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1.
Pan Afr Med J ; 33: 13, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303958

RESUMO

Introduction: Dog-mediated human rabies remains a major public health threat in Ghana. Dog population structure surveys are pre-requisites for appropriate planning for rabies vaccination; however, this information is unavailable in Ghana. This study describes dog population structure in Kumasi, Ghana. Methods: A household cross sectional survey was conducted from January through April 2016 in Ayeduase and Kwame Nkrumah University of Science and Technology (KNUST) campus using a structured questionnaire. Results: A total of 1319 households were surveyed out of which 35.1% (463/1319) kept dogs. We recorded 816 dogs from 463 households, giving dog to household ratio of 1.8:1. Respondents acquired 71% (579/816) of dogs through purchase. Of 2065 persons in Ayeduase, 406 owned dogs, resulting in man to dog ratio of 5.1:1. Male dogs represented 62.9% (513/816) while those aged a year and above recorded 70%. Most of the dogs were not restricted (80.3%) and 49.9% were allowed to enter neighbors' households. Dog rabies vaccination coverage was 28.1% and 64.9% in Ayeduase and KNUST campus respectively. Respondents (87.8%) from Ayeduase knew dog bite was the main means of rabies transmission, however, about 65% believed in traditional ways of treatment such as concoction, herbs and consumption of offending dogs' organs. Conclusion: The high dog to household-human ratio, increased roaming dog population and low vaccination coverage is of concern to rabies. Respondents' knowledge on their dogs is an indication of accessibility for vaccination. Obtained results can be useful for rabies vaccination planning in Kumasi and other comparable settings in Ghana.


Assuntos
Doenças do Cão/prevenção & controle , Vacinas Antirrábicas/administração & dosagem , Raiva/prevenção & controle , Vacinação/estatística & dados numéricos , Animais , Mordeduras e Picadas/virologia , Estudos Transversais , Doenças do Cão/virologia , Cães , Características da Família , Feminino , Gana , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Propriedade/estatística & dados numéricos , Raiva/transmissão , Inquéritos e Questionários , Cobertura Vacinal/estatística & dados numéricos
2.
Parasite ; 26: 40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31298995

RESUMO

A better understanding of malaria transmission at a local scale is essential for developing and implementing effective control strategies. In the framework of a randomized controlled trial (RCT), we aimed to provide an updated description of malaria transmission in the Korhogo area, northern Côte d'Ivoire, and to obtain baseline data for the trial. We performed human landing collections (HLCs) in 26 villages in the Korhogo area during the rainy season (September-October 2016, April-May 2017) and the dry season (November-December 2016, February-March 2017). We used PCR techniques to ascertain the species of the Anopheles gambiae complex, Plasmodium falciparum sporozoite infection, and insecticide resistance mechanisms in a subset of Anopheles vectors. Anopheles gambiae s.l. was the predominant malaria vector in the Korhogo area. Overall, more vectors were collected outdoors than indoors (p < 0.001). Of the 774 An. gambiae s.l. tested in the laboratory, 89.65% were An. gambiae s.s. and 10.35% were An. coluzzii. The frequencies of the kdr allele were very high in An. gambiae s.s. but the ace-1 allele was found at moderate frequencies. An unprotected individual living in the Korhogo area received an average of 9.04, 0.63, 0.06 and 0.12 infected bites per night in September-October, November-December, February-March, and April-May, respectively. These results demonstrate that the intensity of malaria transmission is extremely high in the Korhogo area, especially during the rainy season. Malaria control in highly endemic areas such as Korhogo needs to be strengthened with complementary tools in order to reduce the burden of the disease.


Assuntos
Anopheles/parasitologia , Ecologia , Resistência a Inseticidas , Inseticidas , Malária/transmissão , Animais , Anopheles/genética , Mordeduras e Picadas/epidemiologia , Costa do Marfim , Feminino , Humanos , Malária/prevenção & controle , Controle de Mosquitos , Mosquitos Vetores/genética , Mosquitos Vetores/parasitologia , Plasmodium falciparum/genética , Ensaios Clínicos Controlados Aleatórios como Assunto , Estações do Ano
3.
MMWR Morb Mortal Wkly Rep ; 68(23): 524-528, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31194721

