scholarly journals Case Fatality as an Indicator for the Human Toxicity of Pesticides—A Systematic Scoping Review on the Availability and Variability of Severity Indicators of Pesticide Poisoning

Author(s):  
Susanne Moebus ◽  
Wolfgang Boedeker

Objective: To investigate if case fatality and other indicators of the severity of human pesticide poisonings can be used to prioritize pesticides of public health concern. To study the heterogeneity of data across countries, cause of poisonings, and treatment facilities. Methods: We searched literature databases as well as the internet for studies on case-fatality and severity scores of pesticide poisoning. Studies published between 1990 and 2014 providing information on active ingredients in pesticides or chemical groups of active ingredients were included. The variability of case-fatality-ratios was analyzed by computing the coefficient of variation as the ratio of the standard deviation to the mean. Findings: A total of 149 papers were identified of which 67 could be included after assessment. Case-fatality-ratio (CFR) on 66 active ingredients and additionally on 13 groups of active ingredients were reported from 20 countries. The overall median CFR for group of pesticides was 9%, for single pesticides 8%. Of those 12 active ingredients with a CFR above 20% more than half are WHO-classified as “moderately hazardous” or “unlikely to present acute hazard”. Two of seven pesticides considered “unlikely to present hazard in normal use” showed a CFR above 20%. The cross-study variability of reported case fatality was rather low. Studies most often utilized the Glasgow Coma Score for grading the severity of poisoning. Conclusion: Although human pesticide poisoning is a serious public health problem, an unexpectedly small number of publications report on the clinical outcomes within our study period. However, CFRs of acute human pesticide poisoning are available for several groups of pesticides as well as for active ingredients showing moderate cross-study variability. Our results underline that CFR is an indicator of the human toxicity of pesticides and can be utilized to prioritize highly hazardous pesticides especially since there is limited correspondence between the animal-test-based hazard classification and the human CFR of the respective pesticide. The reporting of available poisoning data should be improved, human case-fatality data are a reasonable tool to be included systematically in the periodic statutory review of pesticides and their regulation.

2017 ◽  
Author(s):  
Susanne Moebus ◽  
Wolfgang Boedeker

AbstractObjectiveTo investigate if case fatality and other indicators of severity of human pesticide poisonings can be used to prioritize pesticides of public health concern. To study the heterogeneity of data across countries, cause of poisonings, and treatment facilities.MethodsWe searched literature databases as well as the internet for studies on case-fatality and severity scores of pesticide poisoning. Studies published between 1990 and 2014 providing information on active ingredients in pesticides or chemical groups of active ingredients were included. The variability of case-fatality-ratios was analyzed by computing the coefficient of variation as the ratio of the standard deviation to the mean.FindingsWe identified 145 studies of which 67 could be included after assessment. Case-fatality-ratio (CFR) on 68 active ingredients and additionally on 13 groups of active ingredients were reported from 20 countries. Mean CFR for group of pesticides is 12 %, for single pesticides 15 %. Of those 12 active ingredients with a CFR above 20 % only two are WHO-classified as “extremely hazardous” or “highly hazardous”, respectively. Two of seven pesticides considered “unlikely to present hazard in normal use” show CFR above 20 %. The variability of reported case fatality was rather low.ConclusionAlthough human pesticide poisoning is a serious public health problem an unexpected small number of publications report on the clinical outcomes. However, CFR of acute human pesticide poisoning are available for several groups of pesticides as well as for active ingredients and show little variability. Therefore the CFR might be utilized to prioritize highly hazardous pesticides especially since there is limited correspondence between the animal-test-based hazard classification and the human CFR of the respective pesticide. Reporting of available poisoning data should be improved, human case-fatality data are a reasonable tool to be included systematically in pesticide registration and regulation.


