scholarly journals DENGUE OUTBREAK;

2012 ◽  
Vol 20 (01) ◽  
pp. 045-053
Author(s):  
MUHAMMAD ASIF SHAHZAD ◽  
ABDUL RAUF ◽  
HUMAYUN SUQRAT HASAN IMAM ◽  
Rameesha Humayun

Background: This longitudinal study was conducted during August to December 2011 in District Faisalabad to analyzeepidemiological pattern of dengue outbreak in the district. Weekly trends of all cases (893) reported through Disease Surveillance Systemfrom week No.33 to 54 were monitored. On the basis of this continuous flow of information, different ongoing vector control measureswere adopted simultaneously in different areas of the district and larval indices were calculated. Methods: The Surveillance data was usedto monitor the trends of the outbreak in terms of time, person and place. Teams of 3102 trained workers were formed to conduct varioussurveillance activities like vector surveillance, fogging, larviciding, and indoor residual sprays. During indoor and outdoor vectorsurveillance, teams also calculated the larval indices for vector control. Results: The rural to urban ratio of cases was 1:3. Maximumcases (215) were reported from Jinnah Town in urban area and (102) cases were reported from Tehsil Sadar among the rural areas. Mostcases of dengue fever were observed during the 40-45 weeks of the year 2011. Mean age was 29±14.7 years for rural and 35±16.5years for urban. Male to Female ratio was 1.2:1 in urban and 1.8:1 in rural areas. Majority of the cases belonged to the age group 21-30.The case fatality rate was 6/1000 cases. The house lndex was 1.03%, the indoor container index was 0.26% and the breateu index wasfound 1.21%. Conclusions: Maximum cases occurred during 44th and 45th weeks. Male were affected more as compare to females.Jinnah Town in urban areas and Tehsil Sadar among the rural areas reported maximum number of cases. The different calculated larvalindices like house index, indoor/outdoor container index and breateu index showed moderate larval growth and hence, the outbreak waswithin control.

2013 ◽  
Vol 33 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Deepak Prasad Koirala ◽  
Kalipatnam Seshagiri Rao ◽  
Kalpana K Malla ◽  
Tejesh Malla

Introduction: Organophosphates (OP) are commonly used pesticides in rural agricultural regions of Nepal and carbamates are popular household insecticides. Because of poor legislation these poisons are easily accessible and are the most popular suicidal poisons. Materials and Methods: This was a retrospective study done in poisoning cases admitted in PICU of Manipal Teaching Hospital (MTH) over a seven year period. Results: Out of 187 cases of poisoning, 30 (16.04%) were OPs and 4 (2.13%) were Carbamates. The male to female ratio was 56:44 and these poisonings were more common in rural areas (56%). Accidental poisoning (82.4%) was more common but suicidal attempts (17.6%) were also observed. Atropine and pralidoxime were used in 82.4% of the cases. The total atropinizing dose was 0.77±0.6 mg/kg and patients required 56.6±23.7 hours of atropinization. In our study 94.1% of the patients survived and none of them developed any sequel. Children developed muscarinic, nicotinic and CNS symptoms similar to adults. Complications were seen in 41.1% of the children and most common being seizure (85.7%). The most common OP observed in childhood poisoning was Metacid (methyl parathion) seen in 26.4% of the cases. Conclusion: OP and Carbamate poisonings are common in children. Possibility of self-harm poisoning in adolescent females cannot be ignored. Atropine is the mainstay of therapy after initial resuscitation and complications are common in children. With prompt treatment the outcome is good even with complications. The case fatality rate is much less as compared to adults.DOI: http://dx.doi.org/10.3126/jnps.v33i2.7799 J Nepal Paediatr Soc. 2013; 33(2):85-90


Stroke ◽  
2019 ◽  
Vol 50 (10) ◽  
pp. 2661-2667 ◽  
Author(s):  
Olivier Grimaud ◽  
Yacine Lachkhem ◽  
Fei Gao ◽  
Cindy Padilla ◽  
Mélanie Bertin ◽  
...  

