Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 58
Filtrar
2.
East Mediterr Health J ; 22(11): 775-777, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30387121

RESUMO

The last few years have seen the WHO Eastern Mediterranean Region suffer from multiple wars and conflicts leading to humanitarian emergencies of unprecedented magnitude. In addition to the many lives lost and affected, the conflicts have significantly impacted the infrastructure needed for delivery of healthcare services. Approximately 30 million people have fled their countries; the refugee population in Jordan has doubled and even tripled in Lebanon. The population displacement and resettlement, overcrowding, poverty, poor sanitation, and malnutrition due to food shortages have increased morbidity and mortality from various diseases, notably communicable diseases.

6.
East Mediterr Health J ; 16(2): 134-40, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20799563

RESUMO

Viral hepatitis is a major problem in Egypt. To define the epidemiology of the disease, sentinel surveillance was established in 5 hospitals in diverse areas of the country in 2001. Data were completed for patients meeting the case definition for viral hepatitis. Of a total of 5909 patients evaluated, 4189 (70.9%) showed positive antibody markers for hepatitis. Out of those, 40.2% had evidence of hepatitis A virus (HAV) infection, 30.0% hepatitis B virus (HBV) and 29.8% hepatitis C virus (HCV) infection. This surveillance system was useful in identifying the variable endemicity of acute HAV infection in different regions and for better understanding the epidemiology of HBV and HCV infection.


Assuntos
Hepatite A/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Vigilância de Evento Sentinela , Doença Aguda , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Egito/epidemiologia , Doenças Endêmicas/estatística & dados numéricos , Feminino , Hepatite A/diagnóstico , Hepatite A/transmissão , Hepatite B/diagnóstico , Hepatite B/transmissão , Hepatite C/diagnóstico , Hepatite C/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Características de Residência , Fatores de Risco , Estações do Ano , Estudos Soroepidemiológicos , Distribuição por Sexo
7.
Vaccine ; 28(43): 7123-9, 2010 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-20659515

RESUMO

The introduction of Haemophilus influenzae type b (Hib) vaccine in developing countries has suffered from a long delay. Between 2005 and 2009, a surge in Hib vaccine adoption took place, particularly among GAVI-eligible countries. Several factors contributed to the increase in Hib vaccine adoption, including support provided by the Hib Initiative, a project funded by the GAVI Alliance in 2005 to accelerate evidence-informed decisions for use of Hib vaccine. This paper reviews the strategy adopted by the Hib Initiative and the lessons learned in the process, which provide a useful model to accelerate uptake of other new vaccines.


Assuntos
Cápsulas Bacterianas/administração & dosagem , Infecções por Haemophilus/prevenção & controle , Vacinas Anti-Haemophilus/administração & dosagem , Programas de Imunização/organização & administração , Países em Desenvolvimento , Humanos , Parcerias Público-Privadas
8.
East Mediterr Health J ; 16(1): 4-9, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20214150

RESUMO

Hepatitis B virus (HBV) infection is a significant health problem in Egypt. To better define risk factors associated with HBV transmission, we conducted a case-control study among patients admitted with acute hepatitis to an infectious disease hospital in Cairo. A total of 60 cases and 120 controls were interviewed about various exposures within 6 months prior to admission. Univariate analysis revealed HBV case-patients were more likely to report providing injections to relatives or friends, injecting drug use, exposure to a household contact with hepatitis, exposure to invasive medical procedures and being in the military. Efforts should be made to implement strict infection control standards in Egypt.