Author(s):  
Vijay Kumar Mishra

Background: It is well known that India is having a massive population (around 130 crores) after China. So, it's more likely to be similar or more positive cases of corona among Indians. However, we are following the ways of social distancing and all possible ways to weaken the corona outbreak. But, India needs a good monitoring and surveillance system to tackle this problem otherwise it may become a serious public health problem. Objectives: This study has done to understand the severity of corona in India and its states and to device a tool based on symptoms suggested by the World Health Organization on the corona. Methods: We have utilized data extracted through the Ministry of Health & Family Welfare, GoI from 30th Jan to 26th March 2020. We have estimated the case fatality rate and cured rate to understand the severity of the newly discovered virus (COVID-19). Results: Out of 694 confirmed corona cases, 47 were foreigners and 647 Indians. Our study found that the case fatality rate due to COVID-19 was 23.1 per 1000 persons in India while the people who were still hospitalized under isolation wards were about 91 percent. The cure rate was estimated at around 64.8 per 1000 persons. Conclusions: Looking at the recovery rate, we may think about the severity of corona among Indians. We can reduce the chances of rapidly increasing corona cases through good monitoring and surveillance system. It is recommended that Government should not only focus on testing the passengers arriving at the airport but also test as much as possible cases based on the symptoms of corona in all the districts so that an actual number of cases can be estimated.


Author(s):  
Pratibha U. Mulik ◽  
Sudam R. Suryawanshi

Background: After comparing data of NFHS-3 and 4, prevalence of overweight and obesity in women of an urban population almost doubled in 10 yr. So, the causes of increasing prevalence need to be studied as public health concern. Objective of the study is to determine prevalence of overweight and obesity among reproductive age group (15-49 years) of women in an urban slum of Mumbai.Methods: Total 220 women were selected among 11 sectors from A to K by simple random method and data collected by using validated questionnaire. WHO’s classification was used to classify as overweight and obese.Results: Out of 220 women participated in study, 14 (6.36%) were obese, 75 (34.09%) were overweight according to BMI and 17 (7.7%) were found to be obese according to waist to hip ratio. From the present study it was seen that age group of the women, socio economic class, education, history of hypothyroidism, family history of obesity, types of work women do, hours of television watching, calorie and fat intake, had a significant relationship with BMI, whereas physical exercise they used to do and tendency to sleep in the afternoon and hours of sleep in the night had non-significant relationship with BMI.Conclusions: Obesity and overweight is found to be a growing public health problem and can be preventable. Interventional measures include developing healthy eating habits, regular moderate physical exercise, sleeping habits, health camps for screening of overweight and obesity.


2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Marian Evans ◽  
Breanna De Leon ◽  
Reaghan Bathrick ◽  
Annie Ricupero

Background: Unintended pregnancy continues to be a public health concern across the nation. National data demonstrates the highest rates of unintended pregnancy occurs in women who are 18 to 24 years old. Providing practical and meaningful health education about contraception has the potential to reduce unintended pregnancy and improve quality of life for young adults. This paper describes the design and methodology for a comprehensive contraceptive education intervention at a public university. Methods: Convenience sampling was used with a custom survey conducted in Women’s Health classes from 2015-2021. Surveys contained questions about demographic characteristics, knowledge of contraception options, sources of knowledge, stress levels, and confidence in knowledge. Students completed a pretest, received a comprehensive contraception health education lecture, and completed a post-test. Data collection was approved by the university’s IRB, and analyses were conducted using SPSS Version 27. Conclusion: At a time when reproductive freedom, choice, and justice is scrutinized and suppressed, it is imperative that young adults maintain and understand the importance of having control over when, where, and how they decide to have children if they desire to do so. There is a need for continued comprehensive health education and appropriate resources at the university level. The use of assessments, building trusted professor-student relationships, and exploring credible and reliable information sources can be used to reduce the number of unintended pregnancies for college-aged students. If significant, the replication of the design and methods could have a significant impact on the public health problem of unintended pregnancies, maternal health equity, and reproductive justice.


