Identifying Vulnerable Populations in Subtropical Brisbane, Australia: A Guide for Heatwave Preparedness and Health Promotion

Building healthy societies is a key step towards climate resilient communities. Ill health is related to increased risk during heat events and is disproportionally distributed within and between communities. To understand the differences in the spatial distribution of climate related health risks and how this will change in the future we have undertaken a spatiotemporal analysis of heatwave risks in urban populations in Brisbane, Australia. The aim of this was to advise emergency managers and public health authorities of high-risk areas during extreme heat events (EHEs). The spatial distribution of heat related morbidity identified areas of high healthcare service demand during EHEs. An index of risk was developed based on social and environmental determinants of vulnerability. Regression analysis was used to determine the key drivers of heat related morbidity from the index. A weighted map of population vulnerability was produced which identified the high risk areas and provided key information to target public health interventions and heat stress prevention policy. The predicted changes in high risk populations such as the proportion of elderly people living in urban areas were also mapped to support longer term adaptation and develop health care infrastructure and health promotion strategies.

Vaginal Delivery and Maternal Knowledge on Correct Breastfeeding Initiation Time as Predictors of Early Breastfeeding Initiation: Lesson from a Community-Based Cross-Sectional Study

Background. Early initiation of breastfeeding is a recommended practice by the World Health Organization (WHO), but in Ethiopia only 52% of the mothers practiced early initiation of breastfeeding. Hence, this study aimed to assess prevalence of early initiation of breastfeeding and the associated factors among mothers in Bahir Dar City, northwest Ethiopia. Methods. A community-based cross-sectional study was conducted among mothers who delivered 12 months before the study began in Bahir Dar City, northwest Ethiopia. A cluster sampling technique was used to select a sample of 819 participants. Bivariate and multivariate analyses were performed. Results. In this study, the prevalence of early initiation was found to be 87.0%. On multivariate logistic regression, delivering vaginally (AOR = 7.37, 95% CI = 4.24, 13.82) and being knowledgeable on correct initiation time (AOR = 6.08, 95% CI = 3.71, 9.95) were found to be independent predictors of early initiation. Conclusions. Prevalence of early initiation of breastfeeding in Bahir Dar city is relatively good but still lower than the national plan. Delivering vaginally and being knowledgeable on correct initiation time were significantly associated with early initiation. Increasing maternal knowledge on correct initiation and providing adequate pain relief and early assistance for mothers who gave birth by C/S were recommended.

Newcastle Disease in Local Chickens of Live Bird Markets and Households in Zamfara State, Nigeria

Newcastle disease constitutes a major constraint to rural poultry production system in Nigeria. This study used serological method to estimate the level of circulating antibodies against ND in nonvaccinated village chickens, raised under traditional management system in Zamfara State, Nigeria. Competitive Enzyme Linked Immunosorbent Assay was used to analyze 504 chicken sera for Newcastle disease virus antibodies from randomly selected households and live bird markets. Higher seroprevalence rate of Newcastle disease virus antibodies was detected in both household and live bird markets. Overall, seropositive rate was found to be 32.5% (164/504). About 35.8% (115/321) sero-positive rate was obtained from live bird markets while 26.8% (49/183) seropositive rate was found in households. Comparison was made between the sero prevalence of house hold and live bird markets as well as between sexes. Live bird markets show a statistically significant higher prevalence rate (P<0.05) when compared with chickens sampled from households (OR 1.53; 95% CI, 1.024–2.275). The prevalence of ND indicated the presence of the virus amongst the population, and hence there should be an improvement in the vaccine campaign against ND for rural poultry especially the use of thermostable vaccine to reduce the chances of vaccine failure.

Grade 2 and 3 Obesity and Diagnosed Prostate Cancer in Middle-Aged and Elderly Men: An Epidemiologic Study with Stratified Multistage Sampling Design

Background. The association of obesity with the odds of diagnosed prostate cancer (DPC) is inconclusive. Whether grade 2 or grade 3 obesity is associated with increased odds of DPC has not been investigated. Design and Methods. Cross-sectional data of 7,974 subjects aged ≥40 years were collected from the National Health and Nutrition Examination Survey 2001–2010. Odds ratios (ORs) of DPC associated with grade 2 or grade 3 obesity were estimated by conducting weighted logistic regression models. Results. The unadjusted rates of DPC did not differ significantly over grades of BMI (P=0.7044). After adjustment for different groups of potential confounding factors, grade 2 or grade 3 obesity was not significantly associated with the odds of DPC with ORs changing from 0.62 to 0.69 for grade 2 obesity and from 0.81 to 1.09 for grade 3 obesity. Moreover, morbid obesity (grade 2 and 3 obesity combined) was not linked to the odds of DPC. Conclusion. Grade 2 or grade 3 obesity was not associated with the odds of DPC. Whether they are associated with a substantially increased risk of high-grade DPC needs to be further investigated as accumulating evidence has shown that obesity increases the risk of high-grade disease.

Nonlinear Analysis of Guillain Barré Time Series to Elucidate Its Epidemiology

The etiology of Guillain Barré Syndrome (GBS) is not fully clarified, and there is a lack of agreement concerning its putative epidemic character. The low incidence rate of this disease is a disadvantage for employing the traditional statistical methods used in the analysis of epidemics. The objective of this paper is to clarify the GBS epidemic behavior applying a nonlinear time series identification approach. The authors obtained one time series of GBS and nine series of classical infectious epidemics (5 national and 4 international). These data were processed with advanced techniques of statistical time series analysis. This paper shows that GBS behaves similar to the other time series of classical epidemic studied. It corresponds to a nonlinear dynamics, with a point attractor. The spectral analysis pointed to an annual periodicity, and preference for the warmest month of the year was found. These results might suggest that Guillain Barré Syndrome has an epidemic behavior. The adequacy of nonlinear methods for analyzing the dynamics of epidemics, particularly those with low incidence rate, such as GBS was revealed.

