Risk factors associated with Dengue fever outbreak in Islamabad, Pakistan (Preprint)

2021 ◽  
Author(s):  
Chaudhry Amjad Mehmood ◽  
Fawad Khalid Khan ◽  
Zakir Hussain ◽  
Mumtaz Ali Laghari ◽  
Ambreen Chaudhry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Attack Rate ◽  
Disease Surveillance ◽  
Signs And Symptoms ◽  
Open Water ◽  
Bed Nets ◽  
Stagnant Water ◽  
Blood Samples ◽  
Active Case

BACKGROUND On 23rd Oct 2016, 79 dengue fever cases were reported from the Union Council (UC) Tarlai to Federal Disease Surveillance and Response Unit Islamabad. A team was deputed to investigate the suspected dengue outbreak. OBJECTIVE This study was aimed to determine the extent of the outbreak and identify the possible risk factors. METHODS Active case finding was conducted through a house-to-house survey. A case was defined as, acute onset of Fever ≥ 38 ℃ in a resident of Tarlai from Oct 2-Nov 11, 2016, with a positive NS-1 test, and any two of the following signs and symptoms; retro-orbital/ocular pain, headache, rash, myalgia, arthralgia, and hemorrhagic manifestations. A structured questionnaire was used to collect data. Age and sex-matched controls (1:1) were identified from the same area. Blood samples were taken and sent to the National Institute of Health for genotype identification. RESULTS During the active case search, 145 cases of dengue fever were identified by surveying 928 houses from 23rd Oct to 11th Nov 2016. Attack rate (AR) was 17.0/10,000 population. The mean age was 34.4±14.4 years. More than half of the cases were male (n=80, 55.2%). Among all cases, 29% belong to the 25-34 years age group while the highest attack rate was found in 35-44 years (AR 35.6/10,000) followed by 55-64 years (AR 35.5/10,000). All five blood samples tested positive for NS-1 (genotype DENV-2). The most frequent presenting sin/symptom was fever and headache (100%). Stagnant water around houses (OR = 4.86, CI: 2.94 -8.01, P<0.0001), presence of flower pots in-home (OR = 2.73, CI: 1.67-4.45, P<0.0001), and open water container (OR 2.24, CI: 1.36-3.60, P<0.0001) showed higher odds among cases. While. use of bed nets (OR 0.44, CI: 0.25-0.77, P 0.003), insecticidal spray (OR 0.33, CI: 0.22-0.55, P<0.0001), door screening (OR 0.27, CI: 0.15-0.46, P<0.0001), use of mosquito coil/mat (OR 0.26, CI: 0.16-0.44, P<0.0001) and cleanliness in house (OR 0.12, CI: 0.05-0.26, P<0.0001) showed a significant protective effect. CONCLUSIONS Stagnant water acting as breeding grounds for vector was the probable cause of the spread of the outbreak. The establishment of a surveillance and early reporting system and the use of protective measures against the vector is strongly recommended.

scholarly journals 59Outbreak investigation of dengue fever in union council (UC) Bharakahu, Islamabad, Pakistan, 2019

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Sajjad Ahmad Khan Sajjad Khan
Keyword(s):  
Dengue Fever ◽  
Attack Rate ◽  
Health Workers ◽  
Nonstructural Protein ◽  
Health Department ◽  
Control Measures ◽  
Stagnant Water ◽  
Blood Samples ◽  
Breeding Sites ◽  
Nonstructural Protein 1

Abstract Background During third week of September 2019, lady health workers reported twelve suspected cases of dengue fever from UC Bharakahu, Islamabad (population 70,000) to health department. Outbreak investigation conducted with objectives to determine risk factors and recommend control measures. Methods Investigation conducted from 20th September to 04th November 2019. Case was defined as any resident of UC Bharakahu with fever and two or more of following signs/symptoms; headache, retro-orbital pain, arthralgia, myalgia, petechial rash with NS1 (Nonstructural Protein 1) positive during 12th August to 18th November 2019. Age and sex matched healthy controls recruited from same neighborhood. Blood samples from seven suspected cases sent for laboratory confirmation. Results Total 993 houses surveyed and 113 cases identified. Mean age was 34.2 years (range 13-90 years). Most affected age group was 35-44 years (Attack Rate 0.78%), Overall attack rate was 0.15%. Males were predominantly involved n = 70 (62%). Out of total cases, 34 (70%) had stagnant water inside and around houses (OR 2.0, CI 1.06-3.75, p &lt; 0.005), 40 (35%) used repellent lotions (OR 0.55, CI 0.32-0.95, p &lt; 0.05), 34 (30%) used insecticide spray (OR 0.35, CI 0.20-0.61, p &lt; 0.05), 97 (86%) used full protective clothing (OR 0.22, CI 0.07-0.68, p &lt; 0.05). All seven blood samples tested positive for NS-1 Ag. Conclusion Presence of stagnant rain water inside and around houses acted as breeding grounds for aedes aegypti mosquitoes and was most probable cause of outbreak. Following our recommendations, health department initiated mosquito breeding sites control activities through insecticide residual spray and advocacy on use of protective measures against mosquito bites. Key words Outbreak, dengue, stagnant water, Bhara Kahu, Islamabad, 2019