2014 ◽  
Vol 34 (1) ◽  
pp. 39-47 ◽  
Author(s):  
N Mondal

Background: Undernutrition is a major public health concern in many of the developing countries of Asia. Due to immense population size, socioeconomic disparities, illiteracy and inadequate access to health facilities prevalence is very high in India. The objective of this study was to determine the prevalence of age-sex specific thinness (low BMI-for-age) among adolescents residing in rural regions in India. Materials and Methods: This cross-sectional study has conducted among 1165 adolescent (602 boys; 563 girls) aged 10-18 years of Darjeeling district, West Bengal, India. Anthropometric measurements were height and weight obtained and BMI (weight/height2, kg/ m2) was calculated. The prevalence of thinness was assessed using newly proposed age-sex specific cut-offs of Cole et al. The data were analyzed using chi-square, ANOVA and Least Mean and Square (L,M and S) model approach. Results: Prevalence of overall thinness is 49.10% (51.16% boys, 46.89% girls) among rural adolescents. The boys are found to be more sufferer than girls in the different thinness grades include mild (grade I; 27.41% vs. 27.11%), moderate (grade II; 14.62% vs. 12.08%) and severe (grade III; 9.14% vs. 8.70%) (p>0.05). The age and sex specific smooth percentile curves of BMI were derived using L,M and S model approach for further evaluation of nutritional status. Conclusion: The existence of high prevalence of thinness among adolescents indicates nutritional deprivation among rural Indian adolescents. There is an urgent need of appropriate nutritional intervention program to address the public health problem related to undernutrition especially among nutritionally vulnerable segments of adolescents residing in rural regions to ameliorate the nutritional status DOI: http://dx.doi.org/10.3126/jnps.v34i1.8922    J Nepal Paediatr Soc 2014;34(1):39-47


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Birhanu Ayelign ◽  
Markos Negash ◽  
Meaza Genetu ◽  
Tadelo Wondmagegn ◽  
Tewodros Shibabaw

The interaction between diabetes and major world infections like TB is a major public health concern because of rapidly rising levels of diabetes. The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health problem. Diabetes mellitus is a major risk factor for the development of active and latent tuberculosis. Immune mechanisms contributing to the increased susceptibility of diabetic patients to TB are due to the defects in bacterial recognition, phagocytic activity, and cellular activation which results in impaired production of chemokines and cytokines. The initiation of adaptive immunity is delayed by impaired antigen-presenting cell (APC) recruitment and function in hyperglycemic host, which results in reduced frequencies of Th1, Th2, and Th17 cells and its secretion of cytokines having a great role in activation of macrophage and inflammatory response of tuberculosis. In addition, impaired immune response and killing of intracellular bacteria potentially increase bacterial load, chronic inflammation, and central necrosis that facilitate bacterial dissemination and miliary tuberculosis. Understanding of the immunological and biochemical basis of TB susceptibility in diabetic patients will tell us the rational development of implementation and therapeutic strategies to alleviate the dual burden of the diseases. Therefore, the aim of this review was focused on the association between diabetes and tuberculosis, focusing on epidemiology, pathogenesis, and immune dysfunction in diabetes mellitus, and its association with susceptibility, severity, and treatment outcome failure to tuberculosis.


2014 ◽  
Vol 6 (1) ◽  
pp. e2014070 ◽  
Author(s):  
Giorgia Sulis ◽  
Alberto Roggi ◽  
Alberto Matteelli ◽  
Mario C. Raviglione

Tuberculosis (TB) is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012. TB is by all means a poverty-related disease, mainly affecting the most vulnerable populations in the poorest countries. The presence of multidrug-resistant strains of M. tuberculosis in most countries, with some where prevalence is high, is among the major challenges for TB control, which may hinder recent achievements especially in some settings. Early TB case detection especially in resource-constrained settings and in marginalized groups remains a challenge, and about 3 million people are estimated to remain undiagnosed or not notified and untreated. The World Health Organization (WHO) has recently launched the new global TB strategy for the “post-2015 era” aimed at “ending the global TB epidemic” by 2035, based on the three pillars that emphasize patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation.This paper aims to provide an overview of the global TB epidemiology as well as of the main challenges that must be faced to eliminate the disease as a public health problem everywhere.


Author(s):  
Bugwesa Z. Katale ◽  
Erasto V. Mbugi ◽  
Sharon Kendal ◽  
Robert D. Fyumagwa ◽  
Gibson S. Kibiki ◽  
...  

