"Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis" (Preprint)

2021 ◽  
Author(s):  
Mohammed Alamad ◽  
Yousef S. Khader, Khader
Keyword(s):  
Surveillance System ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Warning System ◽  
Daily Basis ◽  
Vaccination Status ◽  
Age Group ◽  
Fatality Rate ◽  
Probable Case

BACKGROUND As a consequence of war and collapse of health system in Yemen, diphtheria fatal epidemic occurred at the end of 2017 OBJECTIVE This study aims to describe epidemiology of diphtheria in Yemen, determine its incidence and case fatality rate METHODS Data of patients with diphtheria was obtained from the Diphtheria program in a form of line list which were collected on daily basis by electronic Diseases Early Warning System (eDEWS). Probable case was defined as any person suffered from laryngitis or pharyngitis or tonsillitis and adherent membrane of the tonsils, pharynx and/or nose. Confirmed case was defined as probable case that is laboratory-confirmed or linked epidemiologically to laboratory-confirmed case RESULTS A total of 2,243 cases were reported during the period between July 2017 and August 2018. About 49% of cases were males and 51% of cases were females. About 44% of cases were 5 -15 years old. Respiratory tract infection was the predominant symptoms (91%) followed by psedumembrane (81%). Based on the vaccination status, the percentage of partial vaccinated patients, vaccinated, unvaccinated, and unknown were 7%, 31%, 48% and 14%, respectively. The overall incidence of diphtheria was 8 per 100,000 of population. The highest incidence was among age group <15 years (11 per 100,000) and the lowest incidence was among age group of ≥ 15 years (5 per 100,000). The overall case fatality rate (CFR) among all age groups was 5%, being higher (10%) in the age group < 5 years. . Five of difficult to access governorates had double CFR (22%) which were Raymah, Abyan , Sa'ada, Lahj, Al Jawf. CONCLUSIONS : Diphtheria in Yemen in 2017-2018 affected a significant number of people. The majority of patients were partially or not vaccinated. Children ≤ 15 years were more affected with higher fatality among children < five years. Five of difficult to access governorates had double CFR of WHO estimate. To control diphthereia epidemic in Yemn, it is recommended to increase vaccination coverage through campaigns and boosters, increase public health awareness toward diphtheria and strengthen the surveillance system for early detection and immediate response and provide antitoxin for management of severe cases.

scholarly journals Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis (Preprint)

2021 ◽  
Author(s):  
Suaad Ameen Moghalles ◽  
Basher Ahmed Aboasba ◽  
Mohammed Abdullah Alamad ◽  
Yousef Saleh Khader
Keyword(s):  
World Health Organization ◽  
Vaccination Coverage ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
World Health ◽  
Age Group ◽  
Fatality Rate ◽  
Probable Case ◽  
The World ◽  
Health Organization

BACKGROUND As a consequence of war and the collapse of the health system in Yemen, which prevented many people from accessing health facilities to obtain primary health care, vaccination coverage was affected, leading to a deadly diphtheria epidemic at the end of 2017. OBJECTIVE This study aimed to describe the epidemiology of diphtheria in Yemen and determine its incidence and case fatality rate. METHODS Data were obtained from the diphtheria surveillance program 2017-2018, using case definitions of the World Health Organization. A probable case was defined as a case involving a person having laryngitis, pharyngitis, or tonsillitis and an adherent membrane of the tonsils, pharynx, and/or nose. A confirmed case was defined as a probable case that was laboratory confirmed or linked epidemiologically to a laboratory-confirmed case. Data from the Central Statistical Organization was used to calculate the incidence per 100,000 population. A <i>P</i> value &lt;.05 was considered significant. RESULTS A total of 2243 cases were reported during the period between July 2017 and August 2018. About 49% (1090/2243, 48.6%) of the cases were males. About 44% (978/2243, 43.6%) of the cases involved children aged 5 to 15 years. Respiratory tract infection was the predominant symptom (2044/2243, 91.1%), followed by pseudomembrane (1822/2243, 81.2%). Based on the vaccination status, the percentages of partially vaccinated, vaccinated, unvaccinated, and unknown status patients were 6.6% (148/2243), 30.8% (690/2243), 48.6% (10902243), and 14.0% (315/2243), respectively. The overall incidence of diphtheria was 8 per 100,000 population. The highest incidence was among the age group &lt;15 years (11 per 100,000 population), and the lowest incidence was among the age group ≥15 years (5 per 100,000 population). The overall case fatality rate among all age groups was 5%, and it was higher (10%) in the age group &lt;5 years. Five governorates that were difficult to access (Raymah, Abyan, Sa'ada, Lahj, and Al Jawf) had a very high case fatality rate (22%). CONCLUSIONS Diphtheria affected a large number of people in Yemen in 2017-2018. The majority of patients were partially or not vaccinated. Children aged ≤15 years were more affected, with higher fatality among children aged &lt;5 years. Five governorates that were difficult to access had a case fatality rate twice that of the World Health Organization estimate (5%-10%). To control the diphtheria epidemic in Yemen, it is recommended to increase routine vaccination coverage and booster immunizations, increase public health awareness toward diphtheria, and strengthen the surveillance system for early detection and immediate response.