Background and Purpose— Recent findings suggest that in the United States, stroke incidence is higher in rural than in urban areas. Similar analyses in other high-income countries are scarce with conflicting results. In 2008, the Brest Stroke Registry was started in western France, an area that includes about 366 000 individuals living in various urban and rural settings. Methods— All new patients with stroke included in the Brest Stroke Registry from 2008 to 2013 were classified as residing in town centers, suburbs, isolated towns, or rural areas. Poisson regression was used to analyze stroke incidence and 30-day case fatality variations in the 4 different residence categories. Models with case fatality as outcome were adjusted for age, stroke type, and stroke severity. Results— In total, 3854 incident stroke cases (n=2039 women, 53%) were identified during the study period. Demographic and socio-economic characteristics and primary healthcare access indicators were significantly different among the 4 residence categories. Patterns of risk factors, stroke type, and severity were comparable among residence categories in both sexes. Age-standardized stroke rates varied from 2.90 per thousand (95% CI, 2.59–3.21) in suburbs to 3.35 (95% CI, 2.98–3.73) in rural areas for men, and from 2.14 (95% CI, 2.00–2.28) in town centers to 2.34 (95% CI, 2.12–2.57) in suburbs for women. Regression models suggested that among men, stroke incidence was significantly lower in suburbs than in town centers (incidence rate ratio =0.87; 95% CI, 0.77–0.99). Case fatality risk was comparable across urban categories but lower in rural patients (relative risk versus town centers: 0.76; 95% CI, 0.60–0.96). Conclusions— Stroke incidence was comparable, and the 30-day case fatality only slightly varied in the 4 residence categories despite widely different socio-demographic features covered by the Brest Stroke Registry.


Author(s):  
Yongsheng Tong ◽  
Michael R. Phillips ◽  
Yi Yin ◽  
Zhichao Lan

Abstract Aims The 2014 World Health Organization report on global suicide identified large differences in the male-to-female ratio of suicide rates between countries: most high-income countries (HICs) report ratios of 3:1 or higher while many low- and middle-income countries (LMICs) – including China and India – report ratios of less than 1.5:1. Most authors suggest that gender-based social-cultural factors lead to higher rates of suicidal behaviour among women in LMICs and, thus, to relatively high female suicide rates. We aim to test an alternative hypothesis: differences in the method and case-fatality of suicidal behaviour – not differences in the rates of suicidal behaviour – are the main determinants of higher female suicide rates in LMICs. Methods A prospective registry of suicide attempts treated in all 14 general hospitals in a rural county in China was established and data from the registry were integrated with population and mortality data from the same county from 2009 to 2014. Results There were 160 suicides and 1010 medically-treated suicidal attempts in the county; 84% of female suicides and 58% of male suicides ingested pesticides while 73% of female attempted suicides and 72% of male attempted suicides ingested pesticides. The suicide rate (per 100 000 person-years of exposure) was 8.4 in females and 9.1 in males (M:F ratio = 1.08:1) while the incidence of ‘serious suicidal acts’ (i.e. those that result in death or received treatment in a hospital) was 81.5 in females and 47.7 in males (M:F ratio = 0.59:1). The case-fatality of serious suicidal acts was higher in males than in females (19 v. 10%), increased with age, was highest for violent methods (92%), intermediate for pesticide ingestion (13%) and lowest for other methods (5%). Conclusions The incidence of medically serious suicidal behaviour among females in rural China was similar to that reported in HICs, but the case-fatality was much higher, primarily because most suicidal acts involved the ingestion of pesticides, which had a higher case-fatality than methods commonly used by women in HICs. These findings do not support sociological explanations for the relatively high female suicide rate in China but, rather, suggest that gender-specific method choice and the case-fatality of different methods are more important determinants of the demographic profile of suicide rates. Further research that involves ongoing monitoring of the changing incidence, demographic profile and case-fatality of different suicidal methods in urban and rural parts of both LMICs and HICs is needed to confirm this hypothesis.


