Mathematical Analysis of Malaria-Schistosomiasis Coinfection Model

We formulated and analysed a mathematical model to explore the cointeraction between malaria and schistosomiasis. Qualitative and comprehensive mathematical techniques have been applied to analyse the model. The local stability of the disease-free and endemic equilibrium was analysed, respectively. However, the main theorem shows that if RMS<1, then the disease-free equilibrium is locally asymptotically stable and the phase will vanish out of the host and if RMS>1, a unique endemic equilibrium is also locally asymptotically stable and the disease persists at the endemic steady state. The impact of schistosomiasis and its treatment on malaria dynamics is also investigated. Numerical simulations using a set of reasonable parameter values show that the two epidemics coexist whenever their reproduction numbers exceed unity. Further, results of the full malaria-schistosomiasis model also suggest that an increase in the number of individuals infected with schistosomiasis in the presence of treatment results in a decrease in malaria cases. Sensitivity analysis was further carried out to investigate the influence of the model parameters on the transmission and spread of malaria-schistosomiasis coinfection. Numerical simulations were carried out to confirm our theoretical findings.

Vernal Keratoconjunctivitis in Public Primary School Children in Nigeria: Prevalence and Nomenclature

Objective. This study sought to add to the body of information on the prevalence and pattern of vernal keratoconjunctivitis (VKC) among school aged children in Cross River State, Nigeria. Method. A cross-sectional survey of children in public primary schools in Cross River State, Nigeria, was studied for VKC. Five schools were included, using a multistage sampling technique. Comprehensive eye examinations were conducted in one thousand two hundred and twenty-six (1226) school children. Main Outcome Measures/Results. The mean age of the population of 1226 school attending children was 9.62±2.324. The prevalence of VKC was 18.1% in this population study. The ratio of males to females is 1.8 : 1. The clinical grading of the 223 children with VKC is as follows: 43 (19.3%) quiescent, 134 (60.1%) mild, 44 (19.7%) moderate, and 2 (0.9%) severe VKC. The clinical types reported are as follows: limbal 67 (30.0%), tarsal 105 (47.1%), and mixed 51 (22.9%). The clinical types were used to describe a modified nomenclature. Conclusions. Vernal keratoconjunctivitis is a commonly occurring chronic condition and an important public health problem. A simple diagnostic nomenclature for describing VKC for primary health care workers is recommended.

WHO European Childhood Obesity Surveillance Initiative: Impact of Type of Clothing Worn during Anthropometric Measurements and Timing of the Survey on Weight and Body Mass Index Outcome Measures in 6–9-Year-Old Children

Background. The World Health Organization European Childhood Obesity Surveillance Initiative (COSI) conducted examinations in 6–9-year-old children from 16 countries in the first two rounds of data collection. Allowing participating countries to adhere to their local legal requirements or adapt to other circumstances required developing a flexible protocol for anthropometric procedures. Objectives. (1) Review intercountry variation in types of clothing worn by children during weight and height measurements, clothes weight adjustments applied, timing of the survey, and duration of data collection; (2) assess the impact of the observed variation in these practices on the children’s weight or body mass index (BMI) outcome measures. Results. The relative difference between countries’ unadjusted and clothes-adjusted prevalence estimates for overweight was 0.3–11.5%; this figure was 1.4–33.3% for BMI-for-age Z-score values. Monthly fluctuations in mean BMI-for-age Z-score values did not show a systematic seasonal effect. The majority of the monthly BMI-for-age Z-score values did not differ statistically within a country; only 1–3 monthly values were statistically different within some countries. Conclusions. The findings of the present study suggest that the built-in flexibility in the COSI protocol concerning the data collection practices addressed in the paper can be kept and thus do not necessitate a revision of the COSI protocol.

