ABSTRACT
BACKGROUND: Respiratory viral infections (RVI) are a leading cause of mortality worldwide. We compared the epidemiology and severity of RVI in Ecuador during 2009-2016. METHODS: Respiratory specimens collected within the national surveillance system were tested for influenza viruses, respiratory syncytial virus (RSV), adenovirus, parainfluenza virus, and human metapneumovirus. Overall and virus-specific positive detection rate (PDR) were calculated and compared the timing of epidemics caused by the different viruses. Logistic regression models were used to compare the age distribution and risk of death across respiratory viruses. RESULTS: A total of 41,172 specimens were analyzed: influenza (PDR=14.3%) and respiratory syncytial virus (RSV) (PDR=9.5%) were the most frequently detected viruses. Influenza epidemics typically peaked in December-January and RSV epidemics in March; seasonality was less evident for the other viruses. Compared to adults, children were more frequently infected with RSV, adenovirus, parainfluenza, and influenza B, while the elderly were less frequently infected with influenza A(H1N1)p. The age-adjusted risk of death was highest for A(H1N1)p (odds ratio [OR] 1.73, 95% confidence intervals [CI] 1.38-2.17), and lowest for RSV (OR 0.75, 95%CI 0.57-0.98). CONCLUSIONS: Whilst influenza and RSV were the most frequently detected pathogens, the risk of death differed by RVI, being highest for pandemic influenza and lowest for RSV.
Subject(s)
Respiratory Tract Infections/epidemiology , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Ecuador/epidemiology , Female , Humans , Infant , Infant, Newborn , Influenza A Virus, H1N1 Subtype/isolation & purification , Male , Metapneumovirus/isolation & purification , Middle Aged , Population Surveillance , Respiratory Syncytial Virus, Human/isolation & purification , Respiratory Tract Infections/pathology , Respiratory Tract Infections/virology , Retrospective Studies , Risk Factors , Seasons , Severity of Illness Index , Tropical Climate , Young AdultABSTRACT
Current evidence suggests that periodontal infection may aggravate diabetes control. The aim of this study was to determine the changes in the frequency with which Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans were detected in patients with diabetes with the use of non-surgical therapy plus azithromycin in a randomized clinical trial. One hundred and five (105) patients with diabetes and chronic periodontitis were randomly assigned to three treatment groups: subgingival mechanical therapy with azithromycin, subgingival mechanical therapy with placebo and supragingival prophylaxis with azithromycin. Complete periodontal clinical examinations and detection of periodontal pathogens using polymerase chain reaction were carried out at baseline, 3, 6 and 9 months after periodontal therapy. The frequency with which Porphyromonas gingivalis, Treponemadenticola and Aggregatibacter actinomycetemcomitans were detected decreased at 3 months in all groups. Tannerella forsythia increased after3 months in all groups. All organisms had similar frequencies at 9 months in all groups. Subgingival mechanical therapy with adjunctive azithromycin had no additional effect on the frequency with which the periodontal pathogens investigated were detected in patients with diabetes.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Azithromycin/therapeutic use , Chronic Periodontitis/microbiology , Diabetes Complications/microbiology , Gram-Negative Bacteria/isolation & purification , Periodontal Debridement/methods , Adult , Aged , Aggregatibacter actinomycetemcomitans/drug effects , Aggregatibacter actinomycetemcomitans/isolation & purification , Bacterial Load/drug effects , Bacteroides/drug effects , Bacteroides/isolation & purification , Chronic Periodontitis/drug therapy , Chronic Periodontitis/therapy , Combined Modality Therapy , Dental Plaque Index , Dental Scaling/methods , Female , Follow-Up Studies , Gram-Negative Bacteria/drug effects , Humans , Male , Middle Aged , Placebos , Porphyromonas gingivalis/drug effects , Porphyromonas gingivalis/isolation & purification , Treponema denticola/drug effects , Treponema denticola/isolation & purificationABSTRACT
Evidencia actual sugiere que la infección periodontal puede agravar el control de la diabetes. El objetivo de este estudiofue determinar los cambios en la frecuencia de detección de porphyromonas gingivalis, Tannerella forsythia, Treponema denticola y Aggregatibacter actinomycetemcomitans en pacientes con diabetes con el uso de terapia mecánica no quirúrgica mas azitromicina en un estudio clínico controlado aleatorizado.Ciento cinco pacientes (105) con diabetes y perio -dontitis fueron asignados aleatoriamente en tres grupos: terapiamecánica mas azitromicina, terapia mecánica mas placebo y profilaxis supragingival mas azitromicina. Un análisis periodontal completo y detección de patógenos perio dontales por medio de reacción en cadena de la polimerasa (PCR) se realizaron al inicio, 3, 6 y 9 meses después de la terapia pe -riodontal. La frecuencia de detección de Porphyromonas gingivalis, Treponema denticola y Aggregatibacter actinomycetemcomitans disminuyó a los 3 meses en todos los grupos. La frecuencia de detección de Tannerella forsythia se incrementó a los 3 meses en todos los grupos. Todos los patógenosperiodontales mostraron una frecuencia de detección similar a los 9 meses en todos los grupos. La terapia periodontal mas azitromicina no tuvo efectos adicionales sobre la frecuencia dedetección de los patógenos periodontales investigados en pacientes diabéticos...
Subject(s)
Humans , Male , Female , Middle Aged , Azithromycin/therapeutic use , Diabetes Mellitus , Chronic Periodontitis/etiology , Chronic Periodontitis/therapy , Dental Scaling/methods , Analysis of Variance , Aggregatibacter actinomycetemcomitans/isolation & purification , Colombia , Culture Media , Polymerase Chain Reaction , Chronic Periodontitis/microbiology , Porphyromonas gingivalis/isolation & purification , Treponema denticola/isolation & purificationABSTRACT
Current evidence suggests that periodontal infection may aggravate diabetes control. The aim of this study was to determine the changes in the frequency with which Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans were detected in patients with diabetes with the use of non-surgical therapy plus azithromycin in a randomized clinical trial. One hundred and five (105) patients with diabetes and chronic periodontitis were randomly assigned to three treatment groups: subgingival mechanical therapy with azithromycin, subgingival mechanical therapy with placebo and supragingival prophylaxis with azithromycin. Complete periodontal clinical examinations and detection of periodontal pathogens using polymerase chain reaction were carried out at baseline, 3, 6 and 9 months after periodontal therapy. The frequency with which Porphyromonas gingivalis, Treponemadenticola and Aggregatibacter actinomycetemcomitans were detected decreased at 3 months in all groups. Tannerella forsythia increased after3 months in all groups. All organisms had similar frequencies at 9 months in all groups. Subgingival mechanical therapy with adjunctive azithromycin had no additional effect on the frequency with which the periodontal pathogens investigated were detected in patients with diabetes.
