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1.
BMC Infect Dis ; 20(1): 659, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894092

RESUMO

BACKGROUND: Diarrheagenic Escherichia coli (DEC) are among the leading pathogens associated with endemic diarrhea in low income countries. Yet, few epidemiological studies have focused the contribution of enterohemorrhagic E. coli (EHEC), enteroinvasive E. coli (EIEC) and diffusely adherent E. coli (DAEC). METHODS: We assessed the contribution of EHEC, EIEC and DAEC isolated from stool samples from a case-control study conducted in children aged < 5 years in Southern Mozambique between December 2007 and November 2012. The isolates were screened by conventional PCR targeting stx1 and stx2 (EHEC), ial and ipaH (EIEC), and daaE (DAEC) genes. RESULTS: We analyzed 297 samples from cases with less-severe diarrhea (LSD) matched to 297 controls, and 89 samples from cases with moderate-to-severe diarrhea (MSD) matched to 222 controls, collected between November 3, 2011 and November 2, 2012. DEC were more common among LSD cases (2.7%, [8/297] of cases vs. 1.3% [4/297] of controls; p = 0.243]) than in MSD cases (0%, [0/89] of cases vs. 0.4%, [1/222] of controls; p = 1.000). Detailed analysis revealed low frequency of EHEC, DAEC or EIEC and no association with diarrhea in all age strata. Although the low frequency, EIEC was predominant in LSD cases aged 24-59 months (4.1% for cases vs. 0% for controls), followed by DAEC in similar frequency for cases and controls in infants (1.9%) and lastly EHEC from one control. Analysis of a subset of samples from previous period (December 10, 2007 and October 31, 2011) showed high frequency of DEC in controls compared to MSD cases (16.2%, [25/154] vs. 11.9%, [14/118], p = 0.383, respectively). Among these, DAEC predominated, being detected in 7.7% of cases vs. 17.6% of controls aged 24-59 months, followed by EIEC in 7.7% of cases vs. 5.9% of controls for the same age category, although no association was observed. EHEC was detected in one sample from cases and two from controls. CONCLUSIONS: Our data suggests that although EHEC, DAEC and EIEC are less frequent in endemic diarrhea in rural Mozambique, attention should be given to their transmission dynamics (e.g. the role on sporadic or epidemic diarrhea) considering that the role of asymptomatic individuals as source of dissemination remains unknown.


Assuntos
Diarreia/epidemiologia , Escherichia coli Êntero-Hemorrágica/genética , Infecções por Escherichia coli/epidemiologia , Saúde da População Rural , Estudos de Casos e Controles , Pré-Escolar , Diarreia/microbiologia , Doenças Endêmicas , Escherichia coli Êntero-Hemorrágica/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Moçambique/epidemiologia , Reação em Cadeia da Polimerase , Prevalência , População Rural
2.
J Epidemiol Glob Health ; 10(3): 214-221, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32954712

RESUMO

BACKGROUND: The Kingdom of Saudi Arabia (KSA) reported 170,639 cases and 1430 deaths from COVID-19 since the first case emerged in the country on March 2 through June 25, 2020. The objective of this report is to describe the characteristics and outcome observed among 99 hospitalized COVID-19 patients in the largest academic hospital in KSA, and assess co-infection with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). METHODS: This single-center case series data included select epidemiological, clinical, radiological features and laboratory findings of all confirmed hospitalized cases of COVID-19 in King Saud University Medical City (KSUMC), Riyadh, KSA, from March 22 until May 31, 2020, followed through June 6, 2020. We conducted retrospective analysis of listed data from 99 hospitalized patients and present characteristics and factors associated with severity in percentages and univariate odds ratios. Cases were confirmed using nasopharyngeal or throat swab by real-time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and MERS-CoV by RT-PCR. RESULTS: The 99 hospitalized COVID-19 patients included in this analysis constitute 16% of 632 positive SARS-CoV-2 among 6633 persons who were tested at the KSUMC (positivity rate, 9.4%). MERS-CoV PCR was negative in all 99 patients tested. The majority of these 99 hospitalized patients were males (66%), had a mean age of 44 years (range, 19-87), and a quarter (25.3%) were health care workers. Patients with comorbid conditions accounted for 52.5% of patients including the 8.1% who were asymptomatic; diabetes mellitus being the most frequent (31.3%), followed by hypertension (22.2%). The most common presenting symptoms were fever (67.7%), cough (60.6%), dyspnea (43.4%), upper respiratory symptoms (27.3%), fatigue (26.3%), diarrhea (19.2%) and loss of smell (9.1%). The clinical conditions among these 99 patients included upper respiratory tract infection (47.5%), abnormal chest X-ray, lymphopenia, high inflammatory markers a fifth (21%) of patients had moderate pneumonia, while 7% had severe pneumonia with 22.2% requiring admission to the intensive care unit and 12.1% died. Late presentation with severe disease, an abnormal chest X-ray, lymphopenia, high inflammatory markers (C-reactive protein, ferritin, and procalcitonin), and end organ damage (high creatinine or high aspartate aminotransferase) were predictors for admission to critical care unit or died. CONCLUSION: We observed no MERS-CoV co-infection in this early cohort of hospitalized COVID-19 patients who were relatively young, more than half had comorbid conditions, presented with fever and/or cough, an abnormal chest X-ray, lymphopenia, and high inflammatory markers. Given MERS-CoV endemicity in the country, co-monitoring of MERS-CoV and SARS-CoV-2 coinfection is critical.


