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PubMedDate not supplied

[Viral hepatitis C. Personal experience with diagnostic, monitoring and epidemiologic studies].

In the period from 1991 to 1993, 18 patients with the acute viral hepatitis type C were treated and followed up--13 men and 5 women, the average age of 42 years. The group of 6 patients (4 men and two women) with the "old" proven liver cirrhosis, whose etiology was unknown for 20 years, was analyzed. The investigations showed that the acute viral hepatitis type C usually began with the mild subjective disorders. The half of the patients did not have either jaundice or hepatomegaly, only half of them recover, and the first cases of cirrhosis could have been expected almost as early as a year after the beginning of illness. The developed liver cirrhoses remained compensated for years. About 58% of patients got infected parenterally, and the rest of them could have gotten infected in other manner. ELISA test showed great reliability in proving the antibodies against the viral hepatitis type C in the confirming the diagnosis of illness.

Acute Disease↗
PubMed2000

Deposition and disease: a moss monitoring project as an approach to ascertaining potential connections.

In the years 1995 and 1996 the atmospheric deposition of elements in the EuroRegion Neisse (ERN) was determined in a biomonitoring project using mosses. The mosses Pleurozium schreberi and Polytrichum formosum were chosen as biomonitors because of their wide distribution in the area studied. The moss samples were analysed by ICP-MS and ICP-OES for their concentrations of 37 chemical elements. The results were shown in the form of maps. The data from the moss monitoring project served as a basis for determining those elements in the deposited material that promote the occurrence of disease. This was done by correlating the figures for the various diseases with the appropriate element concentrations in the mosses. Indications were found that a connection exists between the thallium content of mosses and the occurrence of cardiovascular disease and between Ce, Fe, Ga and Ge levels in the mosses and the incidence of diseases of the respiratory system.

Adolescent↗
PubMed2005

HIV-1 resistance genotyping on dried serum spots.

OBJECTIVE: To assess the feasibility of HIV-1 group M resistance genotyping on dried serum spots, by testing samples from previously untreated patients, patients on treatment, and patients having stopped treatment, representing a wide genetic diversity panel. METHODS: Serum samples from 62 HIV-1-infected Caucasian and African patients, with viral load values from 715 copies/ml to more than 750,000 copies/ml, were deposited on filter paper. After elution and RNA extraction, nested RT-PCR was used to amplify the protease and RT regions of the pol gene. Resistance sequencing was performed on all the protease and RT amplicons. The sequences obtained for resistance genotyping were used for subtyping by phylogenetic analysis. RESULTS: Amplification was successful in the protease region in 53/62 cases (85.5%) and in the RT region in 51/62 cases (82.3%). All samples with viral loads of at least 5 Log (17 of 62) were successfully amplified in both the RT and protease regions. Of the 29 samples with viral loads between 4 Log and 5 Log, 28 (97%) were amplified in the RT region and 25 (86%) in the protease region. The detected mutations were in keeping with the treatment status. Marked natural polymorphism was observed in the protease region, but no major consequences were deduced in terms of resistance. The results showed a broad diversity of the panel, including subtype B (n = 36) and non B or recombinant forms (n = 20). CONCLUSION: Our results show the feasibility of this dried serum spot method for monitoring resistance to antiretroviral drugs and the molecular epidemiology of HIV diversity. The simplicity of sample preparation, storage and transport potentially makes this an importance tool for individual and epidemiological monitoring throughout the world.

Antiretroviral Therapy, Highly Active↗
PubMed1995

The concept of biological markers in the field of risk assessment.

Using biological markers as a means to advance toxicological science has come under increasing scrutiny. The concept of using biological fluids to identify an event affecting the organism is at least as old as associating a disease with a change in the color of the urine. What is new is the perception that rapid advances, in both conceptual understanding of toxicology and in the power of analytical biology and chemistry, greatly increase the likelihood of making advances in the development and validation of biological markers. These markers are of significance to human health and the environment, as well as to risk assessment and to other techniques applicable to regulatory decision making. Biological markers can be divided into markers of exposure, effect and susceptibility. There is a continuum between exposure and effect, with some markers being more reflective of either end of the continuum. An ideal marker is one that reflects both exposure and effect. Development of markers requires an understanding of the mechanisms by which agents enter the body, distribute, undergo metabolism and elimination, interact with target cells and molecules and produce adverse effects. The human genome project is likely to lead to a further increase in the availability of susceptible markers. There are many ethical issues concerning biological markers in general and susceptibility markers in particular. Validation of biological markers is a painstaking but necessary effort that requires a concerted effort among laboratories and research organizations.