Despite the apparent public health concern about Bovine tuberculosis (BTB) in Tanzania, little has been done regarding the zoonotic importance of the disease and raising awareness of the community to prevent the disease. Bovine tuberculosis is a potential zoonotic disease that can infect a variety of hosts, including humans. The presence of multiple hosts including wild animals, inefficient diagnostic techniques, absence of defined national controls and eradication programs could impede the control of bovine TB. In Tanzania, the diagnosis of Mycobacterium bovis in animals is mostly carried out by tuberculin skin testing, meat inspection in abattoirs and only rarely using bacteriological techniques. The estimated prevalence of BTB in animals in Tanzania varies and ranges across regions from 0.2% to 13.3%, which is likely to be an underestimate if not confirmed by bacteriology or molecular techniques. Mycobacterium bovis has been detected and isolated from different animal species and has been recovered in 10% of apparently healthy wildebeest that did not show lesions at post-mortem. The transmission of the disease from animals to humans can occur directly through the aerosol route and indirectly by consumption of raw milk. This poses an emerging disease threat in the current era of HIV confection in Tanzania and elsewhere. Mycobacterium bovis is one of the causative agents of human extra pulmonary tuberculosis. In Tanzania there was a significant increase (116.6%) of extrapulmonary cases reported between 1995 and 2009, suggesting the possibility of widespread M. bovis and Mycobacterium tuberculosis infection due to general rise of Human Immunodeficiency virus (HIV). This paper aims to review the potential health and economic impact of bovine tuberculosis and challenges to its control in order to safeguard human and animal population in Tanzania.


2018 ◽  
Vol 54 (02) ◽  
pp. 090-095
Author(s):  
Anjana Singh ◽  
Ved Prakash ◽  
Ravi Kant

ABSTRACT Introduction: Multi drug resistant-TB (MDR-TB) threatens global TB control and is a major public health concern in several countries. The present study was undertaken to detect the epidemiological correlates and treatment outcomes among patients with MDR-TB previously or currently admitted in Department of Respiratory Medicine and Pulmonary and Critical Medicine, KGMU, Lucknow. Material & Methods: This retrospective study included 2370 TB patients admitted in the Department of Respiratory Medicine and Pulmonary and Critical Medicine, KGMU, Lucknow between years 2012 to 2015. Treatment outcomes were observed. SPSS software was used for data analysis. Results: The total number of MDR-TB cases enrolled were 2370. There were 772 (32.6%) males (95% CI: 30.7 % -34.5%) and 1598 (67.4%) females (95% CI: 65.5% -69.3%) registered for MDR-TB treatment. The treatment outcomes were as follows: majority (77.1%) were under treatment, 279 (11.8%) patients were declared cured, 10 (0.4%) were failure cases, while 64 (2.7%) were defaulters, 149 (6.3%) had died and 41(1.7%) were transferred out. Conclusion: Emergence of MDR-TB has the potential to be a serious public health problem in Northern India and this necessitates strengthening of TB control and improved continuous monitoring of therapy.


2021 ◽  
Vol 12 ◽  
Author(s):  
Md. Zeyaullah ◽  
Abdullah M. AlShahrani ◽  
Khursheed Muzammil ◽  
Irfan Ahmad ◽  
Shane Alam ◽  
...  

The ongoing coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China, was triggered and unfolded quickly throughout the globe by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The new virus, transmitted primarily through inhalation or contact with infected droplets, seems very contagious and pathogenic, with an incubation period varying from 2 to 14 days. The epidemic is an ongoing public health problem that challenges the present global health system. A worldwide social and economic stress has been observed. The transitional source of origin and its transport to humans is unknown, but speedy human transportation has been accepted extensively. The typical clinical symptoms of COVID-19 are almost like colds. With case fatality rates varying from 2 to 3 percent, a small number of patients may experience serious health problems or even die. To date, there is a limited number of antiviral agents or vaccines for the treatment of COVID-19. The occurrence and pathogenicity of COVID-19 infection are outlined and comparatively analyzed, given the outbreak’s urgency. The recent developments in diagnostics, treatment, and marketed vaccine are discussed to deal with this viral outbreak. Now the scientist is concerned about the appearance of several variants over the globe and the efficacy of the vaccine against these variants. There is a need for consistent monitoring of the virus epidemiology and surveillance of the ongoing variant and related disease severity.


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