Assuntos
Coinfecção/epidemiologia , Infecções por Coronavirus/epidemiologia , Doenças Endêmicas/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Coronavírus da Síndrome Respiratória do Oriente Médio , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Adulto Jovem
3.
Cent Eur J Public Health ; 28(3): 187-192, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997473

RESUMO

OBJECTIVES: Mediterranean spotted fever (MSF) is a tick-borne endemic disease caused by Rickettsia conorii conorii and transmitted to humans by the brown dog tick Rhipicephalus sanguineus. It is characterized by fever, maculopapular rash and a tick bite skin lesion "tache noire". The disease affects all age groups and usually has mild to moderate course. It has long been considered a benign infection. However, very severe "malignant" forms with fatal outcome strongly influenced by the patients' age were also observed. We aimed to reveal the features of MSF in children by comparing them with some of the disease patterns in adults. METHODS: Our prospective study data are based on the monitoring of all inpatients of the Clinic of Infectious Diseases in Plovdiv City and environs, the largest MSF endemic region in Bulgaria. The total number of patients admitted and treated for MSF over a study period of 10 years is 549, the incidence reaching 9.44/100,000. MSF is confirmed by antibody response to a specific antigen measured by indirect immunofluorescence assay (IFA). IgG ≥ 128 and/or IgM > 64 were considered to be indicative of acute infection. RESULTS: Eighty-five (15.48%) patients were children up to 14 years of age and 464 (84.52%) were aged 15-85 years. The skin lesion "tache noire" was present in 73.68% of children, and in 76.93% of the older age groups; symptoms as anorexia, nausea, vomiting, abdominal pain, and diarrhoea were more frequent in children, till general weakness and malaise was prevalent in adults. Children accounted approximately for 70% of the disease mild forms. No lethality was registered in this age group. Even though there were isolated cases of severe and malignant forms, children did not undergo the fatal complications seen in adults. CONCLUSION: Knowledge of the peculiarities of MSF in children will contribute to children's health protection, timely diagnose and disease prevention.


Assuntos
Febre Botonosa/epidemiologia , Doenças Endêmicas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bulgária/epidemiologia , Criança , Humanos , Incidência , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
4.
S Afr Med J ; 110(7): 657-660, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32880343

RESUMO

BACKGROUND: The World Health Organization recommends praziquantel (PZQ) (40 mg/kg body weight) for treating schistosomiasis. However, drug failure has been reported, prompting use of 60 mg/kg, for which results have been inconsistent. OBJECTIVES: To compare the efficacy of PZQ 40 mg/kg and 60 mg/kg in treating schoolchildren infected with Schistosoma haematobium. METHODS: The study was conducted during November 2017 - August 2018 in the Ingwavuma area, uMkhanyakude District, KwaZulu-Natal Province, South Africa. Children aged 10 - 15 years were screened for S. haematobium using a filtration technique. Infected children were randomly assigned to a dose of PZQ of 40 mg/kg or 60 mg/kg. Side-effects were recorded within 24 hours after treatment using questionnaires and direct observation. Four weeks after treatment, participants were retested for S. haematobium infection. Baseline and post-treatment mean egg counts were calculated. Cure rate (CR) and egg reduction rate (ERR) were used to determine PZQ efficacy, while repeated-measures analysis of variance determined the effect of both doses on infection intensity. A χ2 test was used to determine the association of side-effects with treatment, with a p-value ≤0.05. RESULTS: Forty-three and 36 children were treated with PZQ 40 mg/kg and 60 mg/kg, respectively. The 40 mg/kg group had a CR of 79.0% and an ERR of 97.2%, and the 60 mg/kg group a CR of 83.0% and an ERR of 98.3%. The effect of dose on infection intensity was not significantly different between the two groups (p>0.05). Abdominal pains, dizziness and fatigue were common among children who received PZQ 40 mg/kg, while headache, dizziness and nausea were common in the 60 mg/kg group. CONCLUSIONS: The efficacy of PZQ at 60 mg/kg was similar to that at 40 mg/kg. A dose >40 mg/kg therefore does not add value in treating S. haematobium infection. Transient side-effects (mostly dizziness) were observed more in the 60 mg/kg group than in the 40 mg/kg group. We recommend continued use of 40 mg/kg body weight for treating schistosomiasis.


Assuntos
Anti-Helmínticos/administração & dosagem , Praziquantel/administração & dosagem , Esquistossomose Urinária/tratamento farmacológico , Dor Abdominal , Adolescente , Animais , Anti-Helmínticos/efeitos adversos , Criança , Tontura , Relação Dose-Resposta a Droga , Doenças Endêmicas , Fadiga , Feminino , Cefaleia , Humanos , Masculino , Náusea , Praziquantel/efeitos adversos , Schistosoma haematobium , África do Sul
5.
J Biol Dyn ; 14(1): 748-766, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32990177