Assuntos
Hepatite B/epidemiologia , Hepatite B/transmissão , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Estudos de Casos e Controles , Criança , Pré-Escolar , Egito/epidemiologia , Características da Família , Feminino , Hepatite B/etiologia , Humanos , Injeções/efeitos adversos , Masculino , Pessoa de Meia-Idade , Militares , Fatores de Risco , Inquéritos e Questionários , Reação Transfusional , Sexo sem Proteção , Adulto Jovem
9.
(East. Mediterr. health j).
em Inglês | WHO IRIS | ID: who-117830

RESUMO

Viral hepatitis is a major problem in Egypt. To define the epidemiology of the disease, sentinel surveillance was established in 5 hospitals in diverse areas of the country in 2001. Data were completed for patients meeting the case definition for viral hepatitis. Of a total of 5909 patients evaluated, 4189 [70.9%] showed positive antibody markers for hepatitis. Out of those, 40.2% had evidence of hepatitis A virus [HAV] infection, 30.0% hepatitis B virus [HBV] and 29.8% hepatitis C virus [HCV] infection. This surveillance system was useful in identifying the variable endemicity of acute HAV infection in different regions and for better understanding the epidemiology of HBV and HCV infection


Assuntos
Hepatite Viral Humana , Hepatite A , Hepatite B , Hepatite C , Ensaio de Imunoadsorção Enzimática
10.
(East. Mediterr. health j).
em Inglês | WHO IRIS | ID: who-117808

RESUMO

Hepatitis B virus [HBV] infection is a significant health problem in Egypt. To better define risk factors associated with HBV transmission, we conducted a case-control study among patients admitted with acute hepatitis to an infectious disease hospital in Cairo. A total of 60 cases and 120 controls were interviewed about various exposures within 6 months prior to admission. Univariate analysis revealed HBV case-patients were more likely to report providing injections to relatives or friends, injecting drug use, exposure to a household contact with hepatitis, exposure to invasive medical procedures and being in the military. Efforts should be made to implement strict infection control standards in Egypt


Assuntos
Fatores de Risco , Estudos de Casos e Controles , Hepatite B
11.
Lancet ; 374(9703): 1786-91, 2009 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-19914707

RESUMO

Mass gatherings of people challenge public health capacities at host locations and the visitors' places of origin. Hajj--the yearly pilgrimage by Muslims to Saudi Arabia--is one of the largest, most culturally and geographically diverse mass gatherings in the world. With the 2009 pandemic influenza A H1N1 and upcoming Hajj, the Saudi Arabian Ministry of Health (MoH) convened a preparedness consultation in June, 2009. Consultants from global public health agencies met in their official capacities with their Saudi Arabian counterparts. The MoH aimed to pool and share public health knowledge about mass gatherings, and review the country's preparedness plans, focusing on the prevention and control of pandemic influenza. This process resulted in several practical recommendations, many to be put into practice before the start of Hajj and the rest during Hajj. These preparedness plans should ensure the optimum provision of health services for pilgrims to Saudi Arabia, and minimum disease transmission on their return home. Review of the implementation of these recommendations and their effect will not only inform future mass gatherings in Saudi Arabia, but will also strengthen preparedness efforts in other settings.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Surtos de Doenças/prevenção & controle , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/prevenção & controle , Islamismo , Viagem , Implementação de Plano de Saúde/organização & administração , Humanos , Influenza Humana/epidemiologia , Influenza Humana/transmissão , Guias de Prática Clínica como Assunto , Arábia Saudita
12.
Eur J Clin Microbiol Infect Dis ; 28(5): 429-35, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19002729

RESUMO

To determine the burden of bacterial meningitis and characterize its epidemiology, a laboratory-based surveillance was established in five hospitals in Sudan. Hospital personnel were trained in basic surveillance and bacteriology techniques. Positive cerebrospinal fluid (CSF) cultures were confirmed at Sudan National Laboratories and U.S. Naval Medical Research Unit No. 3. Additionally, 126 frozen CSF samples from culture-negative meningitis cases were tested by polymerase chain reaction (PCR). Of 1,830 suspected meningitis cases enrolled, 75% were less than 5 years old and 63% were males. Of these, 149 (8%) were culture-confirmed, including 121 (81%) Neisseria meningitidis; 18 (12%) Streptococcus pneumoniae, and 10 (7%) Haemophilus influenzae. Of 440 turbid specimens, 132 (30%) were culture-positive. Of the 126 samples from culture-negative meningitis cases that were tested, only 18 (14%) were classified as turbid on gross examination, yet 63 (50%) were positive by PCR. This study suggests that PCR may be useful to more accurately define the burden of disease in epidemic setting. Maintaining laboratory-based surveillance allows evidence-based decision-making and helps monitor the impact of new vaccines introduction.