Biomarkers↗
PubMedDate not supplied

[The importation of malaria from Afghanistan into the USSR (a retrospective analysis of data from epidemiological surveys of cases and foci during 1981-1990)].

A retrospective analysis of imported malaria due to military operations revealed the main regularities in the behaviour of Plasmodium vivax population and the relationships between the imported parasite and the native Anopheles species. High percentage of cases with protracted incubation was noted in soldiers after their home-coming; the clinical symptoms were often registered 7-12 months after return. No epidemic consequence of imported and introduced cases of tertian malaria in malariogenic areas was shown. The effect of mass drug administration in military contingents was proved to be low due to irregular use of drugs or their discontinuance. The import of carriers to malariogenic areas was found to cause a minimal risk of restoration and implantation of tertian malaria. The current epidemiological monitoring system was shown to be rather effective for maintaining the epidemiological prosperity in the country.

Afghanistan↗
PubMed1993

Problems and priorities in epidemiologic research on human health effects related to wiring code and electric and magnetic fields.

Because of a reported excess of cancers among children living near power lines, there is some concern that electric and magnetic fields (EMFs) induced by electric power sources may affect human health, and this possibility has provoked considerable controversy. The scientific question of whether there are such health effects is far from resolved. Building upon a set of detailed reviews of the available evidence, this paper proposes research priorities and places particular emphasis on epidemiologic research. The most pressing need is to verify the validity of the claim that childhood cancer risk is affected by the type of wiring code in the vicinity of the household. More useful work can be done to verify this in the areas in which such studies have already been carried out, and additional studies should be done elsewhere. Methodological investigation of the interrelationships among different measures and proxies for EMF is needed, and this could feed back to influence the type of EMF measures used in epidemiologic studies. Studies of cancer among adults in relation to EMFs in the work place are needed. Of lower priority are studies of adverse reproductive outcomes in relation to parental EMF exposure and studies of the neurobehavioral impact of chronic EMF exposure. This article also discusses the structural impediments of conducting environmental epidemiology research and argues that bold, large-scale epidemiologic monitoring systems are needed. There is a discussion of the interface between epidemiology and public policy in a topic area as controversial as EMFs.

Adult↗
PubMed2002

Estimating human rabies mortality in the United Republic of Tanzania from dog bite injuries.

OBJECTIVE: To make quantitative predictions about the magnitude of underreporting of human rabies deaths in the United Republic of Tanzania. METHODS: Human rabies deaths were estimated by using a series of probability steps to calculate the likelihood of rabies developing after the bite of a suspected rabid dog, incorporating field data on the incidence of animal bite injuries, the accuracy of rabies recognition, the distribution of bite wounds, and post-exposure treatment. FINDINGS: Predicted human rabies mortality was estimated to be (a) 1499 deaths per year (95% confidence interval 891-2238), equivalent to an annual incidence of 4.9 (2.9-7.2) deaths/100,000, when active surveillance data on bite incidence were used, and (b) 193 deaths per year (32-409), corresponding to an annual incidence of 0.62 (0.1-1.32) deaths/100,000, when national bite statistics were used. The annual mean number of rabies deaths officially recorded for the same period was 10.8 (7.7-14.0). CONCLUSION: In the United Republic of Tanzania, cases of rabies in humans have been greatly underreported. Dog bite injuries are an accessible source of epidemiological data that may be used to estimate the public health burden of rabies and to monitor epidemiological trends in developing countries.

Adolescent↗
PubMedDate not supplied

[Outbreak of scabies at a home for the elderly in the province of Huesca].