RESUMO

The outbreak of COVID-19 was first experienced in Wuhan City, China, during December 2019 before it rapidly spread over globally. This paper has proposed a mathematical model for studying its transmission dynamics in the presence of face mask wearing and hospitalization services of human population in Tanzania. Disease-free and endemic equilibria were determined and subsequently their local and global stabilities were carried out. The trace-determinant approach was used in the local stability of disease-free equilibrium point while Lyapunov function technique was used to determine the global stability of both disease-free and endemic equilibrium points. Basic reproduction number, R 0 , was determined in which its numerical results revealed that, in the presence of face masks wearing and medication services or hospitalization as preventive measure for its transmission, R 0 = 0.698 while in their absence R 0 = 3.8 . This supports its analytical solution that the disease-free equilibrium point E 0 is asymptotically stable whenever R 0 < 1 , while endemic equilibrium point E ∗ is globally asymptotically stable for R 0 > 1 . Therefore, this paper proves the necessity of face masks wearing and hospitalization services to COVID-19 patients to contain the disease spread to the population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Modelos Biológicos , Pandemias , Pneumonia Viral/transmissão , Número Básico de Reprodução , Simulação por Computador , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Suscetibilidade a Doenças , Doenças Endêmicas/prevenção & controle , Doenças Endêmicas/estatística & dados numéricos , Humanos , Máscaras/estatística & dados numéricos , Conceitos Matemáticos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Tanzânia/epidemiologia
6.
BMC Public Health ; 20(1): 1233, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787813

RESUMO

BACKGROUND: Control and elimination of onchocerciasis requires regular follow-up and evaluation of community directed treatment with ivermectin (CDTi) program implementation. This research was aimed to assess the epidemiological status of onchocerciasis in disease endemic communities of Asosa and Yeki districts of Ethiopia after 5 and 15 years of successive CDTi respectively, and to evaluate the decline in infection and morbidity burden. METHODS: A community-based cross-sectional study was conducted from August 2017 to January 2018 (i.e. within 2-7 months since the last treatment) using interview, physical and parasitological examinations. Pre-CDTi epidemiological data were obtained from studies conducted prior to the launch of CDTi. RESULTS: A total of 3002 individuals (1567 from Asosa and 1435 from Yeki) were included. No infection was detected from Yeki. In Asosa, the prevalence of infection was 1.6%. The geometric mean intensity of infection was 0.02 mf/mg of skin snip. The prevalence rates of dermatitis, depigmentation, nodule, and atrophy in Yeki were 33(2.3%), 57(4%), 37(2.6%) and 11(0.7%), respectively. The prevalence rates of papular dermatitis, depigmentation, palpable nodule, atrophy, and blindness in Asosa were 94(6%), 38(2.4%), 30(1.9%), 28(1.8%) and 2(0.1%), respectively. Five years of CDTi had significantly reduced prevalence and intensity of infection by 91.8% (p < 0.001) and 99.7% (p < 0.001), respectively. Moreover, CDTi reduced prevalence of papular dermatitis by 95.9% (p < 0.001), palpable nodule by 90.5% (p < 0.001), and atrophy by 30% (p = 0.6) in Yeki. Similarly, CDTi reduced prevalence of papular dermatitis by 88.6% (p < 0.001), depigmentation by 90.3% (p < 0.001), atrophy by 89.5% (p < 0.001), and blindness by 90% (p < 0.001) in Asosa. CONCLUSIONS: Fifteen years of successive CDTi had brought the infection from high to zero in Yeki. However, thorough entomological and serological data need to be generated to ascertain whether complete interruption of parasite transmission has been attained, and for considerations of an evidence-based CDTi cessation. Five years of CDTi in Asosa has significantly reduced the infection and morbidity of onchocerciasis to very low level. We, hereby, recommend biannual CDTi to continue in Asosa and its surroundings until the infection transmission is fully interrupted.


Assuntos
Doenças Endêmicas/prevenção & controle , Ivermectina/uso terapêutico , Administração Massiva de Medicamentos , Oncocercose/tratamento farmacológico , Oncocercose/epidemiologia , Adolescente , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Prevalência , Avaliação de Programas e Projetos de Saúde , Adulto Jovem
7.
PLoS One ; 15(8): e0236141, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764751

RESUMO

BACKGROUND: Novel interventions are needed to reach young people and adult men with HIV services given the low HIV testing rates in these population sub-groups. We assessed the feasibility and acceptability of a peer-led oral HIV self-testing (HIVST) intervention in Kasensero, a hyperendemic fishing community (HIV prevalence: 37-41%) in Rakai, Uganda. METHODS: This study was conducted among young people (15-24 years) and adult men (25+ years) between May and August 2019. The study entailed distribution of HIVST kits by trained "peer-leaders," who were selected from existing social networks and trained in HIVST distribution processes. Peer-leaders received up to 10 kits to distribute to eligible social network members (i.e. aged 15-24 years if young people or 25+ years if adult man, not tested in the past 3 months, and HIV-negative or of unknown HIV status at enrolment). The intervention was evaluated against the feasibility benchmark of 70% of peer-leaders distributing up to 70% of the kits that they received; and the acceptability benchmark of >80% of the respondents self-testing for HIV. RESULTS: Of 298 enrolled into the study at baseline, 56.4% (n = 168) were young people (15-24 years) and 43.6% (n = 130) were adult males (25+ years). Peer-leaders received 298 kits and distributed 296 (99.3%) kits to their social network members. Of the 282 interviewed at follow-up, 98.2% (n = 277) reported that they used the HIVST kits. HIV prevalence was 7.4% (n = 21). Of the 57.1% (n = 12) first-time HIV-positives, 100% sought confirmatory HIV testing and nine of the ten (90%) respondents who were confirmed as HIV-positive were linked to HIV care within 1 week of HIV diagnosis. CONCLUSION: Our findings show that a social network-based, peer-led HIVST intervention in a hyperendemic fishing community is highly feasible and acceptable, and achieves high linkage to HIV care among newly diagnosed HIV-positive individuals.