Assuntos
Meningites Bacterianas/epidemiologia , Adolescente , Adulto , Idoso , Líquido Cefalorraquidiano/microbiologia , Criança , Pré-Escolar , DNA Bacteriano/líquido cefalorraquidiano , Feminino , Haemophilus influenzae/isolamento & purificação , Hospitais , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Neisseria meningitidis/isolamento & purificação , Pacientes , Reação em Cadeia da Polimerase/métodos , Vigilância de Evento Sentinela , Streptococcus pneumoniae/isolamento & purificação , Sudão/epidemiologia , Adulto Jovem
13.
Eur J Clin Microbiol Infect Dis ; 26(5): 331-40, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17404766

RESUMO

Laboratory-based surveillance for bacterial meningitis was conducted in a network of infectious disease hospitals in Egypt to better understand the epidemiology of this infection. Healthcare and laboratory personnel were trained in basic surveillance and microbiologic processing of cerebrospinal fluid (CSF) specimens. All bacterial isolates from CSF were confirmed and tested for antimicrobial susceptibility. PCR testing was performed on a random subset of purulent, culture-negative CSF specimens. Of 11,070 patients who met criteria for the case definition, 843 (8%) were culture positive (42% positive for Streptococcus pneumoniae, 20% for Haemophilus influenzae serotype b, 17% for each of Neisseria meningitidis and Mycobacterium tuberculosis, and 6% for other bacteria). Of 1,784 (46%) CSF specimens tested by PCR, 232 (13%) were positive for the first three major pathogens. Of N. meningitidis isolates, 52% belonged to serogroup A, 35% to serogroup B, and 4% to serogroup W135. S. pneumoniae isolates comprised 46 different serotypes, of which 6B, 1, 19A, 23F, and 6A were the most predominant. The overall case-fatality rate for culture-positive cases was 26% and was highest among patients with M. tuberculosis (47%). Factors significantly associated with death (p < 0.05) included admission to rural hospitals, long prodromal period, referral from other hospitals, antibiotic treatment prior to admission, and clear CSF (<100 cells/mm3). Susceptibility to ampicillin and ceftriaxone was observed in 44 and 100% of H. influenzae serotype b isolates and in 52 and 94% of S. pneumoniae isolates, respectively. This surveillance highlights the significant mortality and morbidity associated with bacterial meningitis in Egypt. Decision makers need to review current treatment guidelines and introduce appropriate vaccines for prevention and control of the disease.


Assuntos
Meningites Bacterianas/microbiologia , Meningites Bacterianas/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , DNA Bacteriano/análise , Egito/epidemiologia , Feminino , Humanos , Lactente , Masculino , Meningites Bacterianas/líquido cefalorraquidiano , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mortalidade , Reação em Cadeia da Polimerase , Vigilância da População/métodos , Sorotipagem
14.
Med Mycol ; 43(3): 219-25, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-16010848

RESUMO

This is a cohort study of pediatric outpatients receiving total parenteral nutrition (TPN) and follow-up care in a Tennessee hospital between January and June 1999. The study was conducted following an increase in the incidence of candidemia. Of 13 children receiving home TPN, five had candidemia; three were due to Candida parapsilosis. Case patients were more likely to have an underlying hematologic disease (P = 0.02) as well as previous history of fungemia (P = 0.02). Two case patients had successive candidemia episodes 3 months apart; karyotypes and RAPD profiles of each patient's successive C. parapsilosis isolates were similar. Candida spp. were frequently detected in hand cultures from cohort members (four of 10) and family member caregivers (nine of 11); C parapsilosis was isolated from five caregivers. Our findings underscore the challenges of maintaining stringent infection control practices in the home health care setting and suggest the need for more intensive follow-up and coordination of home TPN therapy among pediatric patients.