RESUMO

INTRODUCTION: Each year, rabies causes approximately 59,000 deaths worldwide, including approximately two deaths in the United States. Before 1960, dogs were a common reservoir of rabies in the United States; however, increasingly, species of wildlife (e.g., bats, raccoons) are the main reservoirs. This report characterizes human rabies deaths, summarizes trends in rabies mortality, and highlights current rabies risks in the United States. METHODS: Rabies trends in the United States during 1938-2018 were analyzed using national rabies surveillance data. Data from the Healthcare Cost and Utilization Project for 2006-2014 were used to estimate the number of postexposure prophylaxis (PEP) visits per 100,000 persons during 2017-2018. The Centers for Medicare & Medicaid Services' average sales price data were used to estimate PEP costs. RESULTS: From 1960 to 2018, a total of 125 human rabies cases were reported in the United States; 36 (28%) were attributed to dog bites during international travel. Among the 89 infections acquired in the United States, 62 (70%) were attributed to bats. In 2018, approximately 55,000 persons sought PEP after contact with a potentially rabid animal. CONCLUSIONS AND COMMENTS: In the United States, wildlife rabies, especially in bats, continues to pose a risk to humans. Travelers also might be exposed to canine rabies in countries where the disease is still present; increased awareness of rabies while traveling abroad is needed. Vaccinating pets, avoiding contact with wildlife, and seeking medical care if one is bitten or scratched by an animal are the most effective ways to prevent rabies. Understanding the need for timely administration of PEP to prevent death is critical.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Vigilância da População , Raiva/mortalidade , Animais , Mordeduras e Picadas , Quirópteros/virologia , Doenças do Cão/virologia , Cães , Humanos , Internacionalidade , Mortalidade/tendências , Profilaxia Pós-Exposição , Raiva/prevenção & controle , Raiva/transmissão , Raiva/veterinária , Fatores de Risco , Doença Relacionada a Viagens , Estados Unidos/epidemiologia
4.
J Forensic Leg Med ; 65: 105-107, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31132726

RESUMO

Distinguishing between ante-mortem and post-mortem domestic dog injuries is fundamental in order to correctly find the cause of the death. Although fatal aggressions are chiefly perpetrated by pit bull-type dogs, small dogs are responsible for a significant share of animal bites and can cause high-degree injuries. On the other side, indoor and outdoor scavenging can hinder forensic investigation, consuming parts of the body where crucial forensic features like bruises and wounds have been inflicted. In the case we present, a man died after falling down his house stairs because of a traumatic intracranial haemorrhage. His dog, a Jack Russel Terrier, scavenged a significant portion of his facial superficial and deep tissues, suggesting to the investigators the hypothesis of a brutal aggression. In this paper, we showed how the application of advanced 3D processing and modelling techniques can give a crucial contribution to detect the injuries certainly caused by animal teeth.


Assuntos
Mordeduras e Picadas/patologia , Simulação por Computador , Cães , Comportamento Alimentar , Imagem Tridimensional , Dente/diagnóstico por imagem , Acidentes por Quedas , Adulto , Animais , Traumatismos Faciais/etiologia , Traumatismos Faciais/patologia , Odontologia Legal , Patologia Legal , Humanos , Masculino , Lesões do Pescoço/etiologia , Lesões do Pescoço/patologia , Fotogrametria , Fraturas Cranianas/patologia , Hemorragia Subaracnóidea/patologia
5.
Acta Vet Scand ; 61(1): 22, 2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31060620

RESUMO

BACKGROUND: Bite wounds are one of the most common traumatic injuries in dogs and depending on their severity, location, etc., urgent care including antibiotic therapy may be necessary. Serious complications can result from these injuries, such as multiple organ dysfunction syndrome (MODS), as well as a generalized reduction in cerebral perfusion, e.g. during cardiac arrest, shock, or severe hypotension that may cause global brain ischemia (GBI). CASE PRESENTATION: A 5-year-old spayed female Maltese dog was presented with generalized seizures, ataxia, and obtunded mentation. The dog was injured by severe bite wounds that penetrated its abdomen and had received blood transfusions, antibiotic therapy (including metronidazole and cefazoline) and underwent emergency surgery 4 days before its visit. Based on a clinical examination, intracranial hypoxic damage with elevated intra-cranial pressure and MODS were highly suspected, and GBI was confirmed following magnetic resonance imaging. Increased signal intensity diffusely distributed in the olfactory bulb and frontal, temporal, and parietal grey matter was evident on the T2-weighted and fluid attenuated inversion recovery transverse images, along with corresponding high signal intensity observed on diffusion weighted imaging. During the 10-month follow-up period, the clinical signs gradually improved, but intermittent circling and cognitive dysfunction deficits remained. CONCLUSIONS: GBI should be included among the differential diagnoses in case of any peracute non-progressive neurological dysfunction that occurs with episodes of hypotension or hypoxia. The abnormal signal intensity observed on diffusion weighted imaging was a useful indicator for diagnosing this condition. Long-term medical management with antibiotics and anti-convulsant and anti-oxidant therapies were considered to be helpful in managing the GBI concurrent with MODS in this dog.


