scholarly journals Risk Factors of Dengue Fever Outbreak in Karo District, North Sumatera, Indonesia

2019 ◽  
Vol 5 (1) ◽  
pp. 16-22
Author(s):  
Frans Yosep Sitepu
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Significant Risk ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Control Measures ◽  
Breeding Sites ◽  
Mosquito Breeding

Dengue fever (DF) infection continues to present a seriuos public health problem in North Sumatera, Indonesia. A DF outbreak was reported in Merek Sub-district, Karo District which is one tourist destination in North Sumatera during April-May 2017. An epidemiological investigation was conducted to identify the risk factors and recommend control measures. An observational study with a matched case control design was conducted. A case was defined as any resident of Merek sub-district who had suffer major clinical symptoms of DF such as fever, severe headache, pain behind eyes, muscle and joint pains, and rash from April – May, 2017. A control was defined as neighbors of cases who did not have clinical signs and symptoms of DF and were matched for age and sex. We interviewed 37 cases and 37 controls. Age cases ranged from 2 year to 37 years (median= 12 years). The multivariate analyses showed that presence of mosquito breeding sites (OR=4.87, 95%CI=1.33-17.85) and habit of hanging worn clothes (OR=5.12, 95%CI=1.25-21.03) were significant risk factors. It is recommended to eliminate mosquito breeding sites routinely, avoid habit of hanging worn clothes, and conduct strict surveillance of DF continously.

MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaccine Coverage ◽  
Significant Risk ◽  
Public Health Problem ◽  
Maculopapular Rash ◽  
Healthcare Facility ◽  
Control Measures ◽  
Major Public Health Problem ◽  
District Health ◽  
Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

Prevalence and Risk Factors Associated with First-Line Anti-Tuberculosis Induced Hepatotoxicity in Suratthani Hospital, Thailand

2021 ◽  
Vol 104 (2) ◽  
pp. 233-239
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Clinical Symptoms ◽  
Significant Risk ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
First Line ◽  
Drug Induced ◽  
Factors Associated ◽  
Drug Risk

ackground: Tuberculosis (TB) is a major public health problem, including Thailand. Anti-TB drugs are very effective treatment, but they can cause hepatotoxicity. Data on the prevalence of anti-TB drug-induced hepatotoxicity (DIH), as well as the contributing risk factors, are scarce in Thailand. Objective: To measure the prevalence and identify risk factors associated with first-line drugs (FLD) induced hepatoxicity in TB patients. Materials and Methods: The present study was a retrospective study design in TB clinic of Suratthani Hospital, in Southern Thailand. All patients diagnosed with TB and received FLD between January and December 2017, were eligible for the study. Hepatoxicity defined as the following criteria: serum aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >5x upper limit of normal (ULN) without symptoms, or AST or ALT >3x ULN with clinical symptoms. Results: Of all the 198 TB cases, 18 were identified as DIH. Prevalence of DIH was 9.1%. Hepatitis after FLD was independently associated with age>60 years (adjusted OR [aOR] 28.49, 95% CI 2.68 to 302.95, p=0.005) and serum albumin <3.5 g/dL (aOR 20.97, 95% CI 2.11 to 208.51, p=0.009). Conclusion: Age of more than 60 years and low serum albumin of less than 3.5 g/dL were significant risk factors associated with first-line anti-TB drugs induced hepatoxicity. Keywords: Hepatoxicity, Anti-tuberculosis drug, Risk factor, Thailand

Environmental Vector Control Practices among Households of Patients with Dengue Fever during the Epidemic of 2018 in Kerala, India

2021 ◽  
Vol 8 (02) ◽  
pp. 48-52
Author(s):  
Chintha Sujatha ◽  
Reshma Rajan Sudha ◽  
Sreejith Lalitha Krishnankutty ◽  
Prajitha Kannamkottapilly Chandrasekharan
Keyword(s):  
Vector Control ◽  
Dengue Fever ◽  
Protective Factor ◽  
Significant Risk ◽  
Public Health Problem ◽  
Community Level ◽  
Control Measures ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Breeding Habitats

