scholarly journals Clinical picture of pulmonary plague observed in the paediatric wards of antananarivo

2021 ◽  
Vol 4 (1) ◽  
pp. 046-049
Author(s):  
Rakotomalala Rivo Lova Herilanto ◽  
Randriamanga Lovasoa ◽  
Karol Mihary Soa ◽  
Aurélien Mioramalala Sedera ◽  
Robinson Annick Lalaina
Keyword(s):  
Urban Areas ◽  
Case Control Study ◽  
Clinical Signs ◽  
Severe Form ◽  
Warning Signs ◽  
Clinical Form ◽  
Retrospective Case ◽  
Pneumonic Plague ◽  
Male Predominance ◽  
Control Study

Introduction: In Madagascar, plague is a highly contagious acute endemic infectious disease. The diagnosis of the most severe form of pneumonic plague remains difficult in children, hence the objectives of the present study; which is to identify the clinical signs of this clinical form in children and to describe its epidemiological and evolutionary profile. Methods: A retrospective case-control study was conducted in four pediatric wards in Antananarivo during the urban pneumonic plague outbreak from September 2017 to January 2018. Those cases were defined as children aged 0-15 years old suspected of having plague with positive RDT and PCR, and they were defined as children aged 0-15 years old with negative RDT and PCR. Results: Fifty-two cases of pneumonic plague were identified, half of which (50%) were under 24 months of age. A male predominance was noted with a sex ratio of 1.23 and 86.54% of the patients were from urban areas. Several clinical signs were found but none was specific for pneumonic plague: cough (59.62% p: 0.5), dyspnea (3.85% p: 0.16), chest pain (3.85% p: 0.26%), hemoptysis (7.69% p: 0.17), vomiting (9.62% p: 0.14), diarrhea (11.54% p: 0.45), altered general condition (38.46% p: 0.24%). Two deaths were noted (3.8%). Conclusion: No specific clinical warning signs have been identified in childhood pneumonic plague. In the event of an epidemic of urban pneumonic plague, any bacterial pneumonia should at least initially include active treatment against Yersinia pestis.

scholarly journals 1405. Clinical and laboratory features of fatal dengue fever in children: a case-control study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S710-S711
Author(s):  
Dolores E Freire ◽  
Jeniffer D Olaya ◽  
Michael Hawkes
Keyword(s):  
Dengue Fever ◽  
Case Control Study ◽  
Dengue Infection ◽  
Healthcare Providers ◽  
Case Control ◽  
Warning Signs ◽  
Total Leukocyte Count ◽  
Retrospective Case ◽  
Time To Death ◽  
Control Study

Abstract Background Dengue fever (DF) is a mosquito-borne illness that causes significant morbidity and mortality in tropical climates. This study compared the clinical features of fatal DF cases to severe non-fatal, and non-severe controls in Ecuador. Methods Retrospective case-control study of children (1 month to 15 years) hospitalized with serologically-confirmed DF in Guayaquil, Ecuador from 2013 to 2017. Cases of severe, fatal (SF) DF were compared to two control groups: (1) severe DF survivors (SS); and (2) patients with dengue with warning signs (DWS), matched 3:1 to cases for age, sex, and admission date. Observational trial profile Results 1051 patients were admitted with suspected DF and 552 were IgM-positive. Patients were classified as SF (n=11), SS (n=30), or DWS (n=511) (Figure1). Among SF cases, median age was 9.6 years (IQR 5.5-11), 7 (64%) were male, and median time to death was 1.5 days (IQR 0.8-4.0). (Table 1) SF cases had a median of 3 (Range 0-5) encounters with healthcare providers prior to presentation, compared to 2 (Range 0-5, p=0.02) for SS and 2 (Range 0-3, p=0.02) for DWS. Physical findings more common in SF cases than controls included: higher weight, tachycardia, tachypnea, delayed capillary refill, and hepatomegaly (p< 0.05 for all comparisons). Neurological manifestations were more prevalent in the SF group: 9/11 (82%) patients compared to 15/30 (50%, p=0.09) in SS and 7/33 (21%, p< 0.01) in DWS. Total leukocyte count (7.8x103/µL versus 4.5x103/µL, p=0.03) and absolute neutrophil count (5.1x103/µL versus 2.1x103/µL, p=0.03) were higher in SF cases than DWS controls. Fewer SF patients received intravenous dextrose than SS controls (27% versus 70%, p=0.03) (Table 2). Admission characteristics of children with dengue fever Management and outcome Conclusion Delayed recognition by healthcare workers, higher weight, vital sign abnormalities, hepatomegaly, neurological symptoms, leukocytosis, neutrophilia, and lack of dextrose in intravenous solutions were associated with mortality in children with DF. These findings have implications for optimizing the diagnosis and management of severe pediatric dengue infection. Disclosures All Authors: No reported disclosures