Assuntos
Autoavaliação Diagnóstica , Infecções por HIV/diagnóstico , Programas de Rastreamento/psicologia , Infuência dos Pares , Autocuidado/psicologia , Adolescente , Adulto , Doenças Endêmicas , Estudos de Viabilidade , Seguimentos , Anticorpos Anti-HIV/isolamento & purificação , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , Liderança , Masculino , Masculinidade , Programas de Rastreamento/instrumentação , Programas de Rastreamento/métodos , Mucosa Bucal/imunologia , Projetos Piloto , Prevalência , Kit de Reagentes para Diagnóstico , População Rural/estatística & dados numéricos , Autocuidado/instrumentação , Autocuidado/métodos , Uganda/epidemiologia , Adulto Jovem
8.
PLoS Negl Trop Dis ; 14(8): e0008540, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32776933

RESUMO

High-intensity clonorchiasis infection is associated with serious outcomes, including cancer. Understanding the infection intensity of Clonorchis sinensis and its risk factors in local endemic regions could facilitate effective control measures. In a county located in a highly endemic area in Guangxi Province, P. R. China, local residents were randomly enrolled in the study; helminth egg examinations were performed with the Kato-Katz method, and the intensity of infection was identified as mild, moderate or heavy. Knowledge, attitudes, and high-risk behaviours were investigated among those infected with Clonorchis sinensis. A total of 2521 local residents participated in this study, and the Clonorchis sinensis-positive proportion was 28.9% (728 persons). Among the infected persons, the percentages of mild, moderate and heavy infections were 66.2%, 28.4% and 5.4%, respectively. Males experienced a higher proportion of moderate and heavy infections (37.5%) than females (18.1%) (p<0.05). The highest infection proportion among the different levels of infection intensity was identified among persons aged 30-59 years (15.7% for moderate and heavy infections). Among the 509 persons who reported eating raw fish, 302 persons (59.3%) had eaten raw fresh fish for more than 10 years, and 131 (25.7%) persons ate raw fish ≥12 times a year. Multivariate logistic regression revealed that eating raw fish 12-50 times in the last year (adjusted odds ratio [aOR] = 1.74, 95%CI: 1.09-2.80) and eating raw fish >50 times in the last year (aOR = 2.89, 95%CI: 1.20-7.50) were risk factors for high-intensity infections (moderate and heavy). The overall infection proportion was high in the study area, with a large group of residents experiencing high-intensity infections. High frequency of raw fish consumption was associated with high-intensity infections. Intervention strategies targeting people with a high frequency of raw fish consumption should be implemented to reduce the probability of severe consequences.


Assuntos
Clonorquíase/epidemiologia , Doenças Endêmicas , Alimentos Crus , Alimentos Marinhos , Adolescente , Adulto , Animais , China/epidemiologia , Clonorquíase/diagnóstico , Clonorquíase/parasitologia , Clonorchis sinensis , Feminino , Peixes , Humanos , Masculino , Pessoa de Meia-Idade , Alimentos Crus/parasitologia , Fatores de Risco , Alimentos Marinhos/parasitologia , Adulto Jovem
9.
PLoS One ; 15(8): e0236993, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760100

RESUMO

In 1991, Peru launched the first vaccination program against hepatitis B in children aged under 5 years in the hyperendemic [hepatitis B virus (HBV) and hepatitis D virus (HDV)] province of Abancay. We conducted a cross-sectional study to determine the prevalence of HBV and HDV infections, 23 years after the launch of the vaccination program, as well as the post-vaccine response against hepatitis B in terms of prevalence of hepatitis B surface antibody (anti-HBs ≥10 mUI/ml). Among 3165 participants aged from 0 to 94 years, the prevalence rates of hepatitis B surface antigen (HBsAg), and hepatitis B core antibody (total anti-HBc) were 1.2% [95% confidence interval (CI) 0.85-1.64%], and 41.67% (95% CI 39.95-43.41%), respectively. The prevalence rate of anti-HBs at protective levels (≥10 mUI/ml) in individuals who HBsAg and anti-HBc negative was 66.36% (95% CI 64.15-68.51%). The prevalence rate of HBsAg in children aged <15 years was nil, and among adult HBsAg carriers, the prevalence of hepatitis D antibody (anti-HDV) was 5.26% (2/38; 95% CI 0.64-17.74). These findings showed that HBV prevalence has changed from high to low endemicity, 23 years following implementation of the vaccination program against hepatitis B, and HDV infection was not detected in those aged <30 years.


Assuntos
Vacinas contra Hepatite B/história , Hepatite B/prevenção & controle , Hepatite D/epidemiologia , Programas de Imunização/história , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Doenças Endêmicas , Feminino , Anticorpos Anti-Hepatite/sangue , Hepatite B/epidemiologia , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/farmacologia , Vírus da Hepatite B/imunologia , Hepatite D/imunologia , Vírus Delta da Hepatite/imunologia , História do Século XX , História do Século XXI , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Projetos Piloto , Prevalência , Adulto Jovem
10.
PLoS One ; 15(8): e0236414, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32845890

RESUMO

Visceral leishmaniasis (VL) is a common infectious disease that is endemic in Iran. This study aimed to investigate the spatial autocorrelation of VL in the northwest of Iran. In this cross-sectional study, the data of all patients were collected in 2009-2017 and analyzed by SPSS23 and Moran's and General G Index. The MaxEnt3.3.3 software was used to determine the ecological niche. A big hot spot area was identified in five counties in the northwest of Iran. More than 70% of the cases were reported from these regions, and the incidence rate increased in the northwest of Iran from 2013 to 2017. Seasonal rainfall and average daily temperature were the most important climate variables affecting the incidence of VL in this region (p < 0.05). Therefore, it can be concluded that VL in the northwest of Iran is expanding to new areas along the border with the Republic of Azerbaijan, and the northeastern section of this region is a high-risk area.