scholarly journals A Prospective Study of Lymphatic Filariasis in an Endemic Village of Kapilbastu District, Nepal

2009 ◽  
Vol 13 ◽  
pp. 29-34
Author(s):  
R. Gupta ◽  
J. Lanichhane
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Lymphatic Filariasis ◽  
Health Problem ◽  
Bed Nets ◽  
Age Group ◽  
Blood Samples ◽  
Late Night ◽  
A Prospective Study ◽  
Epidemiological Situation

Lymphatic filariasis is a major problems health problem in Nepal. A prospective study was conducted in Maharajgunj VDC, Kapilbastu district, Nepal with the objective to analyze the epidemiological situation of the disease lymphatic filariasis. A total of 505 blood samples were collected by ear-lobe prick method.Out of 505 blood samples, 50 samples (9.90%) were found to be positive for microfilaria (mf) within age between 3 to 85 years. In the present study the highest endemicity rate was found in the age group 61-70 years and the lowest  endemicity rate 6.67% was found in the age group < = 10 years. Illiteracy, poor sanitation , lack of knowledge about the disease and not taking precaution of filariasis , habit of working in the fields till late night and early in the morning, sleeping outdoor without bed-nets, keeping cattle in the same house where they live were identified as risk factors for the disease.Key words: Prevalence; Lymphatic filariasis; Microfilaria; Crude disease rate.doi: 10.3126/eco.v13i0.1626Ecoprint (An International Journal of Ecology)  Vol. 13, No. 1, 2006 Page: 29-34

scholarly journals Risk Factors of Dengue Fever Outbreak in Karo District, North Sumatera, Indonesia

2019 ◽  
Vol 5 (1) ◽  
pp. 16-22
Author(s):  
Frans Yosep Sitepu
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Significant Risk ◽  
Public Health Problem ◽  
Signs And Symptoms ◽  
Control Measures ◽  
Breeding Sites ◽  
Mosquito Breeding

Dengue fever (DF) infection continues to present a seriuos public health problem in North Sumatera, Indonesia. A DF outbreak was reported in Merek Sub-district, Karo District which is one tourist destination in North Sumatera during April-May 2017. An epidemiological investigation was conducted to identify the risk factors and recommend control measures. An observational study with a matched case control design was conducted. A case was defined as any resident of Merek sub-district who had suffer major clinical symptoms of DF such as fever, severe headache, pain behind eyes, muscle and joint pains, and rash from April – May, 2017. A control was defined as neighbors of cases who did not have clinical signs and symptoms of DF and were matched for age and sex. We interviewed 37 cases and 37 controls. Age cases ranged from 2 year to 37 years (median= 12 years). The multivariate analyses showed that presence of mosquito breeding sites (OR=4.87, 95%CI=1.33-17.85) and habit of hanging worn clothes (OR=5.12, 95%CI=1.25-21.03) were significant risk factors. It is recommended to eliminate mosquito breeding sites routinely, avoid habit of hanging worn clothes, and conduct strict surveillance of DF continously.

scholarly journals Knowledge, attitude and practice regarding dengue infection among parents of children hospitalized for dengue fever

2018 ◽  
Vol 5 (3) ◽  
pp. 893 ◽  
Author(s):  
Srinivasa S. ◽  
Harish S. ◽  
Shruthi Patel ◽  
Ranganatha A. Devaranavadagi ◽  
Bhavya G. ◽  
...  
Keyword(s):  
Dengue Fever ◽  
Severe Disease ◽  
Dengue Infection ◽  
Signs And Symptoms ◽  
Bed Nets ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Preventive Practices ◽  
Health Care Burden ◽  
And Behavior

