scholarly journals Case‐Control Study of Risk Factors for Avian Influenza A (H5N1) Disease, Hong Kong, 1997

1999 ◽  
Vol 180 (2) ◽  
pp. 505-508 ◽  
Author(s):  
Anthony W. Mounts ◽  
Heston Kwong ◽  
Hector S. Izurieta ◽  
Yuk‐yin Ho ◽  
Tak‐kwong Au ◽  
...  
2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Lei Zhou ◽  
Ruiqi Ren ◽  
Jianming Ou ◽  
Min Kang ◽  
Xiaoxiao Wang ◽  
...  

Abstract Background.  Human infections with avian influenza A(H7N9) virus have been associated with exposure to poultry and live poultry markets (LPMs). We conducted a case-control study to identify additional and more specific risk factors. Methods.  Cases were laboratory-confirmed A(H7N9) infections in persons in China reported from October 1, 2014 to April 30, 2015. Poultry workers, those with insufficient data, and those refusing participation were excluded. We matched up to 4 controls per case by sex, age, and residential community. Using conditional logistic regression, we examined associations between A(H7N9) infection and potential risk factors. Results.  Eighty-five cases and 334 controls were enrolled with similar demographic characteristics. Increased risk of A(H7N9) infection was associated with the following: visiting LPMs (adjusted odds ratio [aOR], 6.3; 95% confidence interval [CI], 2.6–15.3), direct contact with live poultry in LPMs (aOR, 4.1; 95% CI, 1.1–15.6), stopping at a live poultry stall when visiting LPMs (aOR, 2.7; 95% CI, 1.1–6.9), raising backyard poultry at home (aOR, 7.7; 95% CI, 2.0–30.5), direct contact with backyard poultry (aOR, 4.9; 95% CI, 1.1–22.1), and having ≥1 chronic disease (aOR, 3.1; 95% CI, 1.5–6.5). Conclusions.  Our study identified raising backyard poultry at home as a risk factor for illness with A(H7N9), suggesting the need for enhanced avian influenza surveillance in rural areas.


2014 ◽  
Vol 143 (9) ◽  
pp. 1826-1832 ◽  
Author(s):  
J. LI ◽  
J. CHEN ◽  
G. YANG ◽  
Y. X. ZHENG ◽  
S. H. MAO ◽  
...  

SUMMARYThe first human infection with avian influenza A(H7N9) virus was reported in Shanghai, China in March 2013. An additional 32 cases of human H7N9 infection were identified in the following months from March to April 2013 in Shanghai. Here we conducted a case-control study of the patients with H7N9 infection (n = 25) using controls matched by age, sex, and residence to determine risk factors for H7N9 infection. Our findings suggest that chronic disease and frequency of visiting a live poultry market (>10 times, or 1–9 times during the 2 weeks before illness onset) were likely to be significantly associated with H7N9 infection, with the odds ratios being 4·07 [95% confidence interval (CI) 1·32–12·56], 10·61 (95% CI 1·85–60·74), and 3·76 (95% CI 1·31–10·79), respectively. Effective strategies for live poultry market control should be reinforced and ongoing education of the public is warranted to promote behavioural changes that can help to eliminate direct or indirect contact with influenza A(H7N9) virus.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e043487
Author(s):  
Hao Luo ◽  
Kui Kai Lau ◽  
Gloria H Y Wong ◽  
Wai-Chi Chan ◽  
Henry K F Mak ◽  
...  

IntroductionDementia is a group of disabling disorders that can be devastating for persons living with it and for their families. Data-informed decision-making strategies to identify individuals at high risk of dementia are essential to facilitate large-scale prevention and early intervention. This population-based case–control study aims to develop and validate a clinical algorithm for predicting dementia diagnosis, based on the cognitive footprint in personal and medical history.Methods and analysisWe will use territory-wide electronic health records from the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong between 1 January 2001 and 31 December 2018. All individuals who were at least 65 years old by the end of 2018 will be identified from CDARS. A random sample of control individuals who did not receive any diagnosis of dementia will be matched with those who did receive such a diagnosis by age, gender and index date with 1:1 ratio. Exposure to potential protective/risk factors will be included in both conventional logistic regression and machine-learning models. Established risk factors of interest will include diabetes mellitus, midlife hypertension, midlife obesity, depression, head injuries and low education. Exploratory risk factors will include vascular disease, infectious disease and medication. The prediction accuracy of several state-of-the-art machine-learning algorithms will be compared.Ethics and disseminationThis study was approved by Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW 18-225). Patients’ records are anonymised to protect privacy. Study results will be disseminated through peer-reviewed publications. Codes of the resulted dementia risk prediction algorithm will be made publicly available at the website of the Tools to Inform Policy: Chinese Communities’ Action in Response to Dementia project (https://www.tip-card.hku.hk/).


PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0119019 ◽  
Author(s):  
Mamoona Chaudhry ◽  
Hamad B. Rashid ◽  
Michael Thrusfield ◽  
Sue Welburn ◽  
Barend MdeC. Bronsvoort

2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.


2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background: While hospital-acquired influenza A results in an additional cost burden and considerable mortality in patients, its risk factors are unknown. We aimed to describe the characteristics of patients vulnerable to hospital-acquired influenza A and to identify its risk factors to assist clinicians control hospital-acquired infections and reduce the burden of treatment.Methods: A case-control study was conducted among hospitalized patients aged ≥18 years at a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient with no evidence of influenza A infection on admission. The controls without influenza A were selected among patients exposed to the same setting and time period. We identified risk factors using conditional logistic regression and described the characteristics of hospital-acquired influenza A by comparing the clinical data of infected patients and the controls.Results: Of the 412 hospitalized patients with influenza A from all the departments in the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%), and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002), and pleural effusion (26.9% vs 9.7%, P=0.002) than the matched controls. Infected patients also had longer hospital stays (18 days vs 14 days, P=0.002), and higher mortality rates (10.8% vs 2.2%, P=0.017) than the matched controls. Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P=0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P=0.027), and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P=0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion are independent risk factors that can help identify patients at high risk of hospital-acquired influenza A, which can extend hospital stay and is associated with a high mortality.


2020 ◽  
Author(s):  
Kui Yang ◽  
Ni Zhang ◽  
Chunchen Gao ◽  
Hongyan Qin ◽  
Anhui Wang ◽  
...  

Abstract Background: Hospital-acquired influenza A brings hospitalized patients an additional cost of care and considerable mortality, but risk factors for hospital-acquired influenza A are unknown. We aimed to describe the characteristics of patients vulnerable for hospital-acquired influenza A and to identify its risk factors. This knowledge would help clinicians to control hospital-acquired infection and reduce the burden of treatment.Methods: A case-control study was conducted in hospitalized patients aged ≥18 years in a tertiary level teaching hospital during the 2018–2019 influenza A season. Patient data were retrieved from hospital-based electronic medical records. Hospital-acquired influenza A was defined as a case of influenza A diagnosed 7 days or more after admission, in a patient who had no evidence of viral respiratory infection on admission. The controls without influenza were selected among patients exposed to the same setting during the same time period. We identified risk factors using conditional logistic regression and described characteristics of patients with hospital-acquired influenza A by comparing the clinical data of the influenza patients and the controls.Results: Of 412 hospitalized patients with influenza A from all departments of the study hospital, 93 (22.6%) cases were classified as hospital-acquired. The most common comorbidities of the 93 cases were hypertension (41.9%), coronary heart disease (21.5%) and cerebrovascular disease (20.4%). Before the onset of hospital-acquired influenza A, patients presented more lymphocytopenia (51.6% vs 35.5%, P=0.027), hypoalbuminemia (78.5% vs 57.0%, P=0.002) and pleural effusion (26.9% vs 9.7%, P=0.002) than matched controls. Notably, infected patients had a longer hospital stay (18 days vs 14 days, P=0.002), and higher mortality (10.8% vs 2.2%, P=0.017). Lymphocytopenia (odds ratio [OR]: 3.11; 95% confidence interval [CI]: 1.24–7.80; P =0.016), hypoalbuminemia (OR: 2.24; 95% CI: 1.10–4.57; P =0.027) and pleural effusion (OR: 3.09; 95% CI: 1.26–7.58; P =0.014) were independently associated with hospital-acquired influenza A.Conclusions: Lymphocytopenia, hypoalbuminemia and pleural effusion were independent risk factors that could help identify patients at high risk of hospital-acquired influenza A, which might extend hospital stay and is associated with a high mortality.


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