Geospatial modeling of pre-intervention prevalence of Onchocerca volvulus infection in Ethiopia as an aid to onchocerciasis elimination

Background Onchocerciasis is a neglected tropical and filarial disease transmitted by the bites of blackflies, causing blindness and severe skin lesions. The change in focus for onchocerciasis management from control to elimination requires thorough mapping of pre-control endemicity to identify areas requiring interventions and to monitor progress. Onchocerca volvulus infection prevalence in sub-Saharan Africa is spatially continuous and heterogeneous, and highly endemic areas may contribute to transmission in areas of low endemicity or vice-versa. Ethiopia is one such onchocerciasis-endemic country with heterogeneous O. volvulus infection prevalence, and many districts are still unmapped despite their potential for O. volvulus infection transmission. Methodology/Principle findings A Bayesian geostatistical model was fitted for retrospective pre-intervention nodule prevalence data collected from 916 unique sites and 35,077 people across Ethiopia. We used multiple environmental, socio-demographic, and climate variables to estimate the pre-intervention prevalence of O. volvulus infection across Ethiopia and to explore their relationship with prevalence. Prevalence was high in southern and northwestern Ethiopia and low in Ethiopia's central and eastern parts. Distance to the nearest river (-0.015, 95% BCI: -0.025 - -0.005), precipitation seasonality (-0.017, 95% BCI: -0.032 - -0.001), and flow accumulation (-0.042, 95% BCI: -0.07 - -0.019) were negatively associated with O. volvulus infection prevalence, while soil moisture (0.0216, 95% BCI: 0.014 - 0.03) was positively associated. Conclusions/Significance Infection distribution was correlated with habitat suitability for vector breeding and associated biting behavior. The modeled pre-intervention prevalence can be used as a guide for determining priority for intervention in regions of Ethiopia that are currently unmapped, most of which have comparatively low infection prevalence.

Comorbid disease burden among MS patients 1968–2012: A Swedish register–based cohort study

Background: People with multiple sclerosis (pwMS) have increased comorbid disease (CMD) risk. Most previous studies have not considered overall CMD burden. Objective: To describe lifetime CMD burden among pwMS. Methods: PwMS identified using Swedish registers between 1968 and 2012 ( n = 25,476) were matched by sex, age, and county of residence with general-population comparators ( n = 251,170). Prevalence, prevalence ratios (PRs), survival functions, and hazard ratios by MS status, age, and time period compared seven CMD: autoimmune, cardiovascular, depression, diabetes, respiratory, renal, and seizures. Results: The magnitude of the PRs for each CMD and age group decreased across time, with higher PRs in earlier time periods. Before 1990, younger age groups had higher PRs, and after 1990, older age groups had higher PRs. Male pwMS had higher burden compared with females. Overall, renal, respiratory, and seizures had the highest PRs. Before 2001, 50% of pwMS received a first/additional CMD diagnosis 20 years prior to people without MS, which reduced to 4 years after 2001. PwMS had four times higher rates of first/additional diagnoses in earlier time periods, which reduced to less than two times higher in recent time periods compared to people without MS. Conclusion: Swedish pwMS have increased CMD burden compared with the general population, but this has reduced over time.