BACKGROUND Dengue fever is a major public health problem in Kerala. Vector control measures practiced at household level is the most cost-effective way of controlling dengue. This study aims to assess environmental measures of vector control practised among households of suspected or confirmed dengue patients in Thiruvananthapuram district of Kerala. METHODS A cross sectional study was done among households of patients diagnosed with dengue fever and reported in Integrated Disease Surveillance Programme (IDSP) in Thiruvananthapuram district from June to December 2018. Investigators interviewed the household members and made direct observations to collect data on vector control practices using a structured questionnaire. RESULTS A total of 108 houses were surveyed. Potential breeding habitats were found in 58 (53.7 %) houses. Aedes larva was found in containers from four (3.7 %) houses. Dry day observance was not regular with only 5 (4.6 %) houses practicing it weekly. Waste management practiced was proper in 47 (43.5 %) houses. Community level pre monsoon preparedness for epidemics was done in the vicinity of 53 (49.1 %) houses and it was found to be a protective factor against presence of breeding habitats in and around houses (p = 0.013). Low education (p = 0.012) and low occupational status (p = 0.017) were found to be significant risk factors. CONCLUSIONS Even during an epidemic, with occurrence of infections in the family, only half of the households are practising adequate vector control methods. Community level interventions and targeted information education campaign will help improve practice of environmental methods of vector control in dengue. KEYWORDS Dengue, Vector Control, Aedes Control, Environmental Methods, Community Interventions

scholarly journals MAYA INDEX DAN KEPADATAN LARVA AEDES AEGYPTI ANTARA DUSUN TEGALREJO DAN DUSUN KRAJAN KIDUL NANGGUNGAN PACITAN

2019 ◽  
Vol 14 (2) ◽  
pp. 199
Author(s):  
Yelly Atiefsa Narmala ◽  
R. Azizah
Keyword(s):  
Aedes Aegypti ◽  
Dengue Fever ◽  
Public Health Problem ◽  
Simple Random Sampling ◽  
Risk Category ◽  
Cross Sectional ◽  
Breeding Sites ◽  
Mosquito Breeding ◽  
Descriptive Approach ◽  
Cross Sectional Design

Dengue fever remains a public health problem. Environmental factors influence the mosquito Aedes aegypti’s growth, especially if there are many containers in the neighborhood. The community of Nanggungan Village have a habit of storing water in containers, therefore, they risk to become breeding sites for mosquitoes. This study aims to identify the Maya Index status of Aedes aegypti between Tegalrejo and Krajan Kidul Village. The research was observational with a cross-sectional design. Total samples were 200 homes, which 100 homes from Tegalrejo and 100 homes from Krajan Kidul Village, taken by simple random sampling. The measurement of variables employed observation sheet and analyzed in a descriptive approach. The number of containers observed in the Tegalrejo Village was 394 units, and Karajan Kidul Village was 391 units. Maya Index statuses in Tegalrejo (92%) and Krajan Kidul Village (88%) were low. Maya Index status in Krajan Kidul (13%) was higher than Tegalrejo Village (8%). House Index (HI) in the Tegalrejo (18.0%) was lower than Krajan Kidul Village (25.0%), Container Index in Tegalrejo (5.30%) was lower than in Krajan Kidul Village (8.95%), Breteau Index in Tegalrejo (21.0%) was lower than in Krajan Kidul Village (35.0%), Density Figure in Tegalrejo and Krajan Kidul Village indicated a scale of 3 and 4. Based on the MI’s status, Tegalrejo and Krajan Kidul Village were included as a low-risk category of mosquito breeding sites. Based on the density number of larvae, two villages have a moderate risk of Dengue Fever transmission. The community should implement the Mosquitoes Breeding Sites Eradication Program (PSN 3M Plus) and minimize the presence of the containers.

scholarly journals Corticosteroids for COVID-19 Therapy: Potential Implications on Tuberculosis

2021 ◽  
Vol 22 (7) ◽  
pp. 3773
Author(s):  
Radha Gopalaswamy ◽  
Selvakumar Subbian
Keyword(s):  
Infectious Diseases ◽  
Clinical Symptoms ◽  
Virus Disease ◽  
Clinical Signs ◽  
Significant Risk ◽  
Viral Disease ◽  
Control Measures ◽  
World Health ◽  
Global Pandemic ◽  
Health Organization

On 11 March 2020, the World Health Organization announced the Corona Virus Disease-2019 (COVID-19) as a global pandemic, which originated in China. At the host level, COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), affects the respiratory system, with the clinical symptoms ranging from mild to severe or critical illness that often requires hospitalization and oxygen support. There is no specific therapy for COVID-19, as is the case for any common viral disease except drugs to reduce the viral load and alleviate the inflammatory symptoms. Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis (Mtb), also primarily affects the lungs and has clinical signs similar to pulmonary SARS-CoV-2 infection. Active TB is a leading killer among infectious diseases and adds to the burden of the COVID-19 pandemic worldwide. In immunocompetent individuals, primary Mtb infection can also lead to a non-progressive, asymptomatic latency. However, latent Mtb infection (LTBI) can reactivate symptomatic TB disease upon host immune-suppressing conditions. Importantly, the diagnosis and treatment of TB are hampered and admixed with COVID-19 control measures. The US-Center for Disease Control (US-CDC) recommends using antiviral drugs, Remdesivir or corticosteroid (CST), such as dexamethasone either alone or in-combination with specific recommendations for COVID-19 patients requiring hospitalization or oxygen support. However, CSTs can cause immunosuppression, besides their anti-inflammatory properties. The altered host immunity during COVID-19, combined with CST therapy, poses a significant risk for new secondary infections and/or reactivation of existing quiescent infections, such as LTBI. This review highlights CST therapy recommendations for COVID-19, various types and mechanisms of action of CSTs, the deadly combination of two respiratory infectious diseases COVID-19 and TB. It also discusses the importance of screening for LTBI to prevent TB reactivation during corticosteroid therapy for COVID-19.