Assuntos
Assistência Ambulatorial , Candidíase/etiologia , Infecção Hospitalar/etiologia , Fungemia/etiologia , Nutrição Parenteral Total/efeitos adversos , Adolescente , Candida/isolamento & purificação , Candidíase/epidemiologia , Cuidadores , Criança , Estudos de Coortes , Infecção Hospitalar/epidemiologia , Feminino , Fungemia/epidemiologia , Mãos/microbiologia , Hospitais Pediátricos , Humanos , Incidência , Lactente , Masculino , Fatores de Risco , Especificidade da Espécie , Tennessee/epidemiologia
15.
Epidemiol Infect ; 131(2): 907-14, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14596532

RESUMO

Between 1992 and 1999, 93 cases of blastomycosis, including 25 laboratory confirmed cases, were identified in Missouri (annual incidence, 0.2/100,000 population). Mississippi County in southeastern Missouri had the highest incidence (12/100,000) with a much higher rate among blacks than whites in this county (43.21/100,000). The mortality rate, 44% was also higher among blacks. To determine risk factors for endemic blastomycosis, a case-control study was conducted among southeastern Missouri residents. Independent risk factors for blastomycosis were black race and a prior history of pneumonia. No environmental exposures or socioeconomic factors were significantly associated with increased risk. The increased risk among blacks may possibly be related to genetic factors, but further studies are needed to clarify this. However, heightened awareness of the disease and a better understanding of the risk factors are important and may lead to earlier diagnosis and start of treatment, possibly improving outcome.


Assuntos
Blastomicose/epidemiologia , Doenças Endêmicas/estatística & dados numéricos , Adolescente , Adulto , Idoso , População Negra/estatística & dados numéricos , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Missouri/epidemiologia , Fatores de Risco , Estatísticas não Paramétricas , Inquéritos e Questionários , População Branca/estatística & dados numéricos
16.
J Am Acad Dermatol ; 48(2): 189-93, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12582387

RESUMO

BACKGROUND: Tinea capitis, a fungal infection of the scalp, is of increasing public health importance, and Trichophyton tonsurans has become the primary causative agent in North America. OBJECTIVES: To determine the prevalence of dermatophyte-positive scalp cultures among elementary schoolchildren in Cleveland, Ohio, describe predisposing factors, and measure the antifungal susceptibility of isolates collected. OBSERVATIONS: A total of 937 children from 8 Cleveland elementary schools were cultured for the presence of dermatophytes; 122 children (13%), all of whom were African American, had dermatophyte-positive cultures of the scalp. Sixty percent of cases were asymptomatic, indicating a carrier state. Race, scaling, and the use of anti-dandruff shampoo were associated with increased likelihood of infection. T tonsurans was the only organism isolated (except 1 Microsporum canis isolate). All isolates were susceptible to fluconazole, griseofulvin, itraconazole, and terbinafine. CONCLUSIONS: T tonsurans was the predominant dermatophyte isolated. Further multicenter studies are needed to confirm the predominance of dermatophyte-positive scalp cultures among African American children and to determine modifiable and preventable risk factors.


Assuntos
Tinha do Couro Cabeludo/epidemiologia , Criança , Feminino , Humanos , Masculino , Ohio/epidemiologia , Prevalência , Tinha do Couro Cabeludo/tratamento farmacológico
17.
Clin Infect Dis ; 36(1): 34-9, 2003 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-12491199

RESUMO

Population-based surveillance and a case-control study were conducted in Abancay, Peru, to estimate the burden of disease and to determine risk factors for sporadic lymphocutaneous sporotrichosis (LS). Laboratory records from local hospitals were reviewed for the years of 1997 and 1998, and prospective surveillance was conducted for the period of September 1998 through September 1999. A case-control study was conducted with 2 matched control subjects per case patient. The mean annual incidence was 98 cases per 100,000 persons. Children had an incidence 3 times higher than that for adults and were more likely to have LS lesions on the face and neck. Identified risk factors included owning a cat, playing in crop fields, having a dirt floor in the house, working mainly outdoors, and having a ceiling made of raw wood or conditions associated with a lower socioeconomic status. Decreased environmental exposure, such wearing protective clothing during construction activities for adults or limiting contact with cats and soil for children, and improvements in living spaces may decrease the incidence of LS.