Assuntos
Ecossistema , Doenças Endêmicas/prevenção & controle , Leishmaniose Visceral/epidemiologia , Análise Espacial , Azerbaijão/epidemiologia , Clima , Humanos , Irã (Geográfico)/epidemiologia , Leishmaniose Visceral/parasitologia , Inquéritos e Questionários
11.
PLoS One ; 15(8): e0237165, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764785

RESUMO

This study's objective was to estimate the temporal trends of leprosy according to sex and age groups, as well as to estimate and predict the progression of the disease in a hyperendemic city located in the northeast of Brazil. This ecological time-series study was conducted in Imperatriz, Maranhão, Brazil. Leprosy cases diagnosed between 2006 and 2016 were included. Detection rates stratified by sex and age groups were estimated. The study of temporal trends was accomplished using the Seasonal-Trend Decomposition method and temporal modeling of detection rates using linear seasonal autoregressive integrated moving average model according to Box and Jenkins method. Trend forecasts were performed for the 2017-2020 period. A total of 3,212 cases of leprosy were identified, the average incidence among men aged between 30 and 59 years old was 201.55/100,000 inhabitants and among women in the same age group was 135.28/100,000 inhabitants. Detection rates in total and by sex presented a downward trend, though rates stratified according to sex and age presented a growing trend among men aged less than 15 years old and among women aged 60 years old or over. The final models selected in the time-series analysis show the forecasts of total detection rates and rates for men and women presented a downward trend for the 2017-2020 period. Even though the forecasts show a downward trend in Imperatriz, the city is unlikely to meet a significant decrease of the disease burden by 2020.


Assuntos
Doenças Endêmicas/estatística & dados numéricos , Previsões/métodos , Hanseníase/epidemiologia , Adolescente , Adulto , Fatores Etários , Brasil/epidemiologia , Cidades/estatística & dados numéricos , Feminino , Humanos , Incidência , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
12.
BMC Infect Dis ; 20(1): 466, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615988

RESUMO

BACKGROUND: Dengue fever is a major public health problem in Colombia. A fever surveillance study was conducted for evaluation of the clinical, epidemiological, and molecular patterns of dengue, prior to Chikungunya and Zika epidemics. METHODS: In November 2011-February 2014, a passive facility-based surveillance was implemented in Santa Cruz Hospital, Medellin, and enrolled eligible febrile patients between 1 and 65 years-of-age. Acute and convalescent blood samples were collected 10-21 days apart and tested for dengue using IgM/IgG ELISA. RNA was extracted for serotyping using RT-PCR on acute samples and genotyping was performed by sequencing. RESULTS: Among 537 febrile patients enrolled during the study period, 29% (n = 155) were identified to be dengue-positive. Only 7% of dengue cases were hospitalized, but dengue-positive patients were 2.6 times more likely to be hospitalized, compared to non-dengue cases, based on a logistic regression. From those tested with RT-PCR (n = 173), 17 were dengue-confirmed based on PCR and/or virus isolation showing mostly DENV-3 (n = 9) and DENV-4 (n = 7) with 1 DENV-1. Genotyping results showed that: DENV-1 isolate belongs to the genotype V or American/African genotype; DENV-3 isolates belong to genotype III; and DENV-4 isolates belong to the II genotype and specifically to the IIb sub-genotype or linage. CONCLUSIONS: Our surveillance documented considerable dengue burden in Santa Cruz comuna during non-epidemic years, and genetic diversity of circulating DENV isolates, captured prior to Chikungunya epidemic in 2014 and Zika epidemic in 2015. Our study findings underscore the need for continued surveillance and monitoring of dengue and other arboviruses and serve as epidemiological and molecular evidence base for future studies to assess changes in DENV transmission in Medellin, given emerging and re-emerging arboviral diseases in the region.


Assuntos
Vírus da Dengue/genética , Vírus da Dengue/imunologia , Dengue/epidemiologia , Febre/epidemiologia , Variação Genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Colômbia/epidemiologia , Dengue/virologia , Vírus da Dengue/isolamento & purificação , Doenças Endêmicas , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/virologia , Genótipo , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto Jovem
13.
J Infect Public Health ; 13(6): 877-882, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-436729

RESUMO

BACKGROUND: The global pandemic of coronavirus disease of 2019 (COVID-19) has led to unprecedented psychological stress on health workers (HCWs). We aimed to assess the psychological impact of COVID-19 on HCWs in comparison to the stress brought on by the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic in Saudi Arabia. METHOD: Between February 5th and 16th, 2020, 811 health-care workers (HCWs) of a tertiary care teaching hospital were invited to fill a questionnaire regarding concerns and worries about the novel coronavirus pandemic, along with Generalized Anxiety Disorder (GAD-7) Anxiety Severity screening tool. RESULTS: Out of 582 HCWs who completed the survey questionnaire (response rate of 71.8%), about 40% were exposed previously to MERS-CoV infected or suspected patients during a previous hospital outbreak. While there were no COVID-19 cases reported yet in Saudi Arabia at the time of data collection, still, the anxiety level from COVID-19 was significantly higher than that from MERS-CoV or seasonal influenza: 41.1% were more worried about COVID-19, 41.4% were similarly worried about both MERS-CoV and COVID-19, and 17.5% were more stressed by the previous MERS-CoV hospital outbreak. The most frequent concern was transmitting the infection to family and friends (2.71/5) than to themselves only (2.57/5). CONCLUSION: Pandemic and epidemic infectious diseases such as COVID-19 or MERS-CoV impose a significant level of anxiety and stress on healthcare workers who are caring of infected patients, with their main concern being the risk of transmitting the infection to their families or to acquire it themselves. Therefore, optimizing the compliance of healthcare workers with the proper infection prevention and control measures is paramount during the infectious disease outbreak, to ensure their safety, to decrease the likelihood of getting infected or transmitting the infection to others, and consequently to alleviate their psychological stress and anxiety.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Adulto , Ansiedade/etiologia , Doenças Endêmicas , Feminino , Hospitais de Ensino/estatística & dados numéricos , Humanos , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Coronavírus da Síndrome Respiratória do Oriente Médio , Pandemias , Arábia Saudita/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários , Centros de Atenção Terciária/estatística & dados numéricos
14.
Enferm. actual Costa Rica (Online) ; (38): 61-74, Jan.-Jun. 2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1090087

