Outbreak of an acute aflatoxicosis in Tanzania during 2016

2018 ◽  
Vol 11 (3) ◽  
pp. 311-320 ◽  
Author(s):  
A. Kamala ◽  
C. Shirima ◽  
B. Jani ◽  
M. Bakari ◽  
H. Sillo ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Rate Ratio ◽  
Case Fatality Rate ◽  
Clinical Presentation ◽  
Case Fatality ◽  
Epidemiological Survey ◽  
Food Samples ◽  
Adduct Level ◽  
And Control

In June 2016, an outbreak of an unknown disease was reported to affect clusters of families in two regions of the central part of Tanzania. A rapid epidemiological survey was conducted in the affected villages, with a detailed house-to-house survey in selected households. A total of 68 cases occurred between 14 May and 14 November 2016, of which 20 died, making a case fatality rate of 30%. Over 50% of the cases were below the age of 15 years. The cases presented with jaundice (n=60), abdominal pain (n=59), vomiting (n=56), diarrhoea (n=34) and ascites (n=32). The responsible food item appeared to be home grown maize. The rate ratio indicated that the occurrence of illnesses was associated with ingestion of food contaminated with high levels of aflatoxins (contamination range: 10-51,100 μg/kg and 2.4-285 μg/kg for case and control households, respectively). Serum aflatoxin biomarker indicated that cases were more likely to have higher than 1000 pg/mg aflatoxin-albumin adduct level in their sera compared to controls (Odds Ratio = 13.5; 95% confidence intervals = 1.5-165.3; range of aflatoxin-albumin adduct level = 36- 32,800 pg/mg for cases and 10-4020 pg/mg for controls). Beside aflatoxins, maize samples were also contaminated with high levels of fumonisins (range of contamination; 945-12,630 μg/kg) with 8 of 10 samples analysed from case households co-contaminated with both toxins at levels above the maximum limit of 5 or 10 μg/kg set for AFB1or total aflatoxins and 2,000 μg/kg for fumonisins. Clinical presentation and high levels of aflatoxin in food samples coupled with high levels of serum aflatoxin-albumin adducts among the cases support the causal role of aflatoxins.

scholarly journals An epidemiological investigation of the 2019 suspected pertussis outbreak in northwestern Nigeria

2021 ◽  
Vol 9 ◽  
pp. 205031212110083
Author(s):  
Omoleke Semeeh ◽  
Biniam Getachew ◽  
Yusuf Taofik ◽  
Lukman Surajudeen ◽  
Assad Hassan ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Disease Transmission ◽  
Attack Rate ◽  
Odds Ratio ◽  
Case Fatality Rate ◽  
Adjusted Odds Ratio ◽  
Case Fatality ◽  
Immunization Coverage ◽  
Fatality Rate ◽  
Vaccine Preventable Diseases

Introduction: In 2019, we investigated the profile of the cases and controls and the determinants of pertussis transmission in Kebbi State, Northwestern Nigeria, to inform better immunization and surveillance strategies. Methods: Community-based unmatched case–control study and review of the 2019 pertussis routine surveillance data in the affected settlements in the state were conducted. A total of 52 suspected cases of pertussis and 107 control from two local government areas in Kebbi State were recruited. Data were analyzed using descriptive and inferential statistics. Results: The highest attack rate was observed among between 1- and 4-year age group followed by children less than 1-year old, and the least attack rate was among those above 15 years. The overall attack rate and the case fatality rate were 2.10% and 0.10%, respectively. A higher attack rate was observed among women, whereas the case fatality rate was more among males. From the community survey, we observed that the cases were less likely to have pertussis vaccination history (adjusted odds ratio = 0.28, 95% confidence interval = 0.11–0.74) compared with the controls. Knowing pertussis prevention methods were found protective for pertussis transmission (adjusted odds ratio = 0.14, 95% confidence interval = 0.04–0.45). Conclusion: This study showed the vulnerability of children under 5 years, especially under 1 year, to vaccine-preventable diseases in rural populations, where “real” immunization coverage is sub-optimal, and the dominant socio-demographic factors are supportive of disease transmission. We found immunization and knowledge of the preventive measures to be protective against pertussis outbreaks. Therefore, routine immunization services must be intensified to improve coverage and prevent future pertussis outbreak(s).

scholarly journals COVID-19: Spatial Analysis of Hospital Case-Fatality Rate in France

2020 ◽  
Author(s):  
Marc SOURIS ◽  
Jean-Paul Gonzalez
Keyword(s):  
International Organizations ◽  
Rate Ratio ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Healthcare Systems ◽  
Fatality Rate ◽  
Average Case ◽  
Hospital Case ◽  
Reporting Systems ◽  
Overall Efficiency