Prevalence and risk factors of Strongyloides stercoralis infection among Orang Asli schoolchildren: new insights into the epidemiology, transmission and diagnosis of strongyloidiasis in Malaysia

Parasitology ◽  
2019 ◽  
Vol 146 (12) ◽  
pp. 1602-1614 ◽  
Author(s):  
Hesham M. Al-Mekhlafi ◽  
Nabil A. Nasr ◽  
Yvonne A. L. Lim ◽  
Fatin Nur Elyana ◽  
Hany Sady ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intestinal Parasites ◽  
Agar Plate ◽  
Significant Risk ◽  
Control Programme ◽  
Control Measures ◽  
Parasitic Infections ◽  
Cross Sectional ◽  
Orang Asli ◽  
Direct Smear

AbstractThis cross-sectional study aimed to determine the prevalence and risk factors of S. stercoralis infection among 1142 Orang Asli primary schoolchildren in six different states of Peninsular Malaysia. Fecal samples were examined using direct smear, formalin-ether sedimentation (FES), agar plate culture (APC) and PCR techniques. Overall, 15.8% of the children were found to be infected with S. stercoralis. The prevalence was 0.2, 1.3, 15.2 and 13.7% by direct smear, FES, APC and PCR, respectively. Multivariate analysis showed that an age of >10 years, being male, belonging to a Proto-Malay tribe, belonging to the Senoi tribe, indiscriminate defecation, using an unimproved water source for drinking water and not wearing shoes when outside were the significant risk factors of infection among these children. In conclusion, we provide new evidence on the occurrence of S. stercoralis in Malaysia to show that there is a relatively high prevalence of infection among Orang Asli schoolchildren. Therefore, the use of specific methods for detecting S. stercoralis should be considered when screening these children for intestinal parasites. Moreover, prevention and control measures specific to S. stercoralis should be integrated into the intestinal parasitic infections control programme in Malaysia.

Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Fatality ◽  
Case Control ◽  
Case Definition ◽  
P Value ◽  
Factors Associated ◽  
Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

scholarly journals Seroprevalence of AsymptomaticLeishmania donovaniamong Laborers and Associated Risk Factors in Agricultural Camps of West Armachiho District, Northwest Ethiopia: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Animen Ayehu ◽  
Yibeltal Aschale ◽  
Wossenseged Lemma ◽  
Animut Alebel ◽  
Ligabaw Worku ◽  
...  
Keyword(s):  
Risk Factors ◽  
Leishmania Donovani ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
Control Measures ◽  
Sectional Study ◽  
Cross Sectional ◽  
Associated Risk Factors ◽  
Study Participants

Background. Visceral leishmaniasis (VL, also called kala-azar) is a public health problem in Ethiopia, especially in sesame and sorghum growing areas. Compared to other populations, labor migrants are the most exposed. Knowing the seroprevalence ofLeishmania donovaniand associated risk factors is essential to design appropriate control measures. The main aim of this study was to assess the seroprevalence of asymptomaticL. donovaniamong laborers and associated risk factors in agricultural camps of West Armachiho district, Northwest Ethiopia. Therefore, this study was conducted to know the seroprevalence and associated risk factors ofL. donovaniinfection.Method. A cross-sectional study was conducted among 185 laborers from October to December 2017. A simple random sampling technique was used to select study participants from selected agricultural camps. After obtaining written informed consent, data were collected using a structured pretested Amharic version questionnaire using the interview technique. A single finger prick blood sample was collected from the study participants and the blood samples were subjected to the serological diagnostic method using the rk39 kit. The multivariable logistic regression model was used to identify risk factors associated withL. donovaniinfection.Result. Among 185 participants examined using rk39, 14 (7.6%) were seroreactive forL. donovani.Leishmania donovaniinfection had a statistically significant association with sleeping underBalanitestrees (AOR: 4.36, 95%CI: 1.186-16.06), presence of domestic animals near sleeping place (AOR: 4.68, 95% CI: 1.25-17.56), and lack of knowledge about VL transmission (AOR: 3.79, 95% CI: 1.07-13.47).Conclusion. Seroprevalence of asymptomaticL. donovaniamong laborers in agricultural camps of West Armachiho was low. Prevention measures and health education about risk factors that expose toL. donovaniinfection for the laborers are essential to prevent the spread of the disease.

