Foodborne Disease in a Training Institute in Rabat, Morocco: Case-Control Study (Preprint)

2019 ◽  
Author(s):  
Houda Moumni Abdou ◽  
Ilham Dahbi ◽  
Mohammed Akrim ◽  
Fatima Zahra Meski ◽  
Yousef Khader ◽  
...  
Keyword(s):  
Case Control Study ◽  
Multivariable Analysis ◽  
Disease Outbreak ◽  
Case Control ◽  
Control Measures ◽  
Common Source ◽  
Foodborne Disease ◽  
Hygiene Measures ◽  
Training Institute ◽  
Control Study

BACKGROUND On June 18, 2017, the public health service was alerted about 43 students in the training institute in Rabat who were admitted to the emergency room for acute gastroenteritis following the uptake of a meal a day before. OBJECTIVE This study aimed to investigate the foodborne disease outbreak by confirming the outbreak, identifying the source of contamination, and recommending control measures. METHODS We conducted a case-control study. Cases and controls were selected in a ratio of 1:1. We defined a case as any member of the training institute who attended the Ramadan buffet in the institute’s restaurant and who had presented, in the weekend of June 16 to 20, 2017, symptoms of diarrhea or vomiting with at least one of the following signs: abdominal pain, fever, headache, nausea, and dizziness. A control was defined as anyone who attended the Ramadan buffet in the institute’s restaurant but had not presented any symptoms from June 16 to 20, 2017. We conducted a bivariate and multivariable analysis. Stools of ill students were collected, and a food specimen was collected for bacterial testing. RESULTS A total of 50 cases and 50 controls were selected. Among the cases, males were predominant (43/50, 86%); the median age was 21 years. A total of 47 cases sought medical care. There were no hospitalizations and no deaths. The episode was short with an estimated average incubation period of 9 hours. The epidemic curve oriented toward a common source of contamination. Among food items, briwates were strongly associated with the illness with an odd ratio of 14.23 (95% CI 5.04-40.04; <italic>P</italic>&lt;.001). Laboratory testing of briwates showed presence of <italic>Escherichia coli</italic> O157 and <italic>Staphylococcus aureus</italic>. CONCLUSIONS This foodborne disease outbreak was likely caused by briwates that was contaminated with <italic>S aureus</italic> and <italic>E coli</italic>. We recommended strengthening hygiene measures. Food handling techniques should be taught as part of continuous professional development for food handlers.

scholarly journals Outbreak ofTsukamurellaSpecies Bloodstream Infection among Patients at an Oncology Clinic, West Virginia, 2011–2012

2014 ◽  
Vol 35 (3) ◽  
pp. 300-306 ◽  
Author(s):  
Isaac See ◽  
Duc B. Nguyen ◽  
Somu Chatterjee ◽  
Thein Shwe ◽  
Melissa Scott ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infection ◽  
Case Control Study ◽  
Significant Risk ◽  
Bloodstream Infections ◽  
Case Control ◽  
Control Measures ◽  
Multiple Infection ◽  
Common Source ◽  
Control Study

Objective.To determine the source and identify control measures of an outbreak ofTsukamurellaspecies bloodstream infections at an outpatient oncology facility.Design.Epidemiologic investigation of the outbreak with a case-control study.Methods.A case was an infection in whichTsukamurellaspecies was isolated from a blood or catheter tip culture during the period January 2011 through June 2012 from a patient of the oncology clinic. Laboratory records of area hospitals and patient charts were reviewed. A case-control study was conducted among clinic patients to identify risk factors forTsukamurellaspecies bloodstream infection. Clinic staff were interviewed, and infection control practices were assessed.Results.Fifteen cases ofTsukamurella (Tsukamurella pulmonisorTsukamurella tyrosinosolvens) bloodstream infection were identified, all in patients with underlying malignancy and indwelling central lines. The median age of case patients was 68 years; 47% were male. The only significant risk factor for infection was receipt of saline flush from the clinic during the period September–October 2011 (P= .03), when the clinic had been preparing saline flush from a common-source bag of saline. Other infection control deficiencies that were identified at the clinic included suboptimal procedures for central line access and preparation of chemotherapy.Conclusion.Although multiple infection control lapses were identified, the outbreak was likely caused by improper preparation of saline flush syringes by the clinic. The outbreak demonstrates that bloodstream infections among oncology patients can result from improper infection control practices and highlights the critical need for increased attention to and oversight of infection control in outpatient oncology settings.