RESUMO

Resumo Este estudo teve como objetivo discutir as percepções dos Agentes Comunitários de Saúde e Agentes de Combate a Endemias sobre o processo de orientação da população quanto à prevenção e controle do Aedes Aegypti. Tratase de estudo descritivo-exploratório de natureza qualitativa, realizado com 07 Agentes de Combate a Endemias e 12 Agentes Comunitários de Saúde em uma cidade no interior da Bahia, cujos dados foram coletados por meio de entrevista semiestruturada, gravada com auxílio de gravador e analisado através da técnica do discurso do sujeito coletivo, que permitiu a construção de discursos coletivos. Os resultados mostram que na percepção de tais profissionais, a população não contribui para a prevenção e controle do Aedes Aegypti de modo eficaz, deixando apenas que os profissionais em questão atuem de forma ativa, sendo que este trabalho deve ser em conjunto com a população e os Agentes. Concluímos que com base nos resultados obtidos a população é orientada quanto aos cuidados para a prevenção do AA, no entanto, grande parte das pessoas não colocam em prática o que é pasado para eles, sendo assim, existe a necessidade de implementação de atividades para sensibilização deles.


Abstract This study aimed to discuss the perceptions of Community Health Agents and Endemic Control Agents on the process of guiding the population regarding the prevention and control of Aedes Aegypti. This is a descriptive and exploratory study of qualitative nature, conducted with 07 Endemic Disease Agents and 12 Community Health Agents in a city in the interior of Bahia, whose data were collected through semi-structured interviews, recorded with the aid of tape recorder and analyzed through the technique of collective subject discourse, which allowed the construction of collective discourses. The results show that in the perception of such professionals, the population does not contribute to the prevention and control of Aedes Aegypti effectively, leaving only the professionals in question to act actively, and this work should be together with the population and the agents. We conclude that based on the results obtained the population is oriented towards care for the prevention of AA, however, most people do not put into practice what is passed on to them, so there is a need to implement activities to raise awareness of them.


Resumen Este estudio tuvo como objetivo discutir las percepciones de los Agentes de Salud Comunitaria y los Agentes de Control Endémico sobre el proceso de orientación de la población con respecto a la prevención y el control del Aedes Aegypti. Este es un estudio descriptivo y exploratorio de naturaleza cualitativa, realizado con 07 Agentes de Enfermedades Endémicas y 12 Agentes de Salud Comunitaria en una ciudad del interior de Bahía, cuyos datos fueron recolectados a través de entrevistas semiestructuradas, registradas con la ayuda de una grabadora y analizados a través de la técnica del discurso del sujeto colectivo, que permitió la construcción de discursos colectivos. Los resultados muestran que, en la percepción de tales profesionales, la población no contribuye a la prevención y al control del Aedes Aegypti de manera efectiva, dejando solamente a los profesionales en cuestión para que actúen activamente, y este trabajo debe ser realizado juntamente con la población y con los agentes. Concluimos que, en base a los resultados obtenidos, la población está orientada hacia la atención para la prevención de AA, sin embargo, la mayoría de las personas no ponen en práctica lo que se les transmite, por lo que es necesario implementar actividades para crear conciencia sobre ellos.


Assuntos
Humanos , Prevenção Primária/educação , Brasil , Saúde Pública , Agentes Comunitários de Saúde , Serviços de Saúde Comunitária , Doenças Endêmicas , Aedes , Vigilância em Saúde Pública
15.
Brasília; IPEA; jun. 2020. 20 p. ilus.(Nota Técnica / IPEA. Disoc, 77).
Monografia em Português | LILACS, ECOS | ID: biblio-1102434

RESUMO

Esta nota técnica tem como objetivo identificar ações da Base Industrial de Defesa (BID) brasileira no combate à Covid-19 ­ doença causada pelo Sars-COV-2 (novo coronavírus). Para tanto, será realizado um levantamento das iniciativas empreendidas, para fins comparativos, em outros países selecionados. Nesta seção são apresentados os critérios utilizados para a seleção dos países. A segunda seção consiste no estudo do caso brasileiro no que se refere à atuação da BID durante a crise. Nas seções seguintes, são apresentados breves estudos de caso referentes aos demais países. A última seção, por sua vez, expõe as considerações finais do texto e possíveis recomendações referentes ao desenvolvimento de políticas públicas nacionais sobre o tema.