POLA KONSUMSI DAN GAYA HIDUP KAITANNYA DENGAN KEJADIAN PENYAKIT KARDIOVASKULER DI INDONESIA

ABSTRACT Cardiovascular disease is the number one cause of death in the world and in Indonesia. Many factors can trigger cardiovascular disease. One of the main causes of cardiovascular disease is an unhealthy lifestyle. This analysis aims to identify lifestyle (food consumption patterns, smoking, and physical activity) in relation to the prevalence of cardiovascular disease in each province in Indonesia. The research design in this analysis is an ecological study with a provincial analysis unit. The study sample in this analysis was a sample of households and adult individuals over the age of 15 that included in the Individual Food Consumption Survey (SKMI) 2014 and Basic Health Research (Riskesdas) 2013. Source of the data was the SKMI 2014 food consumption data and individual data of the Riskesdas 2013 to obtain 21.283 samples. After verification, editing, and cleaning, 20.183 samples were obtained. The prevalence of cardiovascular disease, namely heart and strok, was grouped into provinces with high prevalence (prevalence above national average) and low prevalence (prevalence below the national average). Data were analyzed to determine the frequency distribution of each variable and to determine the difference between lifestyle variables on the prevalence of the cardiovascular disease. The results of these analysis showed there was no association between smoking habits, physical activity and consumption of macro nutrients, fiber and sodium in cardiovascular disease in provinces with low or high prevalence. Recommendations for looking the relationship between smoking habits, physical activity, and consumption habits with non-communicable diseases preferably in cohort study. Keywords: cardiovascular, consumption patterns, lifestyle ABSTRAK Penyakit kardiovaskuler menjadi penyebab kematian nomor satu di dunia dan di Indonesia. Banyak faktor yang dapat memicu terjadinya penyakit kardiovaskuler. Salah satu penyebab utama penyakit kardiovaskuler ialah gaya hidup yang tidak sehat (kebiasaan merokok, diet yang tidak sehat, dan kurangnya aktivitas fisik). Analisis ini bertujuan untuk mengidentifikasi gaya hidup (pola konsumsi, merokok, dan aktivitas fisik) kaitannya dengan prevalensi penyakit kardiovaskuler pada tingkat provinsi di Indonesia. Disain penelitian dalam analisis ini adalah studi ekologi dengan unit analisis propinsi. Sampel penelitian adalah sampel rumah tangga dan individu dewasa usia lebih dari 15 tahun yang termasuk ke dalam sampel Survei Konsumsi Makanan Individu (SKMI) 2014 dan Riset Kesehatan Dasar (Riskesdas) 2013. Data yang digunakan ialah data konsumsi SKMI 2014 dan data individu Riskesdas 2013 sehingga diperoleh sampel sebanyak 21.283. Setelah dilakukan verifikasi, editing, dan cleaning maka diperoleh 20.183 sampel. Prevalensi penyakit kardiovaskuler, yaitu jantung dan stroke, dikelompokkan menjadi kelompok provinsi dengan prevalensi tinggi (prevalensi di atas rerata nasional) dan prevalensi rendah (prevalensi di bawah rerata nasional). Data dianalisis untuk mengetahui distribusi frekuensi pada setiap variabel dan untuk mengetahui perbedaan antara variabel gaya hidup terhadap kejadian penyakit kardiovaskuler. Hasil analis lanjut menunjukkan tidak ada keterkaitan antara kebiasaan merokok, aktivitas fisik dan konsumsi zat gizi makro, serat dan natrium terhadap kejadian penyakit kardiovaskuler pada tingkat provinsi dengan prevalensi rendah maupun tinggi. Untuk dapat melihat keterkaitan antara kebiasaan merokok, aktivitas fisik, dan kebiasaan konsumsi dengan penyakit tidak menular, maka disarankan data yang diperlukan adalah data dari penelitian yang diikuti seperti kohor. [Penel Gizi Makan 2018, 41(2):113-123] Kata kunci: kardiovaskuler, pola konsumsi, gaya hidup

Epidemiology of Nontuberculous Mycobacteriosis

Annual prevalence estimates for pulmonary nontuberculous mycobacterial (PNTM) disease in the contiguous United States range from 1.4 to 13.9 per 100,000 persons, while one study found an annual prevalence of up to 44 per 100,000 persons in Hawaii. PNTM prevalence varies by region, sex, and race/ethnicity, with higher prevalence among women and persons of Asian ancestry, as well as in the Southern United States and Hawaii. Studies consistently indicate that PNTM prevalence is increasing, with estimates ranging from 2.5 to 8% per year. Most PNTM disease is associated with Mycobacterium avium complex (MAC), although the proportion of disease attributed to MAC varies by region. Host factors identified as influencing disease risk include structural lung disease, immunomodulatory medication, as well as variants in connective tissue, mucociliary clearance, and immune genes. Environmental variables including measures of atmospheric moisture and concentrations of certain soil factors have also been shown to correlate with higher PNTM prevalence. Prevalence of extrapulmonary NTM disease is lower, stable, and associated with different risk factors, including primary immune deficiencies or HIV infection.

Long Term Mental Illness in Canada: An Epidemiological Perspective on Schizophrenia and Affective Disorders

Canadian national data on psychiatric illness are combined with results from outcome studies to derive figures for the incidence, expectancy, prevalence, prevalence of marked disability, use of institutions and loss of the work force as a result of schizophrenia and affective psychoses. It is hoped that this can be of assistance in planning services and that it will stimulate more direct research into the nature and the scope of the social, psychiatric and economic impact of these illnesses.