When the population risk factors and reporting systems are similar, the assessment of the case-fatality (or lethality) rate (ratio of cases to deaths) represents a perfect tool for analyzing, understanding and improving the overall efficiency of the health system. The objective of this article is to estimate the influence of the hospital care system on lethality in metropolitan France during the inception of the COVID-19 epidemic, by analyzing the spatial variability of the hospital case-fatality rate between French districts (i.e. French departements). The results show that the higher case-fatality rates observed by districts are mostly related to the level of morbidity, therefore to the overwhelming of the healthcare systems during the acute phases of the epidemic. However, the magnitude of this increase of case-fatality rate represents less than 10 per cent of the average case-fatality rate and cannot explain the magnitude of the variations in case-fatality rate reported per country by international organizations or information sites. These differences can only be explained by the systems for reporting cases and deaths, which, indeed, vary greatly from country to country, and not attributed to the care or treatment of patients, even during hospital stress due to epidemic peaks.

scholarly journals Decline of notified dengue infections in Indonesia in 2017: Discussion of the possible determinants

Narra J ◽  
2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Pandji Wibawa Dhewantara ◽  
Kurnia F. Jamil ◽  
Jonny Karunia Fajar ◽  
Panji Probo Saktianggi ◽  
Roy Nusa ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Protective Immunity ◽  
Case Fatality Rate ◽  
Southern Oscillation ◽  
Case Fatality ◽  
Annual Incidence Rate ◽  
Percent Change ◽  
Vector Management ◽  
Notification Data

This study was conducted to quantify the trend in dengue notifications in the country in 2017 and to explore the possible determinants. Annual nation-wide dengue notification data were obtained from the National Disease Surveillance of Ministry of Health of Indonesia. Annual incidence rate (IR) and case fatality rate (CFR) in 2017 and the previous years were quantified and compared. Correlations between annual larva free index (LFI), implementation coverage of integrated vector management (IVM), El Niño Southern Oscillation (Niño3.4), Dipole Mode Index (DMI), Zika virus seropositivity and the percent change in IR and CFR of dengue were examined. The change of dengue IR and CFRs were mapped. In 2017, dengue IR was declined by 71% (22.55 per 100,000 population) compared to 2016 (77.96 per 100,000 population) while the CFR was slightly reduced from 0.79% to 0.75%. Reduction in IR and CFR occurred in 94.1% and 70.1% out of 34 provinces, respectively. The trend of dengue IR seems to be influenced by Niño3.4 but there is no clear evidence that Niño3.4 is the main reason for dengue reduction in 2017. It is difficult to elucidate that the reduction of dengue in 2017 was associated with previous Zika outbreaks. In conclusion, there was a significant reduction on dengue notifications in Indonesia in 2017. Further investigation is needed to look at the role of climate on the decline of dengue IR at finer temporal scale. In addition, study on the role of cross-protective immunity generated by Zika infection on dengue incidence is also warranted.

scholarly journals COVID-19 in Sudan

2021 ◽  
Vol 15 (02) ◽  
pp. 204-208
Author(s):  
Ayman Ahmed ◽  
Nouh Saad Mohamed ◽  
Sarah Misbah EL-Sadig ◽  
Lamis Ahmed Fahal ◽  
Ziad Bakri Abelrahim ◽  
...  
Keyword(s):  
Health Systems ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Control Measures ◽  
Religious Practices ◽  
Mass Gathering ◽  
Fatality Rate ◽  
High Case Fatality Rate ◽  
The Government ◽  
And Control

The steadily growing COVID-19 pandemic is challenging health systems worldwide including Sudan. In Sudan, the first COVID-19 case was reported on 13th March 2020, and up to 11 November 2020 there were 14,401 confirmed cases of which 9,535 cases recovered and the rest 3,750 cases were under treatment. Additionally, 1,116 deaths were reported, indicating a relatively high case fatality rate of 7.7%. Several preventive and control measures were implemented by the government of Sudan and health partners, including the partial lockdown of the country, promoting social distancing, and suspending mass gathering such as festivals and performing religious practices in groups. However, new cases still emerging every day and this could be attributed to the noncompliance of the individuals to the advocated preventive measurements.