BACKGROUND: Individuals residing in institutionalized living facilities are currently a high-risk group as regards scabies outbreaks. This study is aimed at analyzing the characteristics of one of these outbreaks, which occurred at a senior citizen living facility located in the municipality of Barbastro (Huesca) through the Huesca Provincial Epidemiological Monitoring Division. METHODS: Following the initial notification of cases, a specific scabies prevention protocol was set out. An epidemiological investigation was conducted, proceeding to an active search for cases among all of the individuals residing or working at the facility in question. The information gathered on the cases and contacts by means of a validated survey was included in a database using Epiinfo 6.0. The attack rate and the relative risk of those residing in each area of the center were estimated, taking as a reference that having the lowest attack rate. RESULTS: A total of nineteen (18 and 1 respectively) cases of scabies were detected among the 104 residents and 20 workers employed at the facility. The source of the outbreak could not be specifically determined, although at least two of the first cases had begun to show some symptoms six months prior to their detection. The average delay in diagnosis was 53 days. This outbreak had a greater effect on the males in the assisted living quarters (TA = 77%; RR = 18.5, C195% = 2.7-128.7). The only employee affected was the person in charge of this area, who had not employed the universal personal protection measures during his caregiving tasks. CONCLUSIONS: This is a scabies outbreak at a senior citizen living facility, probably due to the delay in diagnosing the first cases and the failure on the part of one caregiver to have employed the personal protection measures. A specific scabies-prevention protocol having been implemented was fundamental for the control of this outbreak.

Aged↗
PubMed2022

A deep learning approach to real-time HIV outbreak detection using genetic data.

Pathogen genomic sequence data are increasingly made available for epidemiological monitoring. A main interest is to identify and assess the potential of infectious disease outbreaks. While popular methods to analyze sequence data often involve phylogenetic tree inference, they are vulnerable to errors from recombination and impose a high computational cost, making it difficult to obtain real-time results when the number of sequences is in or above the thousands. Here, we propose an alternative strategy to outbreak detection using genomic data based on deep learning methods developed for image classification. The key idea is to use a pairwise genetic distance matrix calculated from viral sequences as an image, and develop convolutional neutral network (CNN) models to classify areas of the images that show signatures of active outbreak, leading to identification of subsets of sequences taken from an active outbreak. We showed that our method is efficient in finding HIV-1 outbreaks with R0 ≥ 2.5, and overall a specificity exceeding 98% and sensitivity better than 92%. We validated our approach using data from HIV-1 CRF01 in Europe, containing both endemic sequences and a well-known dual outbreak in intravenous drug users. Our model accurately identified known outbreak sequences in the background of slower spreading HIV. Importantly, we detected both outbreaks early on, before they were over, implying that had this method been applied in real-time as data became available, one would have been able to intervene and possibly prevent the extent of these outbreaks. This approach is scalable to processing hundreds of thousands of sequences, making it useful for current and future real-time epidemiological investigations, including public health monitoring using large databases and especially for rapid outbreak identification.

Humans↗
PubMedDate not supplied

[Evaluation of health surveillance at several primary care units in Cuba].

BACKGROUND: The organization and operation of the epidemiological monitoring carried out at several Primary Care facilities in Cuba was assessed by means of a study conducted for the purpose of ascertaining the effectiveness of the monitoring in question and of contributing to further improve the mechanisms thereof and thus improve the health conditions of the population. This assessment was implemented at eight Polyclinics in the city of Havana throughout the 1998-1999 period. METHOD: By means of the implementation of an integral methodology, an assessment was made of the three factors involved in the monitoring system at the facilities in question, that is, the organization, the process and the results thereof. For this purpose, a survey which quantified some aspects of the system (sensitivity, opportunity, representativeness, usefulness) and a semi-structured survey of epidemiologists and other physicians involved in the monitoring in question in addition to the users of the system was used. RESULTS: The assessment of the organization revealed the monitoring organization to be adequate. In the assessment of the process, sensitivity was found to be low at some polyclinics, problems existing at many of them with regard to the opportunity and flexibility of the system. The assessment of the results of the monitoring revealed them to be satisfactory as regards their effectiveness for detecting acute events, as well as in the perception of the users with regard to the usefulness of these results for solving the problems pinpointed. CONCLUSIONS: The monitoring done at the polyclinics assessed is indicative of there being an adequate organization of the monitoring, although some shortcomings were found to exist with regard to the fulfillment of some aspects of the monitoring. This however has no bearing on the results for the system as a whole, which is capable of detecting any epidemiological situation of importance and of suggesting appropriate measures for controlling the situation.

Cuba↗
PubMed2007

Prevalence of adult problem and pathological gambling between 2000 and 2005: an update.

