Knowledge-based patient screening for rare and emerging infectious/parasitic diseases: a case study of brucellosis and murine typhus.

Many infectious and parasitic diseases, especially those newly emerging or reemerging, present a difficult diagnostic challenge because of their obscurity and low incidence. Important clues that could lead to an initial diagnosis are often overlooked, misinterpreted, not linked to a disease, or disregarded. We constructed a computer-based decision support system containing 223 infectious and parasitic diseases and used it to conduct a historical intervention study based on field investigation records of 200 cases of human brucellosis and 96 cases of murine typhus that occurred in Texas from 1980 through 1989. Knowledge-based screening showed that the average number of days from the initial patient visit to the time of correct diagnosis was significantly reduced (brucellosis-from 17.9 to 4.5 days, p = 0.0001, murine typhus-from 11.5 to 8.6 days, p = 0.001). This study demonstrates the potential value of knowledge-based patient screening for rare infectious and parasitic diseases

"Some Infectious and Parasitic Diseases" Mortality Periodicities, Seasonality and Trend, by Sex, in Portugal (1980-2012)

Rapid CommunicationThis article describes the results on seasonality and trends for mortality due to infectious and parasitic diseasesinfo:eu-repo/semantics/publishedVersio

Medical causes of admissions to hospital among adults in Africa: a systematic review.

BACKGROUND: Despite the publication of several studies on the subject, there is significant uncertainty regarding the burden of disease among adults in sub-Saharan Africa (sSA). OBJECTIVES: To describe the breadth of available data regarding causes of admission to hospital, to systematically analyze the methodological quality of these studies, and to provide recommendations for future research. DESIGN: We performed a systematic online and hand-based search for articles describing patterns of medical illnesses in patients admitted to hospitals in sSA between 1950 and 2010. Diseases were grouped into bodily systems using International Classification of Disease (ICD) guidelines. We compared the proportions of admissions and deaths by diagnostic category using χ2. RESULTS: Thirty articles, describing 86,307 admissions and 9,695 deaths, met the inclusion criteria. The leading causes of admission were infectious and parasitic diseases (19.8%, 95% confidence interval [CI] 19.6-20.1), respiratory (16.2%, 95% CI 16.0-16.5) and circulatory (11.3%, 95% CI 11.1-11.5) illnesses. The leading causes of death were infectious and parasitic (17.1%, 95% CI 16.4-17.9), circulatory (16%, 95% CI 15.3-16.8) and digestive (16.2%, 95% CI 15.4-16.9). Circulatory diseases increased from 3.9% of all admissions in 1950-59 to 19.9% in 2000-2010 (RR 5.1, 95% CI 4.5-5.8, test for trend p<0.00005). The most prevalent methodological deficiencies, present in two-thirds of studies, were failures to use standardized case definitions and ICD guidelines for classifying illnesses. CONCLUSIONS: Cardiovascular and infectious diseases are currently the leading causes of admissions and in-hospital deaths in sSA. Methodological deficiencies have limited the usefulness of previous studies in defining national patterns of disease in adults. As African countries pass through demographic and health transition, they need to significantly invest in clinical research capacity to provide an accurate description of the disease burden among adults for public health policy

Evaluation morphométrique des chevaux pur-sang Arabe en Algérie: mensurations corporelles et proposition d’équations barymétriques