2018 ◽  
Author(s):  
Ying Zhang ◽  
Jefferson Riera ◽  
Kayla Ostrow ◽  
Sauleh Siddiqui ◽  
Harendra de Silva ◽  
...  

AbstractBackgroundMore than 80,000 dengue cases including 215 deaths were reported nationally in less than seven months between 2016-2017, a fourfold increase in the number of reported cases compared to the average number over 2010-2016. The region of Negombo, located in the Western province, experienced the greatest number of dengue cases in the country and is the focus area of our study, where we aim to capture the spatial-temporal dynamics of dengue transmission.MethodsWe present a statistical modeling framework to evaluate the spatial-temporal dynamics of the 2016-2017 dengue outbreak in the Negombo region of Sri Lanka as a function of human mobility, land-use, and climate patterns. The analysis was conducted at a 1 km × 1 km spatial resolution and a weekly temporal resolution.ResultsOur results indicate human mobility to be a stronger indicator for local outbreak clusters than land-use or climate variables. The minimum daily temperature was identified as the most influential climate variable on dengue cases in the region; while among the set of land-use patterns considered, urban areas were found to be most prone to dengue outbreak, followed by areas with stagnant water and then coastal areas. The results are shown to be robust across spatial resolutions.ConclusionsOur study highlights the potential value of using travel data to target vector control within a region. In addition to illustrating the relative relationship between various potential risk factors for dengue outbreaks, the results of our study can be used to inform where and when new cases of dengue are likely to occur within a region, and thus help more effectively and innovatively, plan for disease surveillance and vector control.


Author(s):  
Samia O. Massaad ◽  
Mohammed Ahmed A. Ahmed ◽  
Afra M. Mustafa ◽  
Sami Eldirdiri Elgaili Salah ◽  
Saeed M. Omar ◽  
...  

<p><strong>Background: </strong>Acquired heart diseases (AHD) are heterogeneous diseases including rheumatic heart disease (RHD) and other affecting the heart and blood vessels after birth but usually appear clinically after 5 years of age. AHD considered as major cause of   morbidity and mortality. The present study was designed to document the spectrum, the affected age and clinical characteristics of AHDs in children of Gadarif state, eastern Sudan.</p><p><strong>Methods</strong>: This was a descriptive cross section study conducted in Gadarif pediatrics teaching hospital in period from June to Dec 2019.</p><p><strong>Results: </strong>A total of 46 children from Gadarif pediatrics teaching hospital with confirmed AHD were enrolled in this study. The females were 27 (58.7%), with a male-to-female ratio of 1.4:1. The mean age was 10.6±3.9 years (age’s ≤16 years old); the most common affected age group was 10-14 years accounted 18 (39.1) cases. RHD was the commonest AHD found in 38 (82.6%) patients, the commonest valvular lesion was mitral regurgitation 31 (73.9%).</p><p><strong>Conclusions: </strong>RHD was the most common AHD in the children in the present study, there is need to improve the scope of intervention facilities in the Sudan particularly in rural areas to prevent the growing and spread of these diseases.</p>