scholarly journals Survey and case-control study during epidemics of Puumala virus infection

2009 ◽  
Vol 137 (10) ◽  
pp. 1479-1485 ◽  
Author(s):  
C. H. WINTER ◽  
S. O. BROCKMANN ◽  
I. PIECHOTOWSKI ◽  
K. ALPERS ◽  
M. AN DER HEIDEN ◽  
...  
Keyword(s):  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Multivariable Analysis ◽  
Case Control ◽  
Control Measures ◽  
West Germany ◽  
Federal State ◽  
Puumala Virus ◽  
Conditional Logistic Regression Model ◽  
Control Study

SUMMARYIn Baden-Wuerttemberg, a federal state in south-west Germany, a large outbreak of 1089 laboratory-confirmed human Puumala virus (PUUV) infections occurred in 2007. We conducted a survey to describe the disease burden and a case-control study to identify risk factors for acquiring PUUV. Case-patients were interviewed about clinical outcome and both case-patients and randomly recruited controls were interviewed about exposure. We calculated matched odds ratios (mOR) using a conditional logistic regression model. Multivariable analysis of 191 matched case-control pairs showed that case-patients were more likely than controls to have seen small rodents/their droppings (mOR 1·9, 95% CI 1·2–3·0), cleaned utility rooms (mOR 1·8, 95% CI 1·0–3·4) and visited forest shelters (mOR 3·9, 95% CI 1·1–14·3). Two thirds of case-patients required hospitalization. During PUUV epidemics rodent control measures and use of protective equipment should be considered in utility rooms and shelters.

Impact of Septal Deviation on Recurrent Chronic Rhinosinusitis after Primary Surgery: A Matched Case-Control Study

2018 ◽  
Vol 160 (5) ◽  
pp. 922-927
Author(s):  
Terence Fu ◽  
Daniel Lee ◽  
Jonathan Yip ◽  
Alisha Jamal ◽  
John M. Lee
Keyword(s):  
Chronic Rhinosinusitis ◽  
Case Control Study ◽  
Multivariable Analysis ◽  
Case Control ◽  
Sinus Surgery ◽  
Deviated Nasal Septum ◽  
Primary Surgery ◽  
Academic Center ◽  
The Impact ◽  
Control Study

Objective To evaluate the impact of untreated deviated nasal septum (DNS) on recalcitrant chronic rhinosinusitis (CRS) among patients undergoing revision endoscopic sinus surgery (ESS). Study Design Case-control study. Setting Tertiary academic center. Subjects and Methods We performed a retrospective review of 489 patients undergoing revision ESS for CRS at a tertiary academic center. Patients undergoing septoplasty were matched to nonseptoplasty controls based on age and sex. Preoperative Lund-Mackay score (LMS) was compared between cohorts. Linear regression was used to identify predictors of LMS and ostiomeatal complex (OMC) obstruction. Results Thirty-six matched pairs (72 patients) were selected for analysis: 36 undergoing septoplasty and revision ESS and 36 undergoing revision ESS alone. Compared with nonseptoplasty controls, the septoplasty group had a significantly higher average LMS (17.8 vs 14.6, P = .02) and a greater rate of OMC obstruction (89% vs 61%, P < .01). The septoplasty group also had significantly higher opacification scores in the maxillary (1.5 vs 1.2, P = .03) and posterior ethmoid (1.8 vs 1.4, P = .02) sinuses. On multivariable analysis, DNS was an independent predictor of LMS ( P = .02) and OMC obstruction ( P < .01). Conclusion Untreated DNS is associated with radiographic markers of CRS severity among patients undergoing revision ESS and may contribute to the multifactorial pathogenesis of persistent CRS.