Assuntos
Mordeduras e Picadas/veterinária , Isquemia Encefálica/veterinária , Doenças do Cão/etiologia , Insuficiência de Múltiplos Órgãos/veterinária , Animais , Mordeduras e Picadas/complicações , Mordeduras e Picadas/terapia , Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/etiologia , Doenças do Cão/patologia , Doenças do Cão/terapia , Cães , Feminino , Hidrocefalia/tratamento farmacológico , Hidrocefalia/veterinária , Insuficiência de Múltiplos Órgãos/etiologia , Insuficiência de Múltiplos Órgãos/patologia , Insuficiência de Múltiplos Órgãos/terapia
6.
Forensic Sci Int ; 299: 203-207, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31039547

RESUMO

The discipline of forensic odontology is at a crossroads with the application of bitemark evidence in the court of law. In the last decade, the increase in the number of cases in which bitemarks were the 'smoking gun' to a conviction being appealed and verdicts reverse is alarming and due in a large part to the lack of validated rules and scientific rigor needed to evaluate this evidence objectively. In some cases, post-mortem trauma to human remains has been misinterpreted as human bitemarks. This case report illustrates how bitemarks misinterpreted as human-caused were reevaluated by a computerized imaging analytical method and determined to be consistent with those caused by crayfish scavenging on the remains. Fetal pigs were exposed to crayfish native to the crime scene for a period of 72 h. Crayfish bitemarks on the pigs were compared to marks on the victim and the bite width of the crayfish and found to be statistically the same. These findings led to the exoneration of the convicted individual. Such computer-aided pattern recognition protocols are necessary in traditional forensic identification sciences such as forensic odontology to minimize biased conclusions by extraneous evidence and preconceived assumptions and replace subjective guesswork with sound scientific protocols.


Assuntos
Astacoidea , Mordeduras e Picadas/patologia , Odontologia Legal/métodos , Processamento de Imagem Assistida por Computador , Reconhecimento Automatizado de Padrão , Animais , Pré-Escolar , Comportamento Alimentar , Feminino , Odontologia Legal/legislação & jurisprudência , Homicídio/legislação & jurisprudência , Humanos , Masculino , Mudanças Depois da Morte , Suínos
7.
Malar J ; 18(1): 152, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31036025

RESUMO

BACKGROUND: Several studies carried out in Benin have shown the involvement of Anopheles gambiae sensu lato (s.l.), the Anopheles funestus group in malaria transmission, but none of them reported the contribution of the Anopheles nili group to the transmission of this disease. The current study investigated the question through an entomological cross-sectional survey performed in Northern Benin. METHODS: Mosquito samplings were performed in September and October 2017 in 4 villages located in two districts: Bambaba and Wodara (Kérou district) and, Péhunco 2 and Béké (Péhunco district). The collections were carried out indoors and outdoors using human landing catches (HLC) to assess the human biting rate (HBR) and pyrethrum spray catches (PSC) to evaluate the blood feeding rate and the blood meal origin using the ELISA test. All collected mosquitoes were morphologically identified and, the polymerase chain reaction (PCR) technique was used for molecular identification of sibling species of An. gambiae s.l., An. funestus group and An. nili group sporozoite index (SI) was also assessed by the ELISA test. RESULTS: Overall, An. gambiae s.l., An. funestus group and An. nili group were the three vectors found in the study area. A significantly higher human biting rate (HBR) was recorded in An. nili group (5 bites/human/night) compared to An. funestus group (0.656 bites/human/night) in the Kérou district (p < 0.0001). Anopheles gambiae s.l. displayed the highest HBR (26.19 bites/human/night) in the same district. The entomological inoculation rate (EIR) was 1.875 infected bites/human/month in An. nili group against 13.05 infected bites/human/month in An. gambiae s.l. and 0.938 infected bites/human/month in An. funestus group in Kérou. In Péhunco, the EIR was 1.02 infected bites/human/month in An. gambiae s.l. PCR results showed that An. nili sensu stricto (s.s.) and An. funestus s.s. were the only species of the An. nili and An. funestus groups, respectively. The anthropophagic character of An. gambiae s.l. was also highlighted. CONCLUSION: This study provides useful information on the contribution of An. nili group as secondary vector to malaria transmission in northern Benin. Broader studies must also be carried out in a larger study area to assess the involvement of other Anopheles species to malaria transmission. This will aid to better plan malaria vector control interventions.