Author(s):  
Adel J Hussein

Acute poisoning,a common pediatric emergency,is one of the important causes of morbidity and mortality in children,especially in developing countries. The patterns of poisoning usually differ from country to country and from province to another within the same country.The purpose of this study was to clarify the characteristics of acute chemical and drug poisoning.cases admitted to the emergency department (ED)ofmaternity and children,teaching hospital in Al- Diwaniyah city and to compare poisoning characteristics between different age groupsin the region. A review of medical records of 125 poisoningcases under 7 years of age, except for cases of food poisoning,snake bite,scorpion stings and cases with incomplete data were not included in this study,presenting to the Emergency Department (ED) during 2016 were determined.The mean age of all poisoned patients (mean ± standard deviation) was 2.26 ± 0.750.One hundred and twenty five children,forming 2.2% (125/5494) of total emergency unit admissions of all patients,were under seven years of age. Slightly more boys 71 (56.8%) than girls 54 (43.2%) were intoxicated with the male to female ratio of 1.3:1. The majority of all cases were due to accidental poisoning. In patients younger than one year of age 23 (18.4%),of all poisonings were due to therapeutically error,1 – 3 year 47 (37.6%),4 – 7 year 55 (44%). Chemical agents (58.4%) mostly kerosene (30.1%),agriculturalpesticides/insecticides (19.1%),were the most frequent offending agent,followed by drugs comprised (41.6%),mostly due to Cold and cough medication (15.3%),The vast majority of these materials was stored in non-original containers,These drugs were available at home,being used either by the child or the parents and grandparents.The most common route of poisoning was ingestion of the poison (118 patients; 94.4%) and most were ingested inside the house (73.6%). No deaths were reported.There were obvious seasonal variations and most cases were admitted during in summer (42.4%) and spring (29.6%). Patients from rural areas (57.6%) were more than the patients from the urban areas (42.4%). Effective health promotional programs for parents regarding poisoning hazards are needed to increase the awareness and reduce the incidence of poisoning among children in our region in addition correct dealing with the chemical materials. A relationship exists between the parents’ level of education and the occurrence of pediatric poisoning particularly mothers. Since the level of education in this study was lower in the mothers and for mothers are those who take primary care of children at home; they should be educated regarding care and prevention of lethal injuries to their children at home.


2012 ◽  
Vol 45 (3) ◽  
pp. 385-389 ◽  
Author(s):  
Wilma Batista de Matos ◽  
Gisele Maria Campelo dos Santos ◽  
Vitor Emmanuel Bouças da Silva ◽  
Eloísa da Graça do Rosário Gonçalves ◽  
Antonio Rafael da Silva

INTRODUCTION: The study aimed to show the situation of paracoccidioidomycosis in the state of Maranhão, Brazil. METHODS: This study is a descriptive case series developed in two stages. First, a survey of cases originating from the state of Maranhão at the Instituto de Doenças Tropicais Natan Portela, Piauí (IDTNP) from 1997 to 2007, and second, the clinical description of 29 cases diagnosed in the Centro de Referências em Doenças Infecciosas e Parasitárias, Maranhão (CREDIP) from 2004 to 2010. RESULTS: Two hundred and sixteen cases have been cataloged at the IDTNP. West, east, and central regions of the state of Maranhão recorded 90.3% of cases proving to be important areas for study. The western region, with a prevalence of 10.8/100,000 inhabitants, has a significantly higher proportion of cases than the northern, southern, and eastern regions (p < 0.05). The occurrence was higher in men with 89.3% of cases, and the male-to-female ratio was 8.4:1. The majority of patients were older than 20 years, lived in rural areas, and had farming or soil management as main occupation (73.8%). At CREDIP, 29 cases were diagnosed, of which 26 (89.6%) had multifocal manifestations. Mucous tissues were involved more (75.8%) frequently, followed by lymph nodes, skin, and lungs with 65.5%, 39% and 37.9 %, respectively. The diagnosis was made by combining direct examination, culture, and histopathology. CONCLUSIONS: The study shows the geographical distribution and the epidemiological and clinical aspects of paracoccidioidomycosis, revealing the significance of the disease to the state of Maranhão.


2001 ◽  
Vol 20 (12) ◽  
pp. 611-617 ◽  
Author(s):  
A I Hatzitolios ◽  
M L Sion ◽  
N P Eleftheriadis ◽  
E Toulis ◽  
G Efstratiadis ◽  
...  