scholarly journals Risk factors for sporadic Campylobacter infection: an all-Ireland case-control study

2009 ◽  
Vol 14 (7) ◽  
Author(s):  
K Danis ◽  
M Di Renzi ◽  
W O’Neill ◽  
B Smyth ◽  
P McKeown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Population Attributable Fraction ◽  
Case Control ◽  
Control Measures ◽  
Safety Education ◽  
First Case ◽  
The Republic ◽  
Campylobacter Infection ◽  
Control Study

We report the findings of the first case-control study conducted in both the Republic of Ireland and Northern Ireland to determine risk factors for sporadic Campylobacter infections. A total of 197 cases and 296 case-nominated controls matched for age, were included. Based on Population Attributable Fraction (PAF), the most important risk factors were consuming chicken [adjusted matched (am) OR 6.8; 95%CI 2.1-21.9], consuming lettuce (amOR 3.3; 95%CI 1.5-7.1) and eating in takeaways (amOR=3.1; 95%CI 1.4-6.6). Contact with sheep (amOR=11; 95%CI 1.6-78), peptic ulcer (amOR=19; 95%CI 3.8-93.7), hiatus hernia (amOR=20.3; 95%CI 2.3-183.3), lower bowel problems (amOR=4.5; 95%CI 1.2-16.8) were also independently associated with infection. Mains water supply showed protective effect (amOR=0.2; 95 CI 0.1-0.9). The findings highlight the continued need for consumer food safety education and further control measures throughout the food chain on the island of Ireland.

scholarly journals Clinical and Genetic Factors Associated with Resistance to Treatment in Patients with Schizophrenia: A Case-Control Study

2019 ◽  
Vol 20 (19) ◽  
pp. 4753 ◽  
Author(s):  
Aline Hajj ◽  
Sahar Obeid ◽  
Saria Sahyoun ◽  
Chadia Haddad ◽  
Jocelyne Azar ◽  
...  
Keyword(s):  
Genetic Factors ◽  
Case Control Study ◽  
Rating Scale ◽  
Multivariable Analysis ◽  
Case Control ◽  
Response To Treatment ◽  
Treatment Resistant ◽  
Factors Associated ◽  
Resistance To Treatment ◽  
Control Study

Objectives: To assess clinical and genetic factors affecting response to treatment in a sample of patients with schizophrenia (treatment-resistant patients versus treatment responders). We also aimed at examining if these factors are different when we consider two different resistance classifications (the positive and negative syndrome scale, PANSS and the brief psychiatric rating scale, BPRS). Material and Methods: A case-control study included treatment-resistant patients and good responders. Patients were stratified in two groups based on the established criteria for treatment-resistant schizophrenia using BPRS and PANSS. The study was approved by the ethical committees (references: CEHDF1017; HPC-017-2017) and all patients/legal representatives gave their written consent. Clinical factors were assessed. DNA was obtained using a buccal swab and genotyping for OPRM1, COMT, DRD2 et MTHFR genes using the Lightcycler® (Roche). Results: Some discrepancies between the BPRS and PANSS definitions were noted in our study when assessing the patients’ psychopathological symptoms and response to treatment. The multivariable analysis, taking the presence versus absence of treatment resistance as the dependent variable, showed that that family history of schizophrenia, university studies, time since the beginning of treatment and chlorpromazine equivalent dose as well as the COMT gene are associated with resistance to treatment. In addition, a gender-related difference was noted for COMT SNP; men with at least one Met allele were more prone to be resistant to treatment than Val/Val patients. Conclusion: Uncovering the clinical and genetic factors associated with resistance to treatment could help us better treat our schizophrenic patients in a concept of personalized medicine.

scholarly journals Malaria Outbreak Facilitated by Appearance of Vector-Breeding Sites after Heavy Rainfall and Inadequate Preventive Measures: Nwoya District, Northern Uganda, February–May 2018

