Epidemiology of canine atopic dermatitis

Canine atopic dermatitis (CAD) is a chronic, allergic skin disease associated with IgE-mediated reactions to environmental allergens. Atopic dermatitis/eczema in humans shares many similarities with CAD and is an increasing problem in industrialized countries. This increase has been attributed to lifestyle and environment factors. The current knowledge about the epidemiology of CAD is limited. The aim of this thesis was therefore to investigate the incidence of and potential risk factors for the development of CAD. Three of the included studies involve the use of a large animal-insurance database. The database includes information about a large number of healthy and diseased individuals over time, but it was not collected for research purposes and data-quality issues needed to be addressed. A validation of the diagnosis CAD in the insurance database showed that although the vast majority of the recorded cases could be considered allergic, the important differential diagnosis cutaneous adverse food reactions had not been ruled out for many patients. The overall incidence rate of CAD was 1.7 cases per 1000 dog years at risk. Several factors were found to be associated with an increased risk of CAD in the insured population; living in an urban area or in the south of Sweden, being born in the autumn and belonging to a high-risk breed. Furthermore, a spatial analysis showed that the incidence of CAD increased by increasing human population density and increasing annual rainfall, and was decreased in the north of Sweden and if there was no veterinary dermatologist present in the county. Finally, a case-control study was performed where 12 veterinarians collected CAD cases from the three identified high-risk breeds; boxer, bullterrier and West Highland white terrier. The main finding was that feeding a diet containing home-made/ non-commercial ingredients to the bitch during lactation protected her offspring from developing CAD. In conclusion, a strong breed predisposition for CAD was seen. Evidence of an increased incidence of CAD in densely populated areas exists but might be biased by the locations of veterinary dermatologists. The potential of using diet for primary prevention of CAD is interesting but randomized controlled clinical trials are required to support this finding

Risk factors for occurrence of cephalosporin-resistant Escherichia coli in Norwegian broiler flocks

AbstractA longitudinal study of 27 broiler farms including 182 broiler flocks was performed to determine risk factors for occurrence of cephalosporin-resistant Escherichia coli in Norwegian broiler flocks. Information regarding possible risk factors was collected by an online questionnaire and by samples obtained from broiler and parent flocks during the study period. Additional information was provided by the broiler production company. The prevalence of cephalosporin-resistant E. coli in parent flocks and broiler flocks sampled in the study was estimated.Cephalosporin-resistant E. coli was detected in 13.8% of the parent flocks and 22.5% of the broiler flocks included in the study.A multivariable generalized linear model was used to estimate risk factors. The risk for occurrence of cephalosporin-resistant E. coli was associated with the status of the previous flock in the broiler house (odds ratio=12.7), number of parent flocks supplying the broiler flock with day-old chickens (odds ratio=6.3), routines for disinfection of floor between production cycles (odds ratio=0.1), and transport personnel entering the room where the broilers are raised (odds ratio=9.3).Our findings highlights that implementation of a high level of biosecurity with a minimal number of people entering the broiler house during production cycles, as well as rigorous cleaning and disinfection routines between production cycles will contribute to a decrease in the occurrence of cephalosporin-resistant E. coli in broiler flocks provided that there is no selection pressure from antimicrobial use in the broiler production

Hepatitis C treatment uptake among people who inject drugs in Oslo, Norway: A registry-based study

Background Improving HCV treatment uptake among people who inject drugs (PWID) is crucial to achieving the WHO elimination targets. The aims were to evaluate HCV treatment uptake and HCV RNA prevalence in a large cohort of PWID in Norway. Methods Registry-based observational study where all users of the City of Oslo's low-threshold social and health services for PWID between 2010–2016 ( n = 5330) were linked to HCV notifications (1990–2019) and dispensions of HCV treatment, opioid agonist treatment (OAT) and benzodiazepines (2004–2019). Cases were weighted to account for spontaneous HCV clearance. Treatment rates were calculated using person-time of observation, and factors associated with treatment uptake were analysed using logistic regression. HCV RNA prevalence was estimated among individuals alive by the end of 2019. Results Among 2436 participants with chronic HCV infection (mean age 46.8 years, 30.7% female, 73.3% OAT), 1118 (45.9%) had received HCV treatment between 2010–2019 (88.7% DAA-based). Treatment rates increased from 1.4/100 PY (95% CI 1.1–1.8) in the pre-DAA period (2010–2013) to 3.5/100 PY (95% CI 3.0–4.0) in the early DAA period (2014–2016; fibrosis restrictions) and 18.4/100 PY (95% CI 17.2–19.7) in the late DAA period (2017–2019; no restrictions). Treatment rates for 2018 and 2019 exceeded a previously modelled elimination threshold of 50/1000 PWID. Treatment uptake was less likely among women (aOR 0.74; 95% CI 0.62–0.89) and those aged 40–49 years (aOR 0.74; 95% CI 0.56–0.97), and more likely among participants with current OAT (aOR 1.21; 95% CI 1.01–1.45). The estimated HCV RNA prevalence by the end of 2019 was 23.6% (95% CI 22.3–24.9). Conclusion Although HCV treatment uptake among PWID increased, strategies to improve treatment among women and individuals not engaged in OAT should be addressed.This research received funding from the following sources. KM receives research grants from the South-Eastern Norway Regional Health Authority , grant number: 2020011 . The funding sponsor has not been involved in study design, collection of data, analysis/interpretation of data, in the writing of the article, or in the decision to submit the article for publication.publishedVersio

Canine atopic dermatitis: validation of recorded diagnosis against practice records in 335 insured Swedish dogs

A cross-sectional study of insured Swedish dogs with a recorded diagnosis of canine atopic dermatitis (CAD) was performed. In order to validate the correctness of this specific diagnosis in the insurance database, medical records were requested by mail from the attending veterinarians. All dogs with a reimbursed claim for the disease during 2002 were included in the original study sample (n = 373). Medical records were available for 335 individuals (response rate: 89.8%). By scrutinizing the submitted records it was determined that all dogs had been treated for dermatologic disease, and that 327 (97.6%) could be considered to have some allergic skin disease. However, as information regarding dietary trial testing was missing in many dogs the number that were truly atopic could not be determined. The clinical presentation and nature of test diet for dogs with or without response to dietary trial testing was compared for a subset of 109 individuals that had undergone such testing. The only significant difference between these two groups was that the proportion of dogs with reported gastrointestinal signs was higher in the group that subsequently responded to a diet trial. In conclusion, the agreement between the recorded diagnosis in the insurance database and the clinical manifestations recorded in the submitted medical records was considered acceptable. The concern was raised that many attending veterinarians did not exclude cutaneous adverse food reactions before making the diagnosis of CAD

Insurance data for research in companion animals: benefits and limitations

The primary aim of this article is to review the use of animal health insurance data in the scientific literature, especially in regard to morbidity or mortality in companion animals and horses. Methods and results were compared among studies on similar health conditions from different nations and years. A further objective was to critically evaluate benefits and limitations of such databases, to suggest ways to maximize their utility and to discuss the future use of animal insurance data for research purposes. Examples of studies on morbidity, mortality and survival estimates in dogs and horses, as well as neoplasia in dogs, are discussed