Assuntos
Anopheles/classificação , Anopheles/parasitologia , Malária Falciparum/transmissão , Mosquitos Vetores/classificação , Animais , Benin/epidemiologia , Mordeduras e Picadas , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Comportamento Alimentar , Humanos , Malária Falciparum/epidemiologia , Mosquitos Vetores/parasitologia , Plasmodium falciparum , Reação em Cadeia da Polimerase , Estações do Ano , Esporozoítos
8.
Parasit Vectors ; 12(1): 198, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053094

RESUMO

BACKGROUND: More than 70 arboviruses have been identified in Australia and the transmission cycles of most are poorly understood. While there is an extensive list of arthropods from which these viruses have been recovered, far less is known about the non-human hosts that may be involved in the transmission cycles of these viruses and the relative roles of different mosquito species in cycles of transmission involving different hosts. Some of the highest rates of human infection with zoonotic arboviruses, such as Ross River (RRV) and Barmah Forest (BFV) viruses, occur in coastal regions of north-eastern Australia. METHODS: Engorged mosquitoes collected as a part of routine surveillance using CO2-baited light traps in the Rockhampton Region and the adjoining Shire of Livingstone in central Queensland, north-eastern Australia, were analysed for the source of their blood meal. A 457 or 623 nucleotide region of the cytochrome b gene in the blood was amplified by PCR and the amplicons sequenced. The origin of the blood was identified by comparing the sequences obtained with those in GenBank®. RESULTS: The most common hosts for the mosquitoes sampled were domestic cattle (26/54) and wild birds (14/54). Humans (2/54) were an infrequent host for this range of mosquitoes that are known to transmit arboviruses causing human disease, and in an area where infections with human pathogens like RRV and BFV are commonly recorded. The blood meals identified in the most abundant vector analysed, Culex annulirostris, were from 10 different vertebrate hosts. The notable detection of chimpanzee blood in two mosquitoes, presumably obtained from a nearby zoo, extends the known range of hosts for this species. Culex quinquefasciatus and Cx. sitiens fed almost exclusively on a variety of bird species. CONCLUSIONS: While human-mosquito-human transmission of arboviruses like RRV can occur, this study highlights the potential importance of zoonotic cycles of transmission, including avian species, of arboviruses that are indigenous to Australia. Further studies on larger samples of blood-engorged mosquitoes are required to validate the trends observed herein. Moreover, serological and virological evidence that the hosts on which the mosquitoes are feeding are being infected with arboviruses of interest are required.


Assuntos
Mordeduras e Picadas/sangue , Mordeduras e Picadas/veterinária , Culicidae/fisiologia , Especificidade de Hospedeiro , Mosquitos Vetores/fisiologia , Animais , Arbovirus/classificação , Arbovirus/genética , Arbovirus/isolamento & purificação , Austrália , Aves , Mordeduras e Picadas/parasitologia , Bovinos , Culicidae/classificação , Culicidae/virologia , Comportamento Alimentar , Feminino , Humanos , Masculino , Mosquitos Vetores/classificação , Mosquitos Vetores/virologia , Pan troglodytes
9.
Parasit Vectors ; 12(1): 242, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101131

RESUMO

BACKGROUND: In the Amazon Basin, Nyssorhynchus (Anopheles) darlingi is the most aggressive and effective malaria vector. In endemic areas, behavioral aspects of anopheline vectors such as host preference, biting time and resting location post blood meal have a key impact on malaria transmission dynamics and vector control interventions. Nyssorhynchus darlingi presents a range of feeding and resting behaviors throughout its broad distribution. METHODS: To investigate the genetic diversity related to biting behavior, we collected host-seeking Ny. darlingi in two settlement types in Acre, Brazil: Granada (~ 20-year-old, more established, better access by road, few malaria cases) and Remansinho (~ 8-year-old, active logging, poor road access, high numbers malaria cases). Mosquitoes were classified by the location of collection (indoors or outdoors) and time (dusk or dawn). RESULTS: Genome-wide SNPs, used to assess the degree of genetic divergence and population structure, identified non-random distributions of individuals in the PCA for both location and time analyses. Although genetic diversity related to behavior was confirmed by non-model-based analyses and FST values, model-based STRUCTURE detected considerable admixture of these populations. CONCLUSIONS: To our knowledge, this is the first study to detect genetic markers associated with biting behavior in Ny. darlingi. Additional ecological and genomic studies may help to understand the genetic basis of mosquito behavior and address appropriate surveillance and vector control.


Assuntos
Anopheles/genética , Mordeduras e Picadas , Comportamento Alimentar , Variação Genética , Animais , Brasil , Ecologia , Feminino , Genoma de Inseto , Genótipo , Geografia , Masculino , Controle de Mosquitos , Polimorfismo de Nucleotídeo Único
10.
Indian Pediatr ; 56(4): 329-330, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31064906

RESUMO

The prevalence of poisoning and bites was 0.76% (48/6308) and 1.24% (78/6308), respectively in a community-based survey in Ujjain district, Madhya Pradesh. Household cleansing agents and medicines, and-dog bite and bee-sting were the most common poisons and bites, respectively. Most parents (59%) reported lack of appropriate first-aid knowledge. Educational interventions and implementing the medicine take-back program are suggested.