Background: Dengue fever is a rapidly emergent infection and is one of the leading causes of hospitalization and health care burden in India. Dengue vectors, human knowledge and behavior have each been reported to play an important role in the transmission of the disease. This study is aimed at assessing the knowledge regarding dengue fever, its transmission, identification of the disease and its complications and its preventive measures among the parents.Methods: This is a hospital based cross sectional survey among parents of dengue patients admitted in Department of Pediatrics, KIMS Bangalore during a period of 6 months. Parents were interviewed with pre-designed questionnaire. The questionnaire was divided into 4 parts-knowledge on 1) transmission, 2) signs and symptoms, 3) attitude towards the illness and 4) practices of prevention and treatment.Results: Overall 195 individuals were interviewed. 7% were illiterate while 17% had a college degree. 91% individuals knew mosquito as the vector, 32% identified clear stagnant water as the breeding place. 88% identified fever as a symptom while 22% knew about bleeding manifestations. 71% felt dengue as a severe disease and 84% had a positive attitude towards consulting a doctor for the illness. 58% relied on mats and coils for personal protection followed by bed nets (12%). Majority of the awareness was through television followed by radio and newspapers.Conclusions: It is of utmost significance to identify barriers to action and to seek ways to translate the knowledge of population about dengue into positive preventive practices that would ultimately reduce the transmission of dengue fever in the community.

scholarly journals Risk Factors for Chikungunya Virus Outbreak in Somali Region of Ethiopia, 2019: Unmatched Case-Control Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mikias Alayu ◽  
Tesfalem Teshome ◽  
Hiwot Amare ◽  
Solomon Kinde ◽  
Desalegn Belay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chikungunya Virus ◽  
Case Control Study ◽  
Signs And Symptoms ◽  
Open Water ◽  
Case Control ◽  
The Family ◽  
Water Holding ◽  
Control Study ◽  
Full Body

Background. Chikungunya virus is a ribonucleic acid (RNA) virus transmitted by a mosquito bite. Chikungunya virus outbreaks are characterized by rapid spread, and the disease manifests as acute fever. This study aimed at determining risk factors for chikungunya virus outbreak to apply appropriate prevention and control measures. Methods. Unmatched case-control study was performed to identify risk factors of chikungunya outbreak in Somali region of Ethiopia in 2019. Cases and controls were enrolled with 1 : 2 ratio. All cases during the study period (74 cases) and 148 controls were included in the study. Bivariate and multivariable analyses were implemented. The serum samples were tested by real-time polymerase chain reaction at Ethiopian Public Health Institute Laboratory. Results. A total of 74 chikungunya fever cases were reported starting from 19th May 2019 to 8th June 2019. Not using bed net at daytime sleeping (adjusted odds ratio (AOR): 20.8; 95% confidence interval (CI): 6.4–66.7), presence of open water holding container (AOR: 4.0; CI: 1.2–3.5), presence of larvae in water holding container (AOR: 4.8; CI: 1.4–16.8), ill person with similar signs and symptoms in the family or neighbors (AOR: 27.9; CI: 6.5–120.4), and not wearing full body cover clothes (AOR: 8.1; CI: 2.2–30.1) were significant risk factors. Conclusion. Not using bed net at daytime sleeping, presence of open water holding container, presence of larvae in water holding container, ill person with similar signs and symptoms in the family or neighbors, and not wearing full body cover clothes are risk factors for chikungunya virus outbreak.

MEASLES OUTBREAK IN A RURAL AREA OF A DEVELOPING COUNTRY: A CASE CONTROL STUDY

2018 ◽  
Vol 7 (4) ◽  
pp. 197-201
Author(s):  
Mir M Hassan Bullo ◽  
Mirza Amir Baig ◽  
Jawad Faisal Malik ◽  
Ejaz Ahmad Khan ◽  
Muazam Abbas Ranjha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaccine Coverage ◽  
Significant Risk ◽  
Public Health Problem ◽  
Maculopapular Rash ◽  
Healthcare Facility ◽  
Control Measures ◽  
Major Public Health Problem ◽  
District Health ◽  
Active Case