Assuntos
Doenças Endêmicas , Vigilância da População , Esporotricose/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Análise Multivariada , Peru/epidemiologia , Fatores de Risco
18.
Clin Infect Dis ; 35(5): 627-30, 2002 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-12173140

RESUMO

We describe the annual incidence of primary bloodstream infection (BSI) associated with Candida albicans and common non-albicans species of Candida among patients in intensive care units that participated in the National Nosocomial Infections Surveillance system from 1 January 1989 through 31 December 1999. During the study period, there was a significant decrease in the incidence of C. albicans BSI (P<.001) and a significant increase in the incidence of Candida glabrata BSI (P=.05).


Assuntos
Candida/isolamento & purificação , Candidíase/epidemiologia , Infecção Hospitalar/epidemiologia , Adulto , Candidíase/microbiologia , Infecção Hospitalar/microbiologia , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia
19.
Antimicrob Agents Chemother ; 45(11): 3065-9, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11600357

RESUMO

The antifungal drug susceptibilities of two collections of Cryptococcus neoformans isolates obtained through active laboratory-based surveillance from 1992 to 1994 (368 isolates) and 1996 to 1998 (364 isolates) were determined. The MICs of fluconazole, itraconazole, and flucytosine were determined by the National Committee for Clinical Laboratory Standards broth microdilution method; amphotericin B MICs were determined by the E-test. Our results showed that the MIC ranges, the MICs at which 50% of isolates are inhibited (MIC(50)s), and the MIC(90)s of these four antifungal agents did not change from 1992 to 1998. In addition, very small numbers of isolates showed elevated MICs suggestive of in vitro resistance. The MICs of amphotericin B were elevated (>or=2 microg/ml) for 2 isolates, and the MICs of flucytosine were elevated (>or=32 microg/ml) for 14 isolates. Among the azoles, the fluconazole MIC was elevated (>or=64 microg/ml) for 8 isolates and the itraconazole MIC (>or=1 microg/ml) was elevated for 45 isolates. Analysis of 172 serial isolates from 71 patients showed little change in the fluconazole MIC over time. For isolates from 58 patients (82% of serial cases) there was either no change or a twofold change in the fluconazole MIC. In contrast, for isolates from seven patients (12% of serial cases) the increase in the MIC was at least fourfold. For isolates from another patient there was a 32-fold decrease in the fluconazole MIC over a 1-month period. We conclude that in vitro resistance to antifungal agents remains uncommon in C. neoformans and has not significantly changed with time during the past decade.


Assuntos
Antifúngicos/farmacologia , Criptococose/epidemiologia , Criptococose/microbiologia , Cryptococcus neoformans/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Estados Unidos/epidemiologia
20.
Clin Infect Dis ; 33(9): 1549-52, 2001 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-11568854

RESUMO

Preventive measures are important in the control of invasive aspergillosis (IA) because diagnosis is difficult and the outcome of treatment is poor. If effective strategies are to be devised, it will be essential to have a clearer understanding of the sources and routes of transmission of Aspergillus species. Nosocomial outbreaks of IA highlight the fact that Aspergillus spores are common in the hospital environment. However, in general, such outbreaks are uncommon. Most cases of IA are sporadic in nature, and many of them are now being acquired outside of the hospital setting. Housing patients in high-energy particulate air-filtered hospital rooms helps prevent IA, but it is feasible and cost-effective only for the highest-risk groups and for limited periods. Control measures, which are designed to protect patients from exposure to spores outside the hospital, are even more difficult. Nevertheless, now that high-risk patients are spending more time outside of the hospital, the cost benefits of antifungal prophylaxis and other preventive measures require careful evaluation.


Assuntos
Aspergilose/epidemiologia , Infecção Hospitalar/epidemiologia , Exposição Ambiental , Ar , Aspergilose/prevenção & controle , Aspergillus , Infecção Hospitalar/prevenção & controle , Humanos , Abastecimento de Água
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...