Some Epidemiologic Aspects of Common Warts in Rural Primary School Children

Cutaneous warts are common in children worldwide, although the prevalence figures are conflicting. There are few publications on that issue, particularly in rural Egypt. The present cross-sectional study aimed to assess the prevalence of warts of hands in rural primary school children and to examine some risk factors associated with warts in these children. The study examined 1833 children from 15 rural primary schools in Dakahlia governorate, Egypt, for the presence of warts. Data about sociodemographic, lifestyle, and environmental factors were collected. Prevalence of warts was estimated. Appropriate statistical analyses including multivariate logistic regression were done. The prevalence of warts of hands in the studied children was 2.3% (1.3–3.3%) with no significant sex difference. The risk of warts increased significantly in children reported swimming in Nile channels (adjusted odds ratio (OR) = 5.6; 95% confidence interval (CI) = 2.9–10.6) and child labor (adjusted OR = 4.5; 95% CI = 2.3–8.8). A ninety percent risk reduction was observed in children with educated parents. The study findings demonstrated a significant increase in the risk of warts among rural children reported swimming in Nile channels and child labor. Parents’ education, on the other hand, was found to play an important role in risk reduction.

Developing a Weibull Model Extension to Estimate Cancer Latency

The mathematical model discussed in this paper presents a technique to estimate the length of the cancer’s silent growth period. The methodology described utilizes information obtained from observed cancer incidence to reconstruct what is cautiously believed to be the period of time from malignant cancer initiation to diagnosis. Analyses show a decreasing hazard for cancer indicating that the longer a patient survives, the more likely they are to reach the upper limit of their natural lifespan. Based on previous research, the Weibull distribution has been used to describe the mechanisms of cancer development. In contrast to the memoryless exponential distribution which assumes a constant failure rate, the shape of the Weibull distribution is dependent on past events and preserves a memory of prior survival. This provides a simple but powerful way to characterize how the unobserved experience of cancer relates to the observed as a function to estimate the time between onset and diagnosis. The results indicate a window of opportunity for early intervention when cancer is most treatable. The method presented provides useful information to identify cancers with high mortality and prolonged periods of undetected growth to distinguish types of dire public health concern.

Risk Factors for Fracture in Diabetes: The Canadian Multicentre Osteoporosis Study

Objective. Individuals with diabetes have been found to be at increased risk of nontraumatic fracture. However, within the diabetic population, how to distinguish who is at the highest risk and warranting therapy has remained elusive. Design. Cross-sectional analysis of a national population-based cohort study. Patients. Men and women over the age of 50 with diabetes from across Canada. Measurements. Logistic regression analysis to identify diabetes specific factors associated with a history of one or more non-traumatic fractures. Results. Six hundred and six individuals with diabetes with a mean age of 69 years were examined. Thirty percent had a history of non-traumatic fracture. Macrovascular diseases in the form of stroke or TIA, as well as hypertension, were found to be independently associated with fragility fracture. Other, more traditional, clinical risk factors were also associated with fracture, including increased age, female gender, rheumatoid arthritis, family history of osteoporosis, and decreased bone mineral density. Conclusions. In this cohort of Canadians with diabetes, those with rheumatoid arthritis, a family history of osteoporosis, female gender, increased age, decreased BMD, cerebrovascular disease, or hypertension were more likely to have had a non-traumatic fracture. These risk factors may be important to clinicians when identifying which of their diabetic patients are at highest risk of fracture and in need of preventative therapies.

Disease Control in Age Structure Population

We combine the Leslie model and its derivatives with the classical compartmental SIRS models to build a model of transmission of infected diseases, in a population of hosts, whether opened or closed systems. We calculate the basic reproductive rate R0. Under certain conditions, when R0<1, there is a disease-free equilibrium that is locally asymptotically stable. In contrast, when R0>1, this equilibrium is unstable. Then, through an example, we show how we can define public health strategies to tackle an endemic. Finally we carry a global sensitivity analysis based on this basic reproduction rate to exhibit the most influential parameters of our model that are applied to influenza.

The Epidemiological Implications of Deer Fly Nuisance Biting and Transmission of Loiasis in an Endemic Area in Southeastern Nigeria

This work was aimed at determining the epidemiological implications of deer fly biting in Southeastern Nigeria and ascertaining the circadian and monthly biting pattern and the transmission potential of Chrysops in the area. Human-landing catches were carried out for 52 weeks by a catching team of four. A total of 930 female Chrysops sp. was caught; biting peaked during the months of June through August. The highest monthly biting rate (MBR) was 353 bites per person per month in July 2006. The annual biting rate (ABR) was 3,317 bites per person per year. The overall infective rate was 3.8%. A total of 314 L3s was recorded with a mean of 9.8 L3s per infective Chrysops. The highest monthly transmission potential (MTP) was 389 infective bites per month observed in July 2006. The annual transmission potential (ATP) was 1,265 infective bites per person per year. Parous rate was 29.3% and was higher during dry months of October through February. The circadian biting activities showed two peaks: between 07:00 and 10:00 hours and between 15:00 and 17:00 hours. The epidemiological implications of deer fly biting in the area are multifaceted. Resources must not be spared in bringing an end to their menace.