Background: Measles is highly contagious vaccine preventable disease (VPD), and a major public health problem considered as leading cause of morbidity and mortality in developing countries like Pakistan. An outbreak of measles was reported in Sharifabad Islamabad on 15th of April 2017, and an investigation was launched to assess the magnitude of outbreak, evaluate risk factors and recommend control measures. Methods: A comprehensive house to house active case search along with vaccine coverage survey was conducted from April 19-22, 2017. A case was defined as "onset of maculopapular rash with fever in a resident of Sharifabad with at least one of the following signs/ symptoms, Coryza, Conjunctivitis, Cough, Otitis media or Pneumonia present in between 19 March to 22nd April 2017". Four age & sex matched controls were selected from the neighborhood. Data was collected through interview method using structured questionnaire and vaccination coverage was determined by using Epi survey form. Blood samples were sent for laboratory confirmation. Results: A total of eight cases were identified through active case finding while three were reported by local practitioner. Mean age of cases were 20 months (range 8-36 months). Severely affected age-group was 1-2 years with attack rate of 46%. Around two-third (64%) of cases and a few (16%) of controls were unvaccinated against measles. Contact with measles patient [OR 25.2, CI 3.9-160.1, P=0.00], unvaccinated children [OR 9.2 CI 2.12-40.4, P=0.000], social misconception regarding vaccination [OR 7.8 CI 1.42-42.6, P=0.00], and distance from healthcare facility [OR 5.7 CI 1.15-28.35, P=0.02] were significant risk factors. Vaccine efficacy was 90%. Conclusion: Main reasons of the outbreak were contact with the cases, and low vaccination status. We recommended comprehensive measles vaccination and community awareness sessions. On our recommendations district health authority Islamabad carried out mop up of whole area.

NEONATAL SEPSIS AND IDENTIFICATION OF RISK FACTORS: STUDY IN AVBRH HOSPITAL SAWANGI

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Pramod P. Singhavi
Keyword(s):  
Risk Factors ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Late Onset ◽  
Signs And Symptoms ◽  
Premature Rupture ◽  
Maternal Risk ◽  
Late Onset Sepsis ◽  
Early Onset Sepsis ◽  
Meconium Stained Amniotic Fluid

Introduction: India has the highest incidence of clinical sepsis i.e.17,000/ 1,00,000 live births. In Neonatal sepsis septicaemia, pneumonia, meningitis, osteomyelitis, arthritis and urinary tract infections can be included. Mortality in the neonatal period each year account for 41% (3.6 million) of all deaths in children under 5 years and most of these deaths occur in low income countries and about one million of these deaths are due to infectious causes including neonatal sepsis, meningitis, and pneumonia. In early onset neonatal sepsis (EOS) Clinical features are non-specific and are inefficient for identifying neonates with early-onset sepsis. Culture results take up to 48 hours and may give false-positive or low-yield results because of the antenatal antibiotic exposure. Reviews of risk factors has been used globally to guide the development of management guidelines for neonatal sepsis, and it is similarly recommended that such evidence be used to inform guideline development for management of neonatal sepsis. Material and Methods: This study was carried out using institution based cross section study . The total number neonates admitted in the hospital in given study period was 644, of which 234 were diagnosed for neonatal sepsis by the treating pediatrician based on the signs and symptoms during admission. The data was collected: Sociodemographic characteristics; maternal information; and neonatal information for neonatal sepsis like neonatal age on admission, sex, gestational age, birth weight, crying immediately at birth, and resuscitation at birth. Results: Out of 644 neonates admitted 234 (36.34%) were diagnosed for neonatal sepsis by the paediatrician based on the signs and symptoms during admission. Of the 234 neonates, 189 (80.77%) infants were in the age range of 0 to 7 days (Early onset sepsis) while 45 (19.23%) were aged between 8 and 28 days (Late onset sepsis). Male to female ratio in our study was 53.8% and 46% respectively. Out of total 126 male neonates 91(72.2%) were having early onset sepsis while 35 (27.8%) were late onset type. Out of total 108 female neonates 89(82.4%) were having early onset sepsis while 19 (17.6%) were late onset type. Maternal risk factors were identified in 103(57.2%) of early onset sepsis cases while in late onset sepsis cases were 11(20.4%). Foul smelling liquor in early onset sepsis and in late onset sepsis was 10(5.56%) and 2 (3.70%) respectively. In early onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 21(11.67%), 19 (10.56%), 20(11.11%) and 33 (18.33%) cases respectively. In late onset sepsis cases maternal UTI, Meconium stained amniotic fluid, Multipara and Premature rupture of membrane was seen in 2 (3.70%), 1(1.85%), 3 (5.56%) and 3 (5.56%) cases respectively. Conclusion: Maternal risk identification may help in the early identification and empirical antibiotic treatment in neonatal sepsis and thus mortality and morbidity can be reduced.

scholarly journals Path Analysis on Determinants of Childhood Obesity and Associated Risk Factors of Cardiovascular, Renal, and Hepatic Diseases: The CASPIAN-V Study

2020 ◽  
Vol 10 (01) ◽  
pp. e148-e158
Author(s):  
Vahid Mansouri ◽  
Marjan Mansourian ◽  
Mostafa Qorbani ◽  
Roya Riahi ◽  
Rahele Karimi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Childhood Obesity ◽  
Latent Variables ◽  
Mutual Influence ◽  
Risk Indicators ◽  
Noncommunicable Diseases ◽  
Surveillance Program ◽  
Predisposing Factor ◽  
Blood Samples ◽  
Hepatic Diseases