Assuntos
Mordeduras e Picadas/epidemiologia , Envenenamento/epidemiologia , Adolescente , Animais , Abelhas , Criança , Pré-Escolar , Estudos Transversais , Cães , Feminino , Produtos Domésticos/envenenamento , Humanos , Índia/epidemiologia , Lactente , Masculino , Pobreza , Prevalência
11.
Wilderness Environ Med ; 30(2): 177-185, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31036376

RESUMO

INTRODUCTION: The Northern Territory is sparsely populated with a distinctive climate, geography, and wildlife compared with other states and territories in Australia. Environmental deaths (including drowning, heat-related deaths or environmental exposure, fatal animal attacks or envenomation, and lightning deaths) are reportable to the Northern Territory coroner for further investigation. METHODS: Databases of the Northern Territory coroner's office and the Royal Darwin Hospital Forensic Pathology Unit were searched to identify all environmental deaths over a 15-y period (July 1, 2003-June 30, 2018). RESULTS: A total of 4535 cases were reported to the Northern Territory coroner's office during the studied period, of which 167 (4%) were environmental deaths. Drowning was the most common type of environmental death, followed by heat-related deaths and fatal crocodile attacks. Deaths resulting from lightning and animals other than crocodiles are rare. Local resident, male victims in rural locations were the most commonly affected. Alcohol intoxication played a role in about one-third of cases, and in approximately one-third of cases a known underlying medical condition was identified. CONCLUSIONS: The Northern Territory has a challenging environment that is hot, humid, remote, and isolated. Circumstantial information and thorough police investigations are essential in the medicolegal investigation of environmental deaths.


Assuntos
Acidentes/mortalidade , Jacarés e Crocodilos , Mordeduras e Picadas/mortalidade , Adolescente , Adulto , Intoxicação Alcoólica , Animais , Afogamento/mortalidade , Feminino , Transtornos de Estresse por Calor/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Northern Territory/epidemiologia
12.
Malar J ; 18(1): 167, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31072344

RESUMO

BACKGROUND: Malaria prevention in Cameroon mainly relies on the use of ITNs. Although several free distribution campaigns of treated nets have been conducted across the country, bed net usage remains very low. A household survey was conducted to assess knowledge of the population and practices affecting treated net usage in the city of Yaoundé. METHODS: A community-based descriptive cross-sectional survey was conducted in January 2017 in 32 districts of the city of Yaoundé. Parents (household head, spouse or an elder representative) who consented to the study, were interviewed using a structured pre-tested questionnaire. Interviews were conducted in French or English. A questionnaire consisting of 22 questions was administered to know (i) people's knowledge and attitude on preventive measures; and, (ii) attitudes concerning the treatment of malaria and estimated amount spent for malaria prevention and treatment. RESULTS: A total of 1643 household heads were interviewed. Over 94% of people interviewed associated malaria transmission to mosquito bites. The main methods used against mosquito bites were: treated bed nets (94%; n = 1526) and insecticide spray or coils (32.2%; n = 523). The majority of people interviewed reported using bed nets mainly to prevent from mosquito bites (84.4%, n = 1257), rather than for malaria prevention (47.3%). Knowledge and attitude analysis revealed that people with university or secondary level of education have better knowledge of malaria, prevention and treatment measures compared to those with the primary level (OR = 7.03; P < 0.001). Also, wealthy households were more aware of good practices concerning malaria prevention and treatment compared to poor ones. In the majority of districts of Yaoundé, over 50% of people interviewed per district, had good knowledge of malaria and prevention measures but less than 50% applied good practices concerning malaria treatment and prevention. The amount spent annually by a household for vector control was CFAF 11,589 ± 1133 (US$21.87 ± 2.14) and CFAF 66,403 ± 4012 (US$125.29 ± 7.57) for malaria treatment. CONCLUSION: The study indicated that, despite good knowledge of malaria and prevention measures, few people apply good practices. More sensitization needs to be done to improve adherence to good practices concerning malaria prevention and treatment.


Assuntos
Mordeduras e Picadas/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Malária/prevenção & controle , Controle de Mosquitos/métodos , População Urbana , Adolescente , Adulto , Camarões/epidemiologia , Cidades/epidemiologia , Estudos Transversais , Características da Família , Feminino , Humanos , Mosquiteiros Tratados com Inseticida/estatística & dados numéricos , Malária/epidemiologia , Masculino , Pessoa de Meia-Idade , Controle de Mosquitos/economia , Inquéritos e Questionários , Adulto Jovem
13.
J Forensic Leg Med ; 65: 9-14, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31029004