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Godfrey Nsereko ◽  
Daniel Kadobera ◽  
Denis Okethwangu ◽  
Joyce Nguna ◽  
Damian Rutazaana ◽  
...  
Keyword(s):  
Heavy Rainfall ◽  
Case Control Study ◽  
Preventive Measures ◽  
Case Fatality ◽  
Case Control ◽  
Control Measures ◽  
Northern Uganda ◽  
Entire Study ◽  
Breeding Sites ◽  
Control Study

Background. Malaria is a leading cause of morbidity and mortality in Uganda. In April 2018, malaria cases surged in Nwoya District, Northern Uganda, exceeding expected limits and thereby requiring epidemic response. We investigated this outbreak to estimate its magnitude, identify exposure factors for transmission, and recommend evidence-based control measures. Methods. We defined a malaria case as onset of fever in a resident of Anaka subcounty, Koch Goma subcounty, and Nwoya Town Council, Nwoya District, with a positive rapid diagnostic test or microscopy for malaria from 1 February to 25 May 2018. We reviewed medical records in all health facilities of affected subcounties to find cases. In a case-control study, we compared exposure factors between case-persons and asymptomatic controls matched by age and village. We also conducted entomological assessments on vector density and behavior. Results. We identified 3,879 case-persons (attack rate [AR] = 6.5%) and two deaths (case-fatality rate = 5.2/10,000). Females (AR = 8.1%) were more affected than males (AR = 4.7%) (p<0.0001). Of all age groups, 5–18 years (AR = 8.4%) were most affected. Heavy rain started in early March 2018, and a propagated outbreak followed in the first week of April 2018. In the case-control study, 55% (59/107) of case-persons and 18% (19/107) of controls had stagnant water around households for several days following rainfall (ORM-H = 5.6, 95% CI = 3.0–11); 25% (27/107) of case-persons and 51% (55/107) of controls wore full extremity covering clothes during evening hours (ORM-H = 0.30, 95% CI = 0.20–0.60); 71% (76/107) of case-persons and 85% (91/107) of controls slept under a long-lasting insecticide-treated net (LLIN) 14 days before symptom onset (ORM-H = 0.43, 95% CI = 0.22–0.85); 37% (40/107) of case-persons and 52% (56/107) of controls had access to at least one LLIN per 2 household members (ORM-H = 0.54, 95% CI = 0.30–0.97). Entomological assessment indicated active breeding sites in the entire study area; Anopheles gambiae sensu lato species were the predominant vector. Conclusion. Increased vector-breeding sites after heavy rainfall and inadequate malaria preventive measures were found to have contributed to this outbreak. We recommended increasing coverage for LLINs and larviciding breeding sites in the area.

Risk factors for bleeding from gastrointestinal angiodysplasia: a case-control study in patients with bleeding and non-bleeding angiodysplasia

2020 ◽  
Vol 58 (03) ◽  
pp. 234-240
Author(s):  
Bruno Neu ◽  
Georg Moessmer ◽  
Monther Bajbouj ◽  
Valentin Becker ◽  
Petra Barthel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Bleeding ◽  
Case Control Study ◽  
Clinical Laboratory ◽  
Vascular Malformations ◽  
Case Control ◽  
Common Source ◽  
Primary Hemostasis ◽  
History Of ◽  
Control Study

Abstract Objectives Angiodysplasia (AD) is a common source of gastrointestinal bleeding. Yet, little is known about factors forwarding bleeding in these vascular malformations. The presented study aims to determine risk factors for bleeding that occurs only in patients with symptomatic, but not with asymptomatic, AD. Methods Case-control study in patients with AD and either a positive or a negative history of gastrointestinal bleeding in Munich, Germany. Groups were compared by clinical, laboratory, and endoscopic features. Results 80 patients with (58, f 31, med. age 72) or without bleeding AD (22, f 12, med. age 61) were included. Bleeding from AD was significantly associated with the total number of AD (OR 1.4 (95 % CI 1.1–1.7) p = 0.01) and closure time in PFA/collagen-epinephrine test (OR 1.0 (95 % CI 1.0–1.0) p < 0.01). The total number of AD correlated significantly with age (r = 0.36; p = 0.01). AD were mainly detected in the upper small intestine (> 30 %). Although patients with aortic stenosis suffered not significantly more frequently from bleeding from AD, they demonstrated a loss of high molecular multimers of VWF. Conclusions The amount of AD is clearly correlated to the age of the patient. A higher number of ADs and inhibition of primary hemostasis increase the risk of bleeding.