Association of Breastfeeding and the Federal Poverty Level: National Survey of Family Growth, 2011–2013

Breastfeeding is strongly endorsed in the Healthy People 2020 goals; however, there remain many disparities in breastfeeding prevalence. The purpose of this study was to examine the association between breastfeeding and the Federal Poverty Level in the United States. Data from 5,397 women in the National Survey of Family Growth 2011–2013 survey were included in this study. The data were analyzed for descriptive features and logistic regressions of the Federal Poverty Level on breastfeeding. There were 64.1% of women who reported breastfeeding. Over one-third (35.2%) of women reported having a household income of 0–99% of the Federal Poverty Level. There were 15.2% of women who reported an income of 400% and above the Federal Poverty Level. With statistical adjustment for maternal age, race/ethnicity, education, marital status, parity, preterm birth, birth weight, insurance, and dwelling, the Federal Poverty Level was not significantly associated with breastfeeding. In this recent survey of mothers, Federal Poverty Level was not shown to be a significant factor in breastfeeding.

Hip Fracture-Related Mortality among Older Adults in the United States: Analysis of the CDC WONDER Multiple Cause of Death Data, 1999–2013

Objectives. To examine trends in hip fracture-related mortality among older adults in the United States between 1999 and 2013. Material and Methods. The Wide-Ranging Online Data for Epidemiological Research system was used to identify adults aged 65 years and older with a diagnosis of hip fracture reported in their multiple cause of death record. Joinpoint regression analyses were performed to estimate the average annual percent change in hip fracture-related mortality rates by selected characteristics. Results. A total of 204,254 older decedents listed a diagnosis of hip fracture on their death record. After age adjustment, hip fracture mortality rates decreased by −2.3% (95% CI, −2.7%, and −1.8%) in men and −1.5% (95% CI, −1.9%, and −1.1%) in women. Similarly, the proportion of in-hospital hip fracture deaths decreased annually by −2.1% (95% CI, −2.6%, and −1.5%). Of relevance, the proportion of cardiovascular diseases reported as the underlying cause of death decreased on average by −4.8% (95% CI, −5.5%, and −4.1%). Conclusions. Hip fracture-related mortality decreased among older adults in the United States. Downward trends in hip fracture-related mortality were predominantly attributed to decreased deaths among men and during hospitalization. Moreover, improvements in survival of hip fracture patients with greater number of comorbidities may have accounted for the present findings.

High Tuberculosis Disease Burden among Indigenous People of the Paraguayan Chaco and Associated Community Characteristics, 2002–2004: An Ecological Study

Indigenous populations are generally reported to suffer greater active tuberculosis (TB) disease burden. The objective of this study was to examine ecological associations between cases of active adult and pediatric TB reported from 2002 to 2004 and community characteristics in indigenous communities of the Paraguayan Chaco. Adult and pediatric models were examined by negative binomial and Poisson GLM regression, respectively. Active TB prevalence in indigenous people was eight times higher than the nonindigenous population. Communities with a health post were more than twice as likely to report active adult TB (RR = 2.07, 95% confidence interval (CI) [1.14–3.83], and p<0.05). Each additional average year of education in the community was associated with nearly 50% less likelihood of active pediatric TB (RR = 0.53, 95% CI [0.38–0.73], and p<0.001). Although nonsignificant, the presence of nonindigenous community members had a strong protective association in both the adult (RR = 0.56, 95% CI [0.30–1.03], and p=0.06) and pediatric models (RR = 0.64, 95% CI [0.34–1.14], and p=0.14). These results reinforce the importance of increasing epidemiologic surveillance and investigating the social determinants of TB disease among vulnerable indigenous populations.

Workplace Violence: A Survey of Nationally Registered Emergency Medical Services Professionals

Previous studies on violence against prehospital personnel have mainly reported on “verbal” and “physical” violence. This study explored how provider demographic and work-related characteristics were associated with five different forms of workplace violence (being cursed or threatened; being punched, slapped, or scratched; being spat upon; being stabbed/stabbing attempt; and being shot/shooting attempt). A cohort of nationally registered United States Emergency Medical Services professionals was surveyed to determine the experience of each of these types of patient initiated violence by these providers and their partners. Multivariable logistic regression analyses indicated gender was significantly associated with both being cursed/threatened and being stabbed or experiencing a stabbing attempt (odds ratio (OR) = 0.65, CI = 0.44–0.96; OR = 0.27, CI = 0.09–0.75, resp.). Level of EMT practice was significantly associated with being cursed/threatened, being spat upon, and being punched, slapped, or scratched (OR = 0.17, CI = 0.11–0.27; OR = 0.30, CI = 0.21–0.43; OR = 0.31, CI = 0.22–0.44, resp.). Both community size and experience were significantly associated with all the types of violence investigated. EMS workplace violence research is at its infancy; thus this study adds to a limited but growing body of knowledge.