RESUMO

BACKGROUND: There is sparse literature regarding K-9 (legal intervention) dog bites. It was the purpose of this study to analyze the demographics of K-9 dog bites using a national data base. METHODS: This was a retrospective study of prospectively collected data from National Electronic Injury Surveillance System - All Injury Program for years 2005-2013. Patients with dog bites were identified and those due to legal intervention were analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software. A p < 0.05 was considered statistically significant. RESULTS: There were an estimated 32, 951 K-9 dog bite ED visits, accounting for 1.1% of all ED dog bite visits. The K-9 group was nearly all male (95.0 vs 52.1%) and more commonly Black (42.0 vs 13.0%) compared to the non K-9 group. Bites to the head/neck and upper extremity were less frequent and lower extremity bites more frequent in the K-9 group; K-9 bites more commonly occurred outside the home. Within the K-9 group, the proportion of White patients increased with increasing age and smaller hospital size. Patients seen in small and medium size hospitals were in the middle age ranges, while those in the very young and >64 years of age were only seen at large hospitals. The average annual incidence of K-9 dog bites seen in the ED for US was 2.43 per 100,000 males with no changes over time. CONCLUSIONS: In the US, 1.1% of all ED visits for dog bites are due to K-9 intervention with no change in incidence, even though this study spanned the time when it was encouraged to change K-9 intervention; from "find and bite" to "find and bark". The K-9 dog bite patient is nearly always male, more commonly Black, occurred away from home, and has a 3.7% hospital admission rate. Bites to the head/neck are less common compared to the non K-9 dog bite group.


Assuntos
Mordeduras e Picadas/epidemiologia , Cães , Polícia , Adolescente , Adulto , Distribuição por Idade , Animais , Grupos de Populações Continentais/estatística & dados numéricos , Bases de Dados Factuais , Serviço Hospitalar de Emergência , Feminino , Tamanho das Instituições de Saúde/estatística & dados numéricos , Humanos , Incidência , Extremidade Inferior/lesões , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Distribuição por Sexo , Estados Unidos/epidemiologia , Adulto Jovem
14.
Rev Med Suisse ; 15(646): 780-785, 2019 Apr 10.
Artigo em Francês | MEDLINE | ID: mdl-30969491

RESUMO

Animal and human bites are a common cause of admission to the emergency room and the infections are common, although they are often trivialized. Complications can range from simple cellulitis to septic shock especially in asplenic patients with Capnoyctophaga canimorsus infection. Other less common infections are possible such as rat-bite fever, leptospirosis, tularemia, and evaluation of post-exposure prophylaxis (anti-tetanus, anti-rabies, HIV, HBV) is essential. Antibiotic prophylaxis remains controversial but is recommended for certain groups of patients and must cover common bite pathogens.


Assuntos
Mordeduras e Picadas , Mordeduras Humanas , Raiva , Tétano , Animais , Humanos , Profilaxia Pós-Exposição , Raiva/prevenção & controle , Tétano/prevenção & controle
15.
BMC Infect Dis ; 19(1): 324, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30987580

RESUMO

BACKGROUND: After antibiotic treatment of Lyme borreliosis, a subset of patients report persistent symptoms, also referred to as post-treatment Lyme disease syndrome. The reported prevalence of persistent symptoms varies considerably, and its pathophysiology is under debate. The LymeProspect study has been designed to investigate the prevalence, severity, and a wide range of hypotheses on the etiology of persistent symptoms among patients treated for Lyme borreliosis in the Netherlands. METHODS: LymeProspect is a prospective, observational cohort study among adults with proven or probable Lyme borreliosis, either erythema migrans or disseminated manifestations, included at the start of antibiotic treatment. During one year of follow-up, participants are subjected to questionnaires every three months and blood is collected repeatedly during the first three months. The primary outcome is the prevalence of persistent symptoms after treatment, assessed by questionnaires online focusing on fatigue (CIS, subscale fatigue severity), pain (SF-36, subscale pain) and neurocognitive dysfunction (CFQ). Potential microbiological, immunological, genetic, epidemiological and cognitive-behavioral determinants for persistent symptoms are secondary outcome measures. Control cohorts include patients with long-lasting symptoms and unconfirmed Lyme disease, population controls, and subjects having reported a tick bite not followed by Lyme borreliosis. DISCUSSION: This article describes the background and design of the LymeProspect study protocol. This study is characterized by a prospective, explorative and multifaceted design. The results of this study will provide insights into the prevalence and determinants of persistent symptoms after treatment for Lyme borreliosis, and may provide a rationale for preventive and treatment recommendations. TRIAL REGISTRATION: NTR4998 (Netherlands Trial Register). Date of registration: 13 February 2015.