Objective: To study the epidemiology of acute poisoning patients presenting to an acute medical service ward in a Greek hospital between January 1998 and December 2000. Design: Prospective case series. Results: A total of 273 patients with self-poisoning were included in the study. This represented 3.8% of the overall admissions to the unit. The mean age of patients was 33, the most frequent age group being that aged 20–30 years (36.2% of total) with a male-to-female ratio of 1:1.97. Sixty per cent of patients was admitted within 4 h. Those from urban areas comprised 76.2% and 23.8% from rural areas. The most frequently ingested agents were psychopharmaceuticals (37.4%) and analgesics/anti-rheumatics (32.6%). Pesticides (7.7% of total) were most frequently used by patients coming from rural areas (32.3% of patients from rural areas). Alcohol was included in the overdose in 8.4%. Of the patients, 16.2% had a previous history of overdose. In this case series, psychiatric assessment suggested that 52% of the patients had a formal psychotic diagnosis, 21% had personality disorder and 27% had taken an overdose in response to stress. The most frequently documented precipitating factors were family problems and disputes (37%). Unusually, the seasonal distribution in these patients suggested a peak in summer (37.5% of presentations) with lower numbers in spring (30.2%), autumn (17.7%) and winter (14.6%). Of the patients, 23.7% presented in July. A total of 73.5% of patients was conscious, 16.4% was somnolent, 4.5% was in precoma and 5.6% was in coma (GCS <8). Patients who received antidotal therapy comprised 17.9%. Evidence of hepatic dysfunction was observed in 8.9% of patients and renal dysfunction in 3.6%. Extracorporeal techniques for drug removal (hemodialysis and hemoperfusion) were used in 2.2% of patients. Intensive care therapy was required in 11.4% of patients. The mean overall hospitalization time was 3.3 days. The mortality rate was 2.9%. Conclusions: This study shows that the epidemiology of self-harm by overdose in Greece is significantly different in terms of the seasonal presentation from other parts of Europe. The agents ingested and other features are similar to northern Europe. Psychiatric diagnoses are more common in our group than in those reported from northern Europe.


1998 ◽  
Vol 4 (1) ◽  
pp. 50-57
Author(s):  
Bandaru Narasinga Rao ◽  
Ibrahim Mahdi Kashbur ◽  
Nuri Mohamed Shembesh ◽  
Suliman Mohamed El Bargathy

Over a 14-month period, 77 children with a presumptive diagnosis of acute bacterial meningitis were investigated. The incidence of acute bacterial meningitis was 0.8%, with a case fatality rate of 13.0%. Children pound 1 year of age were more affected [64.9%]. The total male to female ratio was 1.2:1. Gram stain detected more cases [85.7%] than culture [66.2%]. A total of 48 isolates were identified by culture and their antibiotic sensitivity was determined. Haemophilus influenzae [33.8%] was the predominant organism identified, followed by Streptococcus pneumoniae [26.0%], Klebsiella spp. [6.5%] and Neisseria meningitidis [2.6%]. Many of the bacterial isolates were sensitive to gentamicin, cefotaxime and ceftriaxone and least sensitive to tetracycline and ampicillin


2020 ◽  
Vol 7 (2) ◽  
pp. 59-64
Author(s):  
Syamsul Rizal ◽  
Muhammad Jailani ◽  
Mirnasari Amirsyah ◽  
Emil Muzammil

Background: The epidemiology pattern of patients with burn injury varies widely in different parts of the world. This study aimed to identify epidemiological data from hospitalized burn injury patients in Zainoel Abidin General Hospital, a referral Hospital in Aceh. Methods: All hospitalized burn injury patient data from January 2016 to December 2017 were collected from the medical record. Data taken included Gender, age, length of stay (LOS), mortality, severity, and extent of the burn, and etiology of burn. Results: From all hospitalized patients with burn injury, the male to female ratio is 1,6:0,9. The mortality rate is 9%, while the others survive. From all etiology of burn, 57% is flame injury, 19% is electrical injury, 18% is scald burn injury, 4% is contact burn injury, and 1% is a chemical burn injury. No patient with first-degree burns was hospitalized, while 13 patients had third-degree burn injuries, and the rest had second-degree burn injuries. Conclusion: An increasing number of hospitalized patients from 2016 to 2017, from 25 patients to 42 patients. It might happen because of increasing knowledge about burn injury in society and physicians in rural areas to refer patients to the hospital with better facilities.


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