scholarly journals Diphtheria resurgence in Sada'a-Yemen, 2017–2020

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ahmed Abdallah Al-Dar ◽  
Mutahar Al-Qassimi ◽  
Faten Hamid Ezzadeen ◽  
Mohammed Qassime ◽  
Ahmed Mohamed Al murtadha ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Immunization Coverage ◽  
Healthcare Services ◽  
Case Definition ◽  
Vaccination Status ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Fatality Rate

Abstract Background Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe the epidemiology of diphtheria by time, place, and person and vaccination status of affected children. Methods A study was conducted in Sada'a governorate by using accumulative line list of diphtheria from November 2017 to September 2020 at electronic Integrated Disease Early Warning System (eIDEWS). The case definition of WHO was adopted. Data was analyzed by Microsoft Excel and Epi info- version 7.2 and multivariable logistic analysis used for identifying significant associated factors. Results 747 cases were met of WHO case definition. The annual peak of cases started during week 31 and weak 49. Males were slightly more than females (51% vs 49%) and about 35% of cases involved children aged 10 to < 15 years. The overall incidence of diphtheria and case fatality rate (CFR) were 69/ 100,000 and 6.4%, respectively. The highest CFR was among age groups under 5 years 11% (P < 0.001) and among females was 8%. Dysphagia and swollen lymph nodes were the predominant symptoms 98%, 92%, respectively. Based on the Vaccination status, the percentage of unvaccinated and unknown were 53% and 41% respectively, with CFR 11% among cases who received one dose. Furthermore, the most case were from Sahar 40% with case fatality rate 8% and the highest CFR was significantly higher among cases in border and ongoing conflict district (P < 0.05). Conclusions The findings highlight that diphtheria is still an ongoing cause of morbidity and mortality among under 5 children in Sada'a that is rising with the low diphtheria immunization coverage. Therefore, concomitant efforts should now focus on improving and monitoring routine immunization across all age groups and healthcare services, especially in borders and continuing conflict districts.

scholarly journals Erratum: COVID-19, Australia: Epidemiology Report 14. Reporting week ending 23:59 AEST 3 May 2020

2020 ◽  
Vol 44 ◽  
Author(s):  
Keyword(s):  
Data Processing ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Age Group ◽  
Fatality Rate

An error in data processing resulted in the tabulation of incorrect CFR values, for age groups of 50–59 and above, in Table 5 (Crude Case Fatality Rate of all cases and hospitalised cases, by age group) as originally published in the COVID-19 (Australia) epidemiology report 14 (https://doi.org/10.33321/cdi.2020.44.42). The table below provides the corrected values.

scholarly journals Estimating effective infection fatality rates during the course of the COVID-19 pandemic in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christian Staerk ◽  
Tobias Wistuba ◽  
Andreas Mayr
Keyword(s):  
Age Distribution ◽  
Age Groups ◽  
Case Fatality ◽  
Time Dependent ◽  
Temporary Increase ◽  
International Studies ◽  
Age Group ◽  
Fatality Rate ◽  
Substantial Fraction ◽  
Second Wave