AbstractThe interaction between several lifestyle and obesogenic environmental factors is considered as the main underlying factor for the escalating trend of childhood obesity and its adverse consequences. In this study, we assessed the mutual influence of lifestyle habits and body mass index (BMI) as well as risk factors for cardiometabolic, hepatic, and renal disorders to define the causality power of each item. This nationwide cross-sectional study was conducted as the fifth round of a school-based surveillance program. Overall, 14,800 students living in Iran were studied, and blood samples were obtained from 4,200 of them. Demographic factors, anthropometric and biochemical measures were used to define lifestyle-related latent variables as well as cardiac, renal, and hepatic risk indicators. Total, direct, and indirect effects between factors were analyzed using the standardized regression weights for each pathway. Data from 14,274 students (participation rate of 99%) and 3,843 blood samples were included. All of the latent variables had a significant direct effect on BMI, with the most potent effect of unhealthy nutrition (β ≅ 0.63) in boys and girls. BMI has significant direct effects on risk indicators of cardiovascular, renal, and hepatic diseases with the most powerful effect on cardiovascular risk factors (β ≅  − 0.08). The most important predisposing factor for obesity was unhealthy nutrition, whereas increased activity, adequate sleep, and better hygiene had protective roles. BMI shows the strongest association with indicator of cardiovascular diseases. These findings underscore the importance of implementing public health programs for the prevention of chronic noncommunicable diseases.

scholarly journals Risk factors of dengue fever in an urban area in Vietnam: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thang Nguyen-Tien ◽  
Duy Cuong Do ◽  
Xuan Luat Le ◽  
Thi Hai Dinh ◽  
Mats Lindeborg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Prevention And Control ◽  
Case Control Study ◽  
Case Control ◽  
Younger Adults ◽  
The Mean ◽  
Dengue Prevention ◽  
And Control ◽  
Control Study

Abstract Background Dengue is a mosquito-borne flavivirus present in many metropolitan cities of tropical countries. Methods During and after the dengue season (September 2018 to January 2019), we conducted a case-control study in order to determine the risk factors for dengue fever in Hanoi city, Vietnam. 98 dengue patients and 99 patients with other acute infections, such as Hepatitis B virus infection, were recruited at Department of Infectious Disease of Bach Mai national hospital in Hanoi. Patients were interviewed using a structured questionnaire covering demographic, housing, environmental factors and knowledge, attitude, and practice on dengue prevention and control. Univariate analysis and multivariable logistic regression were used to determine the risk factors of dengue status. Results The mean score of knowledge items and practice items was only 7.9 out of total 19 points and 3.9 out of total 17 points, respectively. While the mean score of attitude items was 4.8 out of total 6 points. Multivariable logistic regression indicated that older patients had lesser risk of getting dengue infection as compared to younger adults aged 16–30, and patients living in peri-urban districts were less likely to suffer of dengue fever than patients living in central urban districts (OR = 0.31; 95% CI 0.13–0.75). This study could not find any association with occupation, water storage habit, knowledge, attitude, or practice on dengue prevention. Conclusions All patients had a relatively low level of knowledge and practice on dengue prevention and control. However, the attitude of the participants was good. We found that age group and living district were the risk factors correlated with the dengue status. Communication programs on raising dengue awareness should be repeated all year round and target particular groups of adolescents, younger adults, landlords and migrants from other provinces to improve their knowledge and encourage them to implement preventive measures against dengue fever.

scholarly journals The mortal cause of sudden ECG changes in patients with chronic aortic insufficiency: Aortic dissection

2019 ◽  
Vol 11 (1) ◽  
pp. 68-70
Author(s):  
Mahmut Yesin ◽  
Turgut Karabağ ◽  
Macit Kalçık ◽  
Süleyman Karakoyun ◽  
Metin Çağdaş ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Signs And Symptoms ◽  
Aortic Insufficiency ◽  
Ecg Changes ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment ◽  
High Index Of Suspicion

The symptoms of aortic dissection (AD) may be highly variable and may mimic other much common conditions. Thus, a high index of suspicion should be maintaned, especially when the risk factors for AD are present or signs and symptoms suggest this possibility. However, sometimes AD may be asymptomatic or progression may be subclinical. Various electrocardiographical (ECG) changes may be seen in AD patients such as ST segment elevation in aVR as well as ST segment depression and T-wave inversion. In this case report, we reported a patient with acute AD whose ECG revealed ST segment elevation in aVR lead in addition to diffuse ST segment depression in other leads.

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