scholarly journals Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound

2013 ◽  
Vol 12 (2) ◽  
pp. 118-122
Author(s):  
Liz Andrea Villela Baroncini ◽  
Graciliano Jose Franca ◽  
Aguinaldo de Oliveira ◽  
Enrique AntonioVidal ◽  
Carlos Eduardo Del Valle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Deep Vein Thrombosis ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Below The Knee ◽  
Clinical Conditions ◽  
Deep Vein

BACKGROUND: Symptoms and clinical signs suggestive of deep vein thrombosis (DVT) are common but may have numerous possible causes. OBJECTIVES: 1) To identify the most frequent clinical symptoms and correlate them with duplex ultrasound scan (DS) findings; 2) to identify high-risk clinical conditions for DVT; and 3) to evaluate time since the onset of symptoms and DS examination. METHODS: A total of 528 patients with a clinical suspicion of DVT were evaluated by DS performed by experienced vascular ultrasonographists. RESULTS: DVT was present in 192 (36.4%) of the patients. The external iliac vein was involved in 53 patients (10.04%), the femoral veins in 110 (20.83%), the popliteal vein in 124 (23.48%), and veins below the knee were involved in 157 (29.73%) of the cases. Limb swelling was present in 359 cases (68%), and 303 (57.4%) complained of pain. Sixty nine patients received a DS due to suspected or proven pulmonary embolism (PE); 79 patients were in postoperative period. In the multivariate analysis, independent risk factors for DVT included age>65 years (OR=1.49; 95% confidence interval [95%CI] 1.01-2.18; p=0.042), edema (OR=2.83; 95%CI 1.72-4.65; p<0.001), pain (OR=1.99; 95%CI 1.3-3.05; p=0.002), cancer (OR=2.32; 95%CI 1.45-3.72; p<0.001), and PE (OR=2.62; 95%CI 1.29-5.32; p=0.008).Time since the onset of symptoms did not differ between the groups. CONCLUSIONS: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT.

scholarly journals Clinical Trial of Efficacy and Toxicity of Disoproxil Tenofovir Fumarate and Emtricitabine for Mild to Moderate SARS-CoV-2 Infections

2021 ◽  
Author(s):  
Aldo A M Lima ◽  
Erico A G Arruda ◽  
Roberto J Pires-Neto ◽  
Melissa S Medeiros ◽  
J Quirino-Filho ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Vitamin C ◽  
Respiratory Infection ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Clinical Suspicion ◽  
Pharmacological Intervention ◽  
Controlled Clinical Trial ◽  
Double Blind

This study aimed to evaluate the efficacy and toxicity of tenofovir (TDF) and TDF combined with emtricitabine (TDF/FTC) in patients with mild to moderate COVID-19 infections. We conducted a randomized, double-blind, placebo-controlled clinical trial in patients with clinical suspicion of mild to moderate respiratory infection caused by SARS-CoV-2 who were treated at an outpatient clinic. Patients were randomly recruited to take 10 days of TDF (300 mg/day), TDF (300 mg/day) combined with FTC (200 mg/day) or placebo Vitamin C (500 mg/day). The primary parameter was the score of symptoms and predictive signs of COVID-19, assessed on the seventh day of patient follow-up. From a total of 309 patients with clinical suspicion of SARS-CoV-2, 227 met the inclusion criteria and were randomly distributed into the following groups: (a) 75 (one did not initiate treatment) in the TDF group; (b) 74 in the TDF combined with FTC group; and (c) 77 in the Vitamin C group (placebo). Of the 226 patients, 139 (62%) were positive for SARS-CoV-2. Fever (37.8oC), ageusia or dysgeusia, anosmia or dysosmia, and two or more clinical symptoms or signs were significantly associated with SARS-CoV-2 infection. There was no significant change in clinical score based on clinical symptoms and signs between treatment groups. Patients with mild to moderate infection by SARS-CoV-2 had higher concentrations of G-CSF, IL-1β, IL-6 and TNF-α compared to patients without infection. Patients with mild to moderate respiratory infection, with fever (37.8oC), loss of smell, loss of taste and two or more symptoms, have a better prediction for the diagnosis of COVID-19. Patients with SARS-CoV-2 showed higher and more persistent proinflammatory cytokines profile compared to patients not infected with SARS-CoV-2. Pharmacological intervention with TDF or TDF combined with FTC did not change the clinical signs and symptoms score in mild to moderate respiratory infection in patients with SARS-CoV-2 compared to the Vitamin C group (placebo).

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