BACKGROUND: Excessive gambling is a prominent Public Health problem with high prevalence rates in many countries. Substance abuse and other co-morbidities often constitute a major health hazard for the person which gambles with a loss of material and social resources, as well as being a major concern for his or her significant others. The present study updates and extends prevalence data to include work published between 2000 and 2005 in English and other European languages. METHODS: In a three-step search and exclusion process, studies with current adult prevalence rates were gathered. RESULTS: Almost all studies fulfil basic research standards. The weighted mean prevalence rates for excessive gambling (problem and pathological) are 3.0% for the South Oaks Gambling Survey (problem 1.2%; pathological 1.8%), 3.3% for the Canadian Problem Gambling Index (problem 2.4%; pathological 0.8%) and 3.1% for the DSM-IV (problem 1.9%; pathological 1.2%). CONCLUSION: The prevalence rates are comparable and relatively stable between countries and across survey instruments, and do not differ from earlier reviews. The regular epidemiological monitoring of excessive gambling remains a major Public Health issue although the distinction between pathological and problem gambling is not appropriate for epidemiological research. Further studies are needed with respect to concomitant lifestyle characteristics.

Adult↗
PubMed1995

Heroin epidemics revisited.

This paper reviewed heroin use data from the US government's epidemiologic monitoring system for substance abuse. The monitoring system has multiple components, i.e., the Drug Abuse Warning Network of reporting emergency rooms (9), annual surveys of high school and post-high school youth (3, 4), annual National Household Surveys of Substance Abuse (7, 8, 50), Drug Use Forecasting (51), the Community Epidemiology Work Group (52), and law enforcement systems not reviewed here. These monitoring systems should identify any major increase in heroin incidence in this country relatively early. This is important, because the early stages of heroin epidemics are often hidden from society, and the epidemics are already full-blown by the time health and other agencies become aware of the size of the affected population and are required to respond. The hidden or underground nature of heroin epidemics is caused by 1) the need of each user to hide an illegal activity and 2) the delay between the time when heroin is first used and the onset of physical dependence and other adverse consequences, which bring new heroin addicts to the attention of treatment and enforcement systems. Despite an epidemiologic surveillance system which should rapidly identify large-scale heroin spread in this country, our treatment and law enforcement systems are not organized to respond rapidly to contain an epidemic. Substance abuse treatment services are not structured for rapid expansion and contraction based on fluctuating need. Apart from HIV prevention programs, we do not have outreach teams attached to treatment programs that could quickly identify local outbreaks and involve new heroin abusers in treatment (10).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Gonorrhoea surveillance system in France: 1986-2000.

OBJECTIVE: The objectives of this study were to monitor epidemiologic trends in Neisseria gonorrhoeae (NG) infections and to assess antimicrobial resistance patterns of NG. METHODS: RENAGO, a voluntary-based laboratory surveillance system, including private and public laboratories, was set up in France in 1986. Every NG strain isolated by the participating laboratories was sent to the National Reference Center, Institut Alfred Fournier, Paris, where susceptibility to 6 antibiotics was tested. These laboratories reported monthly numbers of positive NG isolates and associated epidemiologic data. Because the number of laboratories varied every year, the average number of NG isolates per laboratory per year was computed to monitor annual trends in gonorrhea incidence. RESULTS: The average number of NG isolated per laboratory per year decreased steadily from 10.6 in 1986 to 0.6 in 1997 but then yearly increased and reached 1.9 in 2000. Increasing gonorrhea was observed mostly in men and in the Paris area. The proportion of rectal strains increased significantly from 0.9% in 1986 to 9.2% in 2000. From 1998 to 2000, 5.3% of the isolates had reduced susceptibility or were resistant to ciprofloxacin, 7.3% were PPNG strains and 27.4% were resistant to tetracycline, 18.5% had a reduced susceptibility to thiamphenicol, and 1 strain was resistant to the latter. Neither strain was resistant to ceftriaxone or to spectinomycin. CONCLUSION: From 1998 to 2000, gonorrhea markedly increased in France and seemed to affect mainly gay men in Paris, which suggests relapses to risky sexual behaviors and highlights the need for strengthening prevention. During the same period, NG ciprofloxacin resistance has sharply increased and should be carefully monitored because of the wide use of ciprofloxacin single-dose treatment.

Adult↗