Assuntos
Doença de Lyme/tratamento farmacológico , Doença de Lyme/epidemiologia , Adulto , Idoso , Animais , Antibacterianos/uso terapêutico , Mordeduras e Picadas/complicações , Protocolos Clínicos , Estudos de Coortes , Eritema Migrans Crônico/tratamento farmacológico , Eritema Migrans Crônico/epidemiologia , Eritema Migrans Crônico/etiologia , Fadiga/etiologia , Humanos , Doença de Lyme/etiologia , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prevalência , Estudos Prospectivos , Inquéritos e Questionários , Carrapatos
17.
PLoS Negl Trop Dis ; 13(4): e0007234, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30933979

RESUMO

BACKGROUND: Standard human landing catches (sHLCs) have historically been a key component of Onchocerca volvulus transmission monitoring, but expose health-workers to potentially hazardous vector bites. Novel human-bait-free trapping methods have been developed, but do not always work where they are needed and may not generate O. volvulus surveillance data that is directly comparable with historic data. METHODOLOGY: Simuliid sHLCs and mineral-oil protected HLCs (mopHLCs) were performed in a rural village of Amazonas state, Brazil. A four-hour direct comparisons of sHLCs and mopHLCs was carried-out using six vector collectors, each of whom used one leg for a sHLC and one for a mopHLC. Two-person collection teams then exclusively performed either mopHLCs or sHLCs for a further set of 12 four-hour collections. Following the completion of all collections, simuliid-bite mark estimates were made from legs used exclusively in sHLCs and legs used exclusively in mopHLCs. PRINCIPAL FINDINGS: All of the 1669 captured simuliids were identified as the O. volvulus vector Simulium oyapockense. Overall, mopHLC simuliids captured per hour (S/H) rates were lower than those obtained with sHLC trapping (15.5 S/H versus 20 S/H). Direct comparisons of simuliid capture rates found that vector-collectors captured simuliids significantly more efficiently ([Formula: see text]: 20.5 S/H) with mopHLC trapping than with sHLC trapping ([Formula: see text]: 16.4 S/H): P-value = 0.002. MopHLCs performed in isolation were, however, observed to capture vectors less efficiently ([Formula: see text]: 13.4 S/H) than sHLCs performed under similar conditions ([Formula: see text]: 19.98 S/H). All six vector collectors had significantly higher simuliid capture per counted bite mark (SC/CBM) rates using mopHLCs than they were observe to have using sHLCs ([Formula: see text]: 21 SC/CBM versus [Formula: see text]: 1 SC/CBM; p-value = 0.03125). CONCLUSIONS: Vector collectors captured significantly more simuliids per counted bite mark with mopHLCs than with sHLCs. Further investigations into the utility of mopHLCs for onchocerciasis xenomonitoring and beyond are merited.


Assuntos
Mordeduras e Picadas/prevenção & controle , Insetos Vetores , Óleo Mineral/administração & dosagem , Oncocercose/prevenção & controle , Simuliidae , Pele/efeitos dos fármacos , Administração Tópica , Animais , Brasil , Pessoal de Saúde , Humanos , Insetos Vetores/parasitologia , Onchocerca volvulus , Oncocercose/transmissão , População Rural , Simuliidae/parasitologia
18.
PLoS Negl Trop Dis ; 13(4): e0007305, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30933984

RESUMO

Rabies remains a disease of significant zoonotic and economic concern in rabies endemic areas of Bhutan. Rabies outbreaks in livestock threaten the livelihoods of subsistence farming communities and pose a potential public health threat. As a part of identifying approaches to prevent rabies in cattle, a Knowledge, Attitude, and Practice (KAP) survey was conducted among cattle owners in selected rural areas of the southern rabies high-risk zone and low-risk zone in eastern Bhutan. Between March and April 2017, 562 cattle owners (281 in the east and 281 in the south) were interviewed using a questionnaire. Eighty-eight percent of the participants had heard of rabies but only 39% of the participants who had heard of rabies had adequate knowledge about rabies. Multivariable logistic regression analysis showed that residing in the south [OR = 9.25 (95% CI: 6.01-14.53)] and having seen a rabies case [OR = 2.46 (95% CI: 1.6-3.82)] were significantly associated with having adequate knowledge about rabies. Based on our scoring criteria, 65% of the total participants who had heard of rabies had a favorable attitude towards rabies control and prevention programs. The participants residing in the east were two times more likely to have a favourable attitude than their counterparts in the south [OR = 2.08 (95% CI: 1.43-3.05)]. More than 70% of the participants reported engaging in farm activities such as examining the oral cavity of sick cattle and assisting cattle during parturition. Only 25% of the participants reported using personal protective equipment while undertaking these activities. Despite a high level of rabies awareness, we observed that there is a lack of comprehensive knowledge about rabies regarding susceptible hosts, transmission routes, the health outcome of rabies infection in humans, and appropriate health-seeking behaviours. This study highlights the need to strengthen rabies education programs in rural communities to address the knowledge gaps that have been identified.