Risk Factors for Infection with Soil Transmitted Helminths, Cryptosporidium spp., and Giardia duodenalis in Children Enrolled in Preschools in Kafue District, Zambia

Intestinal parasitic infections are common among children worldwide. This study was aimed at determining risk factors for infection with soil transmitted helminths, Cryptosporidium spp., and Giardia duodenalis, among children in preschools. The study was in two parts: a cross-sectional study in which data were collected from 403 children from 10 preschools and a longitudinal study in which 100 children from four preschools from the previous 10 were selected. Prevalence of Ascaris lumbricoides was 12.0%, while that of hookworm was 8.3%. Overall prevalence of Cryptosporidium and G. duodenalis was 28.0% and 29.0%, respectively. Low education level of parent/guardian was a significant risk factor for A. lumbricoides (OR = 2.35, 95% CI: 1.02–5.41; P=0.04), while roofing types other than corrugated iron sheets were found to be protective for G. duodenalis infection in both bivariate and multivariate analyses (multivariate: OR = 0.67, 95% CI: 0.45–0.99; P=0.04). Low socioeconomic level was found to be protective for Cryptosporidium spp. infection in multivariate analysis (OR = 0.59, 95% CI: 0.35–0.99; P=0.04). In the longitudinal study, none of the factors were associated with either infection. These findings may have implications for other preschools in other districts in Zambia.

The Time of the Insult/Triggering Event in Primary Osteosarcoma and Ewing’s Sarcoma of Bone as Determined by Incubation Period Modeling and Age Distribution of Such Malignancies

The time for the triggering event in neoplasms can be estimated using incubation period modeling techniques. We applied these techniques to primary osteosarcoma and Ewing’s sarcoma of bone using the Surveillance Epidemiology and End Results database for all cases of osteosarcoma or Ewing’s sarcoma of bone from 1993 through 2010. Secondary neoplasms were excluded. The age at diagnosis, gender, ethnicity, and anatomic location were collected. The time (xt) of the insult/triggering event was calculated using the best fit frequency distribution of age at diagnosis. There were 4,356 patients with osteosarcoma and 1,832 patients with Ewing’s sarcoma. The Pearson IV distribution was the best fit for both osteosarcoma (r2=0.987) and Ewing’s sarcoma (r2=0.99). For these distributions xt is −0.7 years of age (4 weeks after conception) for Ewing’s sarcoma, 0.45 years for long bone osteosarcoma, and 10.4 years for parosteal osteosarcoma. This confirms the genetic etiology of Ewing’s sarcoma since an xt is 4 weeks after conception. Long bone osteosarcoma is not entirely genetic, as xt was 0.4 years for conventional osteosarcoma and 10.4 years for parosteal osteosarcoma. The etiologies for those two different types of osteosarcoma are thus different.

Distribution of Human Leishmaniasis (VL) and Its Associated Risk Factors, in Metemma, Ethiopia

Background. Leishmaniasis is a parasitic disease caused by obligate intracellular protozoans of the genus Leishmania. Objective. To assess the distribution of human leishmaniasis and assess community knowledge, attitude, and practice with regard to assumed risk factors and control options used by the society. Methods. Retrospective study from November 2013 to May 2014 was used. Six-year data from Metemma hospital record was reviewed and 89 people were interviewed. Results. The rates were 29% (n = 374/1270) and 26% (n = 328/1270) in 2005 E.C and 2003 E.C, respectively. 94% (1194/1270) of the affected individuals were in the age exceeding 15 years. At the same time, the rates in males and female were 97% (n = 1226/1270) and 3% (n = 44/1270), respectively. According to 88.8% (n = 79/89) of the respondents, transmission occurs through bite of sandflies, while 98.9% (n = 88/89) of the respondent’s indicated that waste disposal in an open space was one of the risk factors for disease occurrence. Regarding the control measures, respondents replied that 73% (n = 65/89) of them use impregnated bed net and others use cleaning and proper waste disposal. Conclusion. The current finding indicated that the disease was common in the study area; as a result, proper use of impregnated bed net, early diagnosis and treatment, and reduction of different risk factors were essential.