Neonatal tetanus at the close of the 20th century in Nigeria

2007 ◽  
Vol 37 (3) ◽  
pp. 165-167 ◽  
Author(s):  
Tinuade A Ogunlesi ◽  
John A O Okeniyi ◽  
Joshua A Owa ◽  
Gabriel A Oyedeji
Keyword(s):  
Odds Ratio ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Neonatal Tetanus ◽  
World Health ◽  
Preventive Strategies ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Organization ◽  
Year 2000

The year 2000 marked another failed World Health Organization deadline for neonatal tetanus (NNT) eradication. Existing preventive strategies can be enhanced by exploring factors involved in the persistence of the scourge. Thus, records of neonates admitted between 1996 and 2000 into the Wesley Guild Hospital, Ilesa, were analysed. Of 3051 total neonatal admissions,162 (5.3%) had NNT. Eighty-nine (54.9%) mothers had clinic-based antenatal care (ANC), but only 59 (36.4%) had tetanus toxoid (TT) vaccines. The majority (66.7%) of them delivered at home or churches and others at either private clinics or primary health centres. Overall, the case fatality rate was 43.8%, though it was significantly higher among babies whose mothers had neither clinic-based ANC (odds ratio [OR] = 2.62; 95% confidence interval [CI] = 1.33-5.18) nor antenatal TT vaccination (OR = 2.41; 95% CI = 1.17-5.03). Thus, improvement on ANC, anti-tetanus immunization and ensuring hygienic deliveries are crucial for eliminating NNT in the 21st century.

scholarly journals Corona Contact Tracing Apps: Empirical Study on Self-Focused and Other-Focused Health Concerns as Predictors of App-Uptake (Preprint)

2021 ◽  
Author(s):  
Fenne große Deters ◽  
Tabea Meier ◽  
Anne Milek ◽  
Andrea B. Horn
Keyword(s):  
Odds Ratio ◽  
Demographic Variables ◽  
Contact Tracing ◽  
Curvilinear Relationship ◽  
Economic Activities ◽  
German Speaking ◽  
The Government ◽  
App Design ◽  
And Control

BACKGROUND Corona contact tracing apps are a novel and promising measure to reduce the spread of COVID-19. They can help to balance the need to maintain normal life and economic activities as much as possible while still avoiding exponentially growing case numbers. However, a majority of citizens needs to be willing to install such an app for it to be effective. Hence, knowledge about drivers for app-uptake is crucial. OBJECTIVE The present study aims to add to our understanding of underlying psychological factors motivating app-uptake. More specifically, we investigated the role of concern for one’s own health and concern to unknowingly infect others. METHODS A two-wave survey with N = 346 German-speaking participants from Switzerland and Germany was conducted. We measured the uptake of two decentralized contact tracing apps officially launched by governments (“Corona-Warn-App”, Germany; “SwissCovid”, Switzerland) as well as concerns regarding COVID-19 and control variables. RESULTS While controlling for demographic variables as well as general attitudes towards the government and the pandemic, logistic regression analysis showed a significant effect of self-focused concerns (Odds Ratio = 1.64, P <.01). Meanwhile, concern to unknowingly infect others did not contribute significantly to the prediction of app-uptake over and above concern for one’s own health (Odds Ratio = 1.01, P = .92). Longitudinal analyses replicated this pattern and showed no support for the possibility that app-uptake provokes changes in levels of concern. Testing for a curvilinear relationship, no evidence was found that “too much” concern leads to defensive reactions and reduces app-uptake. CONCLUSIONS As one of the first studies to assess the installation of already launched corona tracing apps, our study extends our knowledge of the motivational landscape of app-uptake. Based on that, practical implications for communication strategies and app design are discussed. CLINICALTRIAL

scholarly journals The Uncertainties Underlying Herd Immunity against COVID-19

2020 ◽  
Author(s):  
Farid Rahimi ◽  
Amin Talebi Bezmin Abadi
Keyword(s):  
Antiviral Therapy ◽  
Case Fatality Rate ◽  
Herd Immunity ◽  
Case Fatality ◽  
Healthcare Systems ◽  
Fatality Rate ◽  
Economic Implications ◽  
Rate Transmission ◽  
The Social ◽  
And Control

Herd immunity happens when a relatively large proportion of a population becomes infected by an agent, subsequently recovers, and attains immunity against the same agent. That proportion thus indirectly protects the naïve population by preventing the spread of the infection. Herd immunity has been suggested to interrupt and control the COVID-19 pandemic. However, relying on establishing herd immunity can be catastrophic considering the virulence and lethality of SARS-CoV-2. Meanwhile our understanding of the pathogenesis, case-fatality rate, transmission routes, and antiviral therapy for COVID-19 remains limited now. Interrupting or slowing the COVID-19 transmission seems more opportune than vaccination, antiviral therapy, or herd immunity, all of which will take some time to yield. Thus, social distancing, face-masking, and hygiene are the most appropriate immediate countermeasures. Because the social fabrics, economic implications, and local demands of various nations are unique, early relaxation of restrictions may seem hasty particularly when fatality rates are high, or when the healthcare systems could be inadequate or become inundated. Conclusively, avoiding any overwhelmingly risky approach in fighting the pandemic is prudent.