Abstract Background The infection fatality rate (IFR) of the Coronavirus Disease 2019 (COVID-19) is one of the most discussed figures in the context of this pandemic. In contrast to the case fatality rate (CFR), the IFR depends on the total number of infected individuals – not just on the number of confirmed cases. In order to estimate the IFR, several seroprevalence studies have been or are currently conducted. Methods Using German COVID-19 surveillance data and age-group specific IFR estimates from multiple international studies, this work investigates time-dependent variations in effective IFR over the course of the pandemic. Three different methods for estimating (effective) IFRs are presented: (a) population-averaged IFRs based on the assumption that the infection risk is independent of age and time, (b) effective IFRs based on the assumption that the age distribution of confirmed cases approximately reflects the age distribution of infected individuals, and (c) effective IFRs accounting for age- and time-dependent dark figures of infections. Results Effective IFRs in Germany are estimated to vary over time, as the age distributions of confirmed cases and estimated infections are changing during the course of the pandemic. In particular during the first and second waves of infections in spring and autumn/winter 2020, there has been a pronounced shift in the age distribution of confirmed cases towards older age groups, resulting in larger effective IFR estimates. The temporary increase in effective IFR during the first wave is estimated to be smaller but still remains when adjusting for age- and time-dependent dark figures. A comparison of effective IFRs with observed CFRs indicates that a substantial fraction of the time-dependent variability in observed mortality can be explained by changes in the age distribution of infections. Furthermore, a vanishing gap between effective IFRs and observed CFRs is apparent after the first infection wave, while an increasing gap can be observed during the second wave. Conclusions The development of estimated effective IFR and observed CFR reflects the changing age distribution of infections over the course of the COVID-19 pandemic in Germany. Further research is warranted to obtain timely age-stratified IFR estimates, particularly in light of new variants of the virus.

scholarly journals Disease Profile and Death Pattern among the Children Admitted in Rajshahi Medical College Hospital

2021 ◽  
Vol 34 (1) ◽  
pp. 55-62
Author(s):  
Be Nazir Ahmmad ◽  
Fazlur Rahman ◽  
Naznin Parvin ◽  
Md Shamsul Alam ◽  
Shitangshu Banerjee ◽  
...  
Keyword(s):  
Health Care ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Medical College Hospital ◽  
Watery Diarrhea ◽  
Fatality Rate ◽  
College Hospital ◽  
Under Five ◽  
Medical College

Background: Rajshahi medical college hospital is a tertiary care teaching and referral center in the North-West part of Bangladesh. To assess the epidemiological trend in hospital admission, including morbidity and mortality pattern of illness in the pediatric population, it needs to develop effective health care planning, appropriate resource allocation, and integration of existing health care service facilities. Objective: To evaluate the diseases and deaths of children admitted in the department of pediatrics, Rajshahi medical college hospital, Rajshahi. Materials and methods: This is a retrospective study. The collected case records of all patients admitted in the department of pediatrics from 1st January 2017 to 31st December 2019 (3 years) were analyzed.  Result: A total of 62000 children were admitted during the mentioned study period. All the patients were distributed into three age groups infant, under five, and more than five, contributing 22%, 27.5%, and 19%, respectively. Acute watery diarrhea (21%), hereditary hemolytic anemia (18%), bronchopneumonia (10.4%), acute gastritis (9.4%), and acute bronchiolitis and wheezy child (7.17%) were the top five diseases in each of the three years of admission. Among the total admitted patients, 1003 (1.61%) patients died. Infant, under five, and more than five age groups constitute 61.3%, 28.1%, and 15.1%, respectively. Encephalitis and fulminant hepatic failure found the top two diseases causing death with a case fatality rate was 61% and 43%, respectively. The next highest case fatality rate was found in acute leukemia (15%). Other common causes of death include meningitis, cerebral palsy with complications (7.5%), bronchopneumonia with complications (3.8%). Conclusion: An admission-related comprehensive evaluation of this study will help to understand the diseases and death patterns of a hospital, leading to the development of more effective planning and case management strategies. TAJ 2021; 34: No-1: 55-62