Cette étude vise à la caractérisation morphobiométrique des chevaux de course pur-sang arabe et à l’estimation d’équations barymétriques adaptées à cette race. La caractérisation a concerné 98 chevaux, dont 44 femelles et 54 mâles, tous âgés de trois ans et plus, auprès de 77 propriétaires-éleveurs dans 3 hippodromes d’Algérie (Zemmouri, Tiaret et Caroubier). Dix-neuf mensurations étaient relevées ainsi que le poids vif (PV). Le poids moyen est de 456,2 +/- 43,0 kg, variant de 335 kg à 545 kg. La sélection des variables à inclure dans les équations barymétriques a été réalisée à l’aide de la procédure stepwise du SAS. Quatre mensurations parmi les 19 réalisées ont été retenues pour la proposition d’équations d’estimation du poids vif des chevaux : le périmètre thoracique (PT), la hauteur à la croupe (HC), la longueur de l’encolure (LE) et le tour de l’encolure (TE). Ainsi, les équations proposées pour les mâles et pour les femelles sont respectivement de : PV= 7,024*PT - 787,119 (R²=0,99); PV=6,207*PT + 0,633*HC + 0,668*TE - 0,878*LE - 746,370 (R²=0,96). Les résultats de cette étude devraient permettre aux propriétaires-éleveurs et entraineurs de suivre aisément le poids de leurs chevaux. Ce suivi est nécessaire pour adapter l’activité et l’alimentation des chevaux et favoriser leur performance en course

Prescribing antibiotics to preschool children in primary health care in Croatia

The use of antibiotics depends on cultural and socioeconomic factors, physician's characteristics as well as on microbiological considerations. Aim of our study was to asses antibiotic prescription among preschool children in primary health care in Croatia in relation to socioeconomic factors, symptoms and diagnoses, and type of health care provider. Retrospective longitudinal survey was conducted in 7 teaching primary health care offices in the Croatian capital of Zagreb during 2004, among 1700 preschool children. Antibiotics were prescribed to 611 (46%) children. Significantly more antibiotics were prescribed to boys (66.7%, P = 0.024) and to children whose parents had lower educational level. Most frequently antibiotics were prescribed for the symptoms such as fever (32%), cough (32.5%), nasal discharge (12%), and for the diagnoses such as respiratory diseases (J00-J99) (40%), infectious and parasitic diseases (A00-A99) (31%), and diseases of the middle ear and mastoid (H60-H95) (15%). Logistic regression analyses also predicted correlation of antibiotic prescriptions with socioeconomic factors, symptoms and diagnoses and health care of pediatrician. Prescription of antibiotics for preschool children in primary health care in Croatia related to socioeconomic factors, type of health care provider, certain symptoms and diagnosis groups which should be taken into account when assessing and planning primary health care for preschool children

Does the Relationship Between Mortality and the Business Cycle Vary by the Level of Economic Development? Evidence from Mexico

We investigate the relationship between mortality and business cycles within Mexico, where development varies significantly. We exploit this variation by separately analyzing the top ten and bottom ten developed states. We find that while mortality is procyclical nationally and in the top ten states, it is countercyclical in the bottom ten. Further, we show that in the top ten states mortality due to noncommunicable conditions is procyclical, while in the bottom ten mortality due to noncommunicable conditions and infectious and parasitic diseases is countercyclical. This suggests that the relationship between mortality and business cycles may vary by level of development.

Antimicrobial use in European acute care hospitals: results from the second point prevalence survey (PPS) of healthcare-associated infections and antimicrobial use, 2016 to 2017

Antimicrobial agents used to treat infections are life-saving. Overuse may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. In 2016-17, we performed the second point-prevalence survey (PPS) of healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals. We included 1,209 hospitals and 310,755 patients in 28 of 31 European Union/European Economic Area (EU/EEA) countries. The weighted prevalence of antimicrobial use in the EU/EEA was 30.5% (95% CI: 29.2-31.9%). The most common indication for prescribing antimicrobials was treatment of a community-acquired infection, followed by treatment of HAI and surgical prophylaxis. Over half (54.2%) of antimicrobials for surgical prophylaxis were prescribed for more than 1 day. The most common infections treated by antimicrobials were respiratory tract infections and the most commonly prescribed antimicrobial agents were penicillins with beta-lactamase inhibitors. There was wide variation of patients on antimicrobials, in the selection of antimicrobial agents and in antimicrobial stewardship resources and activities across the participating countries. The results of the PPS provide detailed information on antimicrobial use in European acute care hospitals, enable comparisons between countries and hospitals, and highlight key areas for national and European action that will support efforts towards prudent use of antimicrobials