scholarly journals Policy Disparities in Fighting COVID-19 Among Japan, Italy, Singapore and China

2020 ◽  
Author(s):  
Xiaohan Wang ◽  
Leiyu Shi ◽  
Yuyao Zhang ◽  
Haiqian Chen ◽  
Gang Sun
Keyword(s):  
Prevention And Control ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Mitigation Measures ◽  
Cumulative Number ◽  
Fatality Rate ◽  
Epidemic Control ◽  
Growth Trend ◽  
Control Policies ◽  
And Control

Abstract Objective This study systematically summarizes the COVID-19 prevention and control policies of Japan, Italy, China and Singapore in order to provide policy basis for other countries currently coping with the COVID-19 pandemic.Methods This study summarizes the epidemic prevention and control policies in Japan, Italy, China, and Singapore, and analyzes the effects of policies in the four countries using official statistics.Results As of May 27, 2020, the growth trend of new cases in Japan, Italy, China and Singapore has all stabilized. However, the cumulative number of confirmed cases (231139) and case-fatality rate (14.3%) in Italy far exceeded those in the other three countries, and the effect of epidemic control was inferior. Singapore began to experience a domestic resurgence after April 5, with a cumulative number of confirmed cases reaching 32876, but the case-fatality rate remained extremely low (0.1%). The growth of cumulative confirmed cases in China (84547) is almost stagnant, and the case-fatality rate is low (5.5%). The growth of cumulative confirmed cases in Japan (16661) increased slowly, and the case-fatality rate (4.8%) was slightly lower than that in China.Conclusion This study divides the epidemic prevention and control policies of the four countries into two categories: the blocking measures taken by China and Singapore, and the mitigation measures taken by Japan and Italy. According to the results of epidemic control in the four countries, we can conclude that the blocking measures are more effective. Pay attention to the admission of mild patients and cases tracking as the core strategy of blocking measures, which can be considered in countries all over the world.

scholarly journals Role of Environmental Temperature on the Attack rate and Case fatality rate of Coronavirus Disease 2019 (COVID-19) Pandemic

2020 ◽  
Vol 10 (1) ◽  
pp. 1792620 ◽  
Author(s):  
Mohammad M. Hassan ◽  
Mohamed E. El Zowalaty ◽  
Shahneaz A. Khan ◽  
Ariful Islam ◽  
Md. Raihan K. Nayem ◽  
...  
Keyword(s):  
Attack Rate ◽  
Case Fatality Rate ◽  
Environmental Temperature ◽  
Case Fatality ◽  
Fatality Rate

scholarly journals Protective role of intravesical BCG in COVID-19 severity

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Héctor Gallegos ◽  
Pablo A. Rojas ◽  
Francisca Sepúlveda ◽  
Álvaro Zúñiga ◽  
Ignacio F. San Francisco
Keyword(s):  
Cumulative Incidence ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
National Registry ◽  
Categorical Variables ◽  
Control Group ◽  
Fatality Rate ◽  
Incidence And Mortality ◽  
Intravesical Bcg

Abstract Objectives To establish the role of BCG instillations in the incidence and mortality of COVID-19. Patients and methods NMIBC patients in instillations with BCG (induction or maintenance) during 2019/2020 were included, establishing a COVID-19 group (with a diagnosis according to the national registry) and a control group (NO-COVID). The cumulative incidence (cases/total patients) and the case fatality rate (deaths/cases) were established, and compared with the national statistics for the same age group. T-test was used for continuous variables and Fisher's exact test for categorical variables. Results 175 patients were included. Eleven patients presented CIS (11/175, 6.3%), 84/175 (48.0%) Ta and 68/175 (38.9%) T1. Average number of instillations = 13.25 ± 7.4. One hundred sixty-seven patients (95.4%) had complete induction. Forty-three patients (cumulative incidence 24.6%) were diagnosed with COVID-19. There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed. COVID-19 group fatality rate = 1/43 (2.3%). Accumulated Chilean incidence 70–79 years = 6.3%. Chilean fatality rate 70–79 years = 14%. Conclusions According to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.

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