Phylogenetic group and serotype of E. coli isolates are important risk factors affecting intensity of colibacillosis in broilers

2018 ◽  
Author(s):  
S. Kumar ◽  
R. Gupta ◽  
N. Jindal and Y.C. Bangar
Keyword(s):  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Phylogenetic Group ◽  
Fatality Rate ◽  
Phylogenetic Groups ◽  
Factors Affecting ◽  
E Coli ◽  
Significant Difference ◽  
Class 1

The study was conducted on 106 E. coli isolates to determine the phylogenetic group, serotype and carriage of Class 1 integrons in isolates and ascertain their association along with other parameters with vital disease measures in broiler flocks affected with colibacillosis. Out of 32 isolates of which “O” antigen was characterized, serogroup O2 comprising of 12 (37.5%) isolates was most prevalent in the present study. Most of the isolates (85/106; 80.19%) belonged to phylogenetic group B2. Mean apparent morbidity, mortality and case fatality rate (CFR) were 3.77%, 2.32% and 61.49%, respectively. There was significant difference in number of outbreaks reported in different age groups (p less than 0.0001). Also, there was significant association between phylogenetic group and age of outbreak due to E. coli (p=0.024). Comparatively, no significant association was observed between age of outbreaks and serotypes (p=0.980). There was significant association between various disease measures and E. coli isolates affiliated to various phylogenetic groups and serotypes. All the measures (apparent morbidity, mortality and CFR) of disease were highest in outbreaks due to isolates of phylogenetic group B2 and serogroup O20. However, the measures were not significantly affected by the presence of integrons in the E. coli.

Ten-Year Study of Pediatric Drownings and Near-Drownings in King County, Washington: Lessons in Injury Prevention

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1035-1040
Author(s):  
Linda Quan ◽  
Edmond J. Gore ◽  
Kim Wentz ◽  
Jill Allen ◽  
Alvin H. Novack
Keyword(s):  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
King County ◽  
Fatality Rate ◽  
Swimming Pools ◽  
Older Children ◽  
History Of ◽  
Water Sports ◽  
Preschool Aged Children

The factors associated with submersion events among &lt;20-year-old persons that occurred in King County from 1974 to 1983 were studied to focus prevention efforts. Near-drowning (n = 103) and drowning (n = 96) victims were identified from medical examiners' reports, paramedics' reports, and hospital discharge registers. Annual incidence was 5.5; the mortality rate was 2.6 per 100,000 children. Although preschool-aged children had the largest incidence (12.8), followed by older adolescents (4.9), adolescents had the largest case fatality rate, 77%. Lake and river victims had the largest incidence, mortality, and case fatality rate; swimming pools, the smallest case fatality rate (25%). A total of 89% of all victims had absent or no supervision; victims supervised by lifeguards had a 42% case fatality rate. Prior seizures were part of the history of 7.5% of all victims; 25% of fatal submersions by adolescents were associated with alcohol. Bathtub submersions were associated with child abuse in three of 16 preschool-aged children and epilepsy in four of five older children. Certain age groups and sites combined had the greatest incidence: preschool-aged children in swimming pools, infants in bathtubs, teenagers in lakes and rivers. Incidence decreased in public and semipublic pools coincident with fencing regulations. These findings suggest prevention strategies: extending fencing requirements to private pools, discouraging alcohol consumption during water sports, changing bathing practices of epileptics, and improving lifeguard efficacy.

Mortality of tetanus at the Lagos University Teaching Hospital, Nigeria

2005 ◽  
Vol 35 (3) ◽  
pp. 178-181 ◽  
Author(s):  
F I Ojini ◽  
M A Danesi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Developed Countries ◽  
University Teaching ◽  
Age Group ◽  
Fatality Rate ◽  
Medical Wards