Assuntos
Política Pública , Vacinas , Coronavirus , Doenças Endêmicas , Infecções por Coronavirus , Pandemias
16.
Artigo em Inglês | MEDLINE | ID: mdl-32520213

RESUMO

Although the chemical control against leishmaniasis began in 1953 in Brazil, little information is available on how this strategy has affected populations of phlebotomine sandflies in the field. The objective of this study was to analyze the susceptibility profile of four populations of phlebotomine sandflies to the insecticide alpha-cypermethrin. Sandflies collected in field in four Brazilian municipalities were evaluated using CDC bottles in different concentrations of alpha-cypermethrin. A total of 1,186 phlebotomine sandflies were used in the bioassays. The LD50 ranged from 1.48 to 2.57 ug/mL in the field populations. For a dose of 5 ug/mL of alpha-cypermethrin, the LT50 and LT95 ranged from 17.9 to 27.5 minutes, and LT95 from 39.7 to 61.5 minutes, respectively. All the populations studied were highly susceptible to the insecticide alpha-cypermethrin. Routine studies are needed to detect changes in sandflies susceptibility to insecticides.


Assuntos
Insetos Vetores/efeitos dos fármacos , Inseticidas/farmacologia , Psychodidae/efeitos dos fármacos , Piretrinas/farmacologia , Animais , Brasil , Doenças Endêmicas , Feminino , Insetos Vetores/classificação , Leishmaniose/transmissão , Psychodidae/classificação
17.
PLoS One ; 15(6): e0234445, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32579586

RESUMO

This study aimed to describe the sand fly fauna and detect trypanosomatids in these insects from Casa Branca, state of Minas Gerais, Brazil, an endemic area of both visceral (VL) and tegumentary leishmaniasis (TL). Sand flies were collected bimonthly from May 2013 to July 2014, using automatic light traps exposed for three consecutive nights in peridomiciliary areas of nine houses with previous reports of VL and TL. ITS1-PCR and DNA sequencing were performed for trypanosomatids identification. A total of 16,771 sand flies were collected belonging to 23 species. The most abundant species was Nyssomyia whitmani (Antunes & Coutinho, 1939) (70.9%), followed by Lutzomyia longipalpis (Lutz & Neiva, 1912) (15.2%) and Migonemyia migonei (França, 1920) (9.1%). Leishmania amazonensis DNA was detected in Ny. whitmani (four pools) and Le. braziliensis DNA was detected in Psychodopygus lloydi (one pool). In seven pools of Ny. whitmani and in one pool of Lu. longipalpis positive for Leishmania DNA, the parasite species was not determined due to the low quality of the sequences. Moreover, DNA of Herpetomonas spp. was detected in Ny. whitmani (two pools) and Cortelezzii complex (one pool). DNA of Crithidia spp. was detected in Ny. whitmani and Ps. lloydi (both one pool). Our results suggest that Ny. whitmani may be involved in the transmission of Le. amazonensis in the study area. The molecular detection of Le. amazonensis suggests the presence of this species in a sylvatic cycle between vertebrate and invertebrate hosts in the region of Casa Branca. Our data also reveal the occurrence of other non-Leishmania trypanosomatids in sand flies in Casa Branca District.


Assuntos
Biodiversidade , Insetos Vetores/parasitologia , Leishmania/isolamento & purificação , Phlebotomus/parasitologia , Psychodidae/parasitologia , Animais , Brasil/epidemiologia , DNA de Protozoário/isolamento & purificação , Doenças Endêmicas/prevenção & controle , Feminino , Humanos , Leishmania/genética , Leishmaniose/epidemiologia , Leishmaniose/parasitologia , Leishmaniose/prevenção & controle , Leishmaniose/transmissão , Análise de Sequência de DNA
18.
BMC Infect Dis ; 20(1): 424, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-32552759

RESUMO

BACKGROUND: In malaria endemic areas, identifying spatio-temporal hotspots is becoming an important element of innovative control strategies targeting transmission bottlenecks. The aim of this work was to describe the spatio-temporal variation of malaria hotspots in central Senegal and to identify the meteorological, environmental, and preventive factors that influence this variation. METHODS: This study analysed the weekly incidence of malaria cases recorded from 2008 to 2012 in 575 villages of central Senegal (total population approximately 500,000) as part of a trial of seasonal malaria chemoprevention (SMC). Data on weekly rainfall and annual vegetation types were obtained for each village through remote sensing. The time series of weekly malaria incidence for the entire study area was divided into periods of high and low transmission using change-point analysis. Malaria hotspots were detected during each transmission period with the SaTScan method. The effects of rainfall, vegetation type, and SMC intervention on the spatio-temporal variation of malaria hotspots were assessed using a General Additive Mixed Model. RESULTS: The malaria incidence for the entire area varied between 0 and 115.34 cases/100,000 person weeks during the study period. During high transmission periods, the cumulative malaria incidence rate varied between 7.53 and 38.1 cases/100,000 person-weeks, and the number of hotspot villages varied between 62 and 147. During low transmission periods, the cumulative malaria incidence rate varied between 0.83 and 2.73 cases/100,000 person-weeks, and the number of hotspot villages varied between 10 and 43. Villages with SMC were less likely to be hotspots (OR = 0.48, IC95%: 0.33-0.68). The association between rainfall and hotspot status was non-linear and depended on both vegetation type and amount of rainfall. The association between village location in the study area and hotspot status was also shown. CONCLUSION: In our study, malaria hotspots varied over space and time according to a combination of meteorological, environmental, and preventive factors. By taking into consideration the environmental and meteorological characteristics common to all hotspots, monitoring of these factors could lead targeted public health interventions at the local level. Moreover, spatial hotspots and foci of malaria persisting during LTPs need to be further addressed. TRIAL REGISTRATION: The data used in this work were obtained from a clinical trial registered on July 10, 2008 at www.clinicaltrials.gov under NCT00712374.