Risk factors for sporadicVibrio parahaemolyticusgastroenteritis in east China: a matched case-control study

2014 ◽  
Vol 143 (5) ◽  
pp. 1020-1028 ◽  
Author(s):  
W. X. YAN ◽  
Y. DAI ◽  
Y. J. ZHOU ◽  
H. LIU ◽  
S. G. DUAN ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Multivariable Analysis ◽  
Antibiotic Use ◽  
Population Based ◽  
Case Control ◽  
Population Attributable Fractions ◽  
Attributable Fractions ◽  
Matched Case ◽  
Control Study

SUMMARYTo determine risk factors for sporadicVibrio parahaemolyticusgastroenteritis, we conducted a population-based case-control study in sentinel hospital surveillance areas of Shanghai and Jiangsu province, China. Seventy-one patients with diarrhoea and confirmedV. parahaemolyticusinfections were enrolled, and they were matched with 142 controls for gender, age and residential area. From the multivariable analysis,V. parahaemolyticusinfections were associated with antibiotics taken during the 4 weeks prior to illness [odds ratio (OR) 8·1, 95% confidence interval (CI) 1·2–56·4)], frequent eating out (OR 3·3, 95% CI 1·1–10·1), and shellfish consumption (OR 3·2, 95% CI 1·0–9·9), with population-attributable fractions of 0·09, 0·25, and 0·14, respectively. Protective factors included keeping the aquatic products refrigerated (OR 0·4, 95% CI 0·1–0·9) and pork consumption (OR 0·2, 95% CI 0·1–0·8). Further study of the association ofV. parahaemolyticusgastroenteritis with prior antibiotic use and shellfish consumption is needed.

A case–control study of risk factors for multiple sclerosis in Iran

2011 ◽  
Vol 17 (5) ◽  
pp. 550-555 ◽  
Author(s):  
Alvaro Alonso ◽  
Stuart D Cook ◽  
Amir-Hadi Maghzi ◽  
Afshin A Divani
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Case Control Study ◽  
Past History ◽  
Multivariable Analysis ◽  
Case Control ◽  
Sunlight Exposure ◽  
Farm Animals ◽  
History Of ◽  
Control Study

Background: Numerous studies have assessed risk factors for multiple sclerosis (MS), although none have been conducted previously in Iran. Objective: The objective of this study was to study lifestyle and environmental risk factors of MS in the Iranian population. Methods: A case–control study, including 394 MS cases and 394 matched controls, was conducted in MS clinics in different Iranian cities. Information on lifestyles, environmental exposures, and past medical history was obtained from medical charts and phone interviews. Results: In multivariable analysis, sunlight exposure was associated with a lower risk of MS: the odds ratio (OR) and 95% confidence interval (CI) of MS associated with a 1-h increment in daily sunlight was 0.62 (0.53–0.73). Smoking was associated with MS risk in women (OR: 6.48, 95% CI: 1.46–28.78), but not in men (OR: 0.72, 95% CI: 0.31–1.68) ( p = 0.002 for interaction). Finally, past history of common surgical procedures, infectious disorders, or exposure to pets and farm animals was not associated with MS risk. Conclusions: Different modifiable lifestyles, including sunlight exposure and smoking, were associated with lower MS risk in Iran. Interventions aimed at promoting smoking cessation and, more importantly, at increasing exposure to sunlight might contribute to the prevention of MS.

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