224 A RETROSPECTIVE CASE–CONTROL STUDY ASSESSING THE CLINICAL AND ENDOSCOPIC CHARACTERISTICS OF EOSINOPHILIC ESOPHAGITIS IN JAPAN

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kazumi Imamura ◽  
Ken Haruma ◽  
Hiroshi Matsumoto ◽  
Yasuhiko Maruyama ◽  
Maki Ayaki ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Japanese Population ◽  
Case Control Study ◽  
High Power Field ◽  
Retrospective Case ◽  
Male Predominance ◽  
Endoscopic Findings ◽  
History Of ◽  
Endoscopic Characteristics ◽  
Control Study

Abstract   Eosinophilic esophagitis (EoE) is an allergy-associated clinicopathologic condition gaining an increasing amount of recognition in various areas of the world. While the clinical definition and characteristics may differ depending on country and region, sufficient studies have not yet been performed in Japan. To assess the prevalence of EoE among the Japanese population and the clinical features and the prognosis associated with the disease. Methods Medical data from January 2012 to October 2018 was gathered from nine Japanese clinical institutes. EoE, defined as more than 15 intraepithelial eosinophils per high power field, was determined based on esophageal biopsies. Clinical and endoscopic patterns in the cases with EoE were investigated and compared with 186 age- and sex-matched controls. We also analyzed the treatment and prognosis of an individual patient. Results From 130,013 upper endoscopic examinations, 66 cases of EoE were identified (0.051%; mean age: 45.2 years (range 7-79); 45 males). Patients with EoE had more symptoms (69.7 vs. 10.8%; P < 0.01) such as dysphagia and food impaction, and more allergies (63.6 vs. 23.7%; P < 0.01) compared with the controls. The prevalence of atrophic gastritis was lower in EoE patients than in the controls (20.0% vs. 33.3%). In 55 patients analyzed, 32 patients (78.0%) received proton pump inhibitors with or without swallowed topical corticosteroids. During the follw-up period (mean 23 months), no patient got worse regarding clinical and endoscopic findings. Conclusion The prevalence of EoE in the Japanese population was 0.051% which was comparable with previous reports in Japan. Male predominance, a history of allergies, and the absence of Helicobacter pylori infection might be risk factors for EoE. Our study also indicated that the prognosis of EoE might be relatively good in Japanese populations.

scholarly journals The Lebanese Cohort for COVID-19; A Challenge for the ABO Blood Group System

2020 ◽  
Author(s):  
Athar Khalil ◽  
Mahmoud Hassoun ◽  
Rita Feghali
Keyword(s):  
Blood Group ◽  
North Africa ◽  
Case Control Study ◽  
Severe Form ◽  
Abo Blood Group ◽  
Blood Group System ◽  
Retrospective Case ◽  
State Of Emergency ◽  
Group System ◽  
Control Study

A sudden outbreak of pneumonia caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has rapidly spread all over the world facilitating the declaration of the resultant disease as a pandemic in March,2020. In Lebanon, the fast action of announcing a state of emergency with strict measures was among the factors that helped in achieving a successful containment of the disease in the country. Predisposing factors for acquiring COVID-19 and for developing a severe form of this disease were postulated to be related to epidemiological and clinical characteristics as well as the genomics signature of a given population or its environment. Biological markers such as the ABO blood group system was amongst those factors that were proposed to be linked to the variability in the disease course and/or the prevalence of this infection among different groups. We therefore conducted the first retrospective case-control study in the Middle-East and North Africa that tackles the association between the blood group types and the susceptibility as well as the severity of SARS-CoV2 infection. Opposing to the current acknowledged hypothesis, our results have challenged the association significance of this system with COVID-19. Herein, we highlighted the importance of studying larger cohorts using more rigorous approaches to diminish the potential confounding effect of some underlying comorbidities and genetic variants that are known to be associated with the ABO blood group system.

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