Assuntos
Malária/epidemiologia , Malária/transmissão , Análise Espaço-Temporal , Quimioprevenção , Doenças Endêmicas , Humanos , Incidência , Malária/parasitologia , Malária/prevenção & controle , Plasmodium , Chuva , Fatores de Risco , Senegal/epidemiologia
19.
PLoS Negl Trop Dis ; 14(6): e0008272, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32555598

RESUMO

INTRODUCTION: Presence of asymptomatic individuals in endemic areas is common. The possible biomarkers in asymptomatic individuals once they get exposed to infection as well as following conversion to symptomatic disease are yet to be identified.We identified asymptomatic Visceral leishmaniasis (VL) infection amongst rK39+sorted direct agglutination test positive (DAT+) endemic healthy population and confirmed it by quantitative PCR(qPCR).The immunological determinants such as Adenosine deaminase (ADA), Interferon gamma (IFN-γ), Tumour Necrosis Factor alpha (TNF-α) and Interleukin 10 (IL-10)were examined to predict probable biomarkers for conversion to symptomatic VL. METHODS: Sample size was 5794 healthy individuals from VL endemic region. Antibody tests(DAT &rK39) were performed and later a qPCR assay was employed using kDNA specific primers and probes. Immunological biomarkers examined were ADA level by ADA-MTP kit and quantitative cytokines(IFN-γ, IL-10 and TNF-α) by ELISA. RESULTS: 120 asymptomatic individuals of 308 rK39 sero-positives were DAT positive comprising of 56 with previous history and 64 with no history of VL. RT-PCR confirmed asymptomatic VL in 42 sero-positives. These were followed up through repeated qPCR and evaluation of immunological determinants. We observed10 symptomatic cases converted from a total of 42 asymptomatic individuals identified at base-line. The level of ADA, IL-10 and IFN-γ remained consistently high in asymptomatic cases and amongst these, ADA and IL-10 but not IFN-γ remained higher at the development of clinical symptoms into active VL. On the contrary, there was no significant change in the mean concentration of TNF-α at both stages of the disease. DISCUSSION: We surmise from our data that considerable proportion of asymptomatic cases can be a reservoir and may play a crucial role in transmission of visceral leishmaniasis in endemic areas. The data also suggests that ADA and IL-10 can serve as a potential biomarker during the conversion of asymptomatic into symptomatic VL.


Assuntos
Anticorpos Antiprotozoários/sangue , Citocinas/sangue , Leishmaniose Visceral/epidemiologia , Adolescente , Adulto , Idoso , Testes de Aglutinação , Infecções Assintomáticas/epidemiologia , Biomarcadores/sangue , Criança , Progressão da Doença , Doenças Endêmicas , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Índia/epidemiologia , Leishmania donovani , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/imunologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Soroconversão , Adulto Jovem
20.
PLoS One ; 15(6): e0232867, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497049

RESUMO

INTRODUCTION: The Neglected Tropical Diseases Roadmap of the WHO set targets for potential elimination as a "public health problem" for the period 2012-2020 in multiple countries in Africa, with the aim of global elimination of schistosomiasis as a "public health problem" by 2025. AIM: The purpose of the study was to estimate the cost from a provider's perspective of the Department of Health's Schistosomiasis Mass Drug Administration (MDA) in Ugu District, KwaZulu-Natal in 2012, with a view to project the costs for the entire KwaZulu Natal Province. METHODS: A total of 491 public schools and 16 independent schools in Ugu District, a predominantly rural district in KwaZulu-Natal with a total of 218 242 learners, were included in the schistosomiasis control programme. They were randomly selected from schools situated below an altitude of 300 meters, where schistosomiasis is endemic. A retrospective costing study was conducted using the provider's perspective to cost. Cost data were collected by reviewing existing records including financial statements, invoices, receipts, transport log books, equipment inventories, and information from personnel payroll, existing budget, and the staff diaries. RESULTS: A total of 15571 children were treated in 2012, resulting in a total cost of the MDA programme of ZAR 2 137 143 and a unit cost of ZAR 137. The three main cost components were Medication Costs (37%), Human Resources Cost (36%) and Capital items (16%). The total cost for treating all eligible pupils in KwaZulu-Natal will be ZAR 149 031 888. However, should the capital cost be excluded, then the unit cost will be ZAR 112 per patient and this will translate to a total cost of ZAR 121 836 288. CONCLUSIONS: Low coverage exacerbates the cost of the programme and makes a decision to support such a programme difficult. However, a normative costing study based on the integration of the programme within the Department of Health should be conducted.


Assuntos
Anti-Helmínticos/economia , Custos Diretos de Serviços/estatística & dados numéricos , Administração Massiva de Medicamentos/economia , Praziquantel/economia , Esquistossomose/tratamento farmacológico , Serviços de Saúde Escolar/economia , Adolescente , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/uso terapêutico , Gastos de Capital/estatística & dados numéricos , Criança , Custos de Medicamentos/estatística & dados numéricos , Doenças Endêmicas/economia , Doenças Endêmicas/prevenção & controle , Feminino , Humanos , Masculino , Folhetos , Praziquantel/administração & dosagem , Praziquantel/uso terapêutico , Estudos Retrospectivos , População Rural , Amostragem , Esquistossomose/economia , Esquistossomose/epidemiologia , África do Sul/epidemiologia
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