Assuntos
Doenças dos Bovinos/prevenção & controle , Surtos de Doenças/veterinária , Fazendeiros , Conhecimentos, Atitudes e Prática em Saúde , Raiva/veterinária , Zoonoses/prevenção & controle , Adolescente , Adulto , Animais , Conscientização , Butão/epidemiologia , Mordeduras e Picadas , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/virologia , Estudos Transversais , Surtos de Doenças/prevenção & controle , Fazendas , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Raiva/epidemiologia , Raiva/prevenção & controle , População Rural/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem , Zoonoses/epidemiologia , Zoonoses/virologia
19.
San Salvador; s.n; abr. 2019. 67 p. ilus, tab, graf.
Tese em Espanhol | LILACS | ID: biblio-1007162

RESUMO

OBJETIVO: Determinar la caracterización clínica y epidemiológica de los pacientes pediátricos con mordeduras de perros, Hospital Nacional de Niños Benjamín Bloom, San Salvador, El Salvador, 2016-2017. METODOLOGÍA: Estudio descriptivo, retrospectivo. La información fue obtenida por medio de los sistemas de información del Simmow y Vigepes de los 244 pacientes que cumplieron los criterios de inclusión en los años 2016-2017, se diseñó un formulario para la recolección de los sistemas de información y se almacenó en una matriz que facilito el análisis del estudio. RESULTADOS: El 44% de los pacientes fueron niños entre los 1-5 años y 39% entre 5-9 años; el 55% fueron del sexo masculino, el 79% eran del área urbana; un 76% de las mordidas ocurrieron en la casa y los meses en los cuales las lesiones fueron más frecuentes febrero y marzo con 14% respectivamente. El 72% de las mordeduras fue catalogado como grave, 59% ocurrió en la cara; el 85% fueron perros conocidos y 72% de éstos no fueron provocados. Un 67% de perros estaban vacunados. 58% recibieron tratamiento con suero antirrábico y vacuna, el 99% fueron referidos a las UCSF para seguir el tratamiento y el 100% egreso vivo del hospital. CONCLUSIONES: La mayoría de pacientes mordidos por perro, fueron niños menores de 9 años, especialmente entre las edades de 1-5 años, el perro era conocido y pertenecía a la casa y la mayoría de las lesiones fueron graves, ya que ocurrieron en la cara y la cabeza


Assuntos
Humanos , Criança , Mordeduras e Picadas , Escala de Gravidade do Ferimento , Cães , Epidemiologia Descritiva , Estudos Retrospectivos , Administração em Saúde
20.
BMC Infect Dis ; 19(1): 321, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975098

RESUMO

BACKGROUND: Rabies remains a major public health problem in developing countries. Most fatal rabies cases, especially in children, result from dog bites and occur in low-income countries, such as those in Sub-Saharan Africa. Rabies can be controlled through mass dog vaccination and human deaths prevented through timely and appropriate post-exposure prophylaxis (PEP). As access to appropriate PEP remains a serious challenge for bite-victims, the aim of this study was to understand the use of PEP, to evaluate the knowledge, attitudes and practices with respect to rabies and to identify risk factors related to non-compliance with PEP to define recommendations for improving PEP in Senegal. METHODS: This study included patients with suspicion of rabies exposure who sought PEP at the Pasteur Institute of Dakar from April 2013 to March 2014. Patients with rabies clinical symptoms, those who had already started PEP and those with exposure outside Senegal or for more than 3 months were excluded. Data on risk factors and propensity to seek and complete PEP were collected using questionnaires and phone interviews. The association between acceptability and compliance with PEP and other independent variables were evaluated using multivariate regression analysis. RESULTS: Among the 905 patients enrolled into the study, 67% were male (sex ratio M/F, 2) and 46%, children under 15 years of age. Exposures by animal bites represented 87%, whereas the remainder were due to scratches or contact; 76% were classified as WHO category III and 88% were due to dogs. Among these patients, 7% refused to start PEP and 54.5% completed the full schedule. Main factors reported by non-compliant patients were vaccine costs and affordability, and knowledge on status of biting animal. CONCLUSION: This study shows that despite the awareness about rabies dangers and prevention, only half of the patients completed the full PEP schedule. The following recommendations, such as free of charge prophylaxis or intradermal regimens as an alternative to intramuscular regimens, should be considered to increase the adherence to PEP at the Pasteur Institute of Dakar and in Senegal.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Profilaxia Pós-Exposição , Vacinas Antirrábicas/uso terapêutico , Raiva/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Mordeduras e Picadas , Criança , Pré-Escolar , Estudos de Coortes , Custos e Análise de Custo , Países em Desenvolvimento , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Profilaxia Pós-Exposição/métodos , Profilaxia Pós-Exposição/tendências , Estudos Prospectivos , Vacinas Antirrábicas/economia , Fatores de Risco , Senegal , Adulto Jovem
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