Records of 349 tetanus patients, aged 10 years and above, admitted to the Lagos University Teaching Hospital, Nigeria, between 1990 and 1999 were reviewed. The male:female ratio was 1.98:1, and the ages were between 10 and 88 years, with a mean age of 29.8 years. The overall case fatality rate (CFR) of tetanus was 36.96% (33.19% for men and 44.44% for women). The CFR is similar to that previously reported in the hospital, but higher than that reported from Europe and North America. The lowest CFR was in the 10-19-year age group, and there was a trend towards increasing CFR with increasing age. Tetanus patients in the intensive care unit (ICU) had a significantly higher CFR than those in the medical wards. Unlike in developed countries, where management of tetanus in ICU has resulted in a decrease in CFR, the CFR of tetanus at the Lagos University Teaching Hospital has not significantly reduced over the years.

scholarly journals Chagas Disease-Related Mortality in Spain, 1997 to 2018

2021 ◽  
Vol 9 (9) ◽  
pp. 1991
Author(s):  
Jose-Manuel Ramos-Rincon ◽  
Jara Llenas-García ◽  
Hector Pinargote-Celorio ◽  
Veronica Sánchez-García ◽  
Philip Wikman-Jorgensen ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Chagas Disease ◽  
Case Fatality Rate ◽  
Hospital Admissions ◽  
Multivariable Analysis ◽  
Age Groups ◽  
Case Fatality ◽  
Fatality Rate ◽  
Infected People ◽  
Male Sex

Background. Chagas disease (CD) is associated with excess mortality in infected people in endemic countries, but little information is available in non-endemic countries. The aim of the study was to analyze mortality in patients admitted to the hospital with CD in Spain. Methods. A retrospective, observational study using the Spanish National Hospital Discharge Database. We used the CD diagnostic codes of the 9th and 10th International Classification of Diseases to retrieve CD cases from the national public registry from 1997 to 2018. Results. Of the 5022 hospital admissions in people with CD, there were 56 deaths (case fatality rate (CFR) 1.1%, 95% confidence interval (CI) 0.8%, 1.4%), 20 (35.7%) of which were considered directly related to CD. The median age was higher in those who died (54.5 vs. 38 years; p < 0.001). The CFR increased with age, peaking in the 70–79-year (7.9%, odds ratio (OR) 6.27, 95% CI 1.27, 30.90) and 80–89-year (16.7%, OR 14.7, 95% CI 2.70, 79.90) age groups. Men comprised a higher proportion of those who died compared to survivors (50% vs. 22.6%; p < 0.001). Non-survivors were more likely to have neoplasms (19.6% vs. 3.4%; p < 0.001), heart failure (17.9% vs. 7.2%; p = 0.002), diabetes (12.5% vs. 3.7%; p = 0.001), chronic kidney failure (8.9% vs. 1.6%; p < 0.001), and HIV (8.9% vs. 0.8%; p < 0.001). In the multivariable analysis, the variables associated with mortality were age (adjusted OR (aOR) 1.05; 95% CI: 1.03, 1.07), male sex (aOR 1.79, 95% CI 1.03, 3.14), cancer (aOR: 4.84, 95% CI 2.13, 11.22), and HIV infection (aOR 14.10 95% CI 4.88, 40.73). Conclusions. The case fatality rate of CD hospitalization was about 1%. The mortality risk increased with age, male sex, cancer, and HIV infection.

scholarly journals Age-specific infection and death rates for human A(H5N1) avian influenza in Egypt

2009 ◽  
Vol 14 (18) ◽  
Author(s):  
J P Dudley
Keyword(s):  
Influenza A ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Age Group ◽  
Fatality Rate ◽  
Death Rates ◽  
H5n1 Avian Influenza ◽  
Human H5n1 ◽  
Sex Biases ◽  
Age And Sex

The age-specific infection and death profiles among confirmed human cases of influenza A(H5N1) infection in Egypt differ markedly from those recorded in other countries. The case fatality rate among human H5N1 cases in Egypt is 34%, versus an average of 66% in other countries. In Egypt, children younger than 10 years comprise 48% of reported cases, nearly twice the global average of approximately 25%, and no H5N1 fatalities have been confirmed among individuals in this age group as of 23 April 2009. Females outnumber males among confirmed H5N1 cases by a factor of nearly 2:1, and 90% of reported fatalities in Egypt have been females. The evident age and sex biases in morbidity and mortality among H5N1 cases in Egypt are phenomena that warrant further investigation and analysis.

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