Risk of Dengue Incidence in Children and Adolescents in Zulia, Venezuela, using a Negative Binomial Generalized Linear Mixed Model

Introduction: Dengue is the most important arboviral disease. Its incidence has increased 30-fold over the last 50 years, causing global concerns. Studies have showed children to be the most vulnerable. Methods: Observational study using dengue cases from Zulia state, Venezuela, modelling through a Negative Binomial Generalized Linear Mixed Model (GLMM) accounting for heterogeneity in the variance via a hierarchical Bayesian framework, was done. We assessed risk factors such as age and sex. The Bayesian framework enabled the estimation of Relative Risk (RR) and a Binomial regression was run using the WinBUGS software. Results: During 2002-2008, there were 49,330 cases of dengue in Zulia state, Venezuela. Most of them (18.71%) in 2007. The model revealed that children aged from 5 to 14 y-old had 1.59-higher risk (95%CI 1.41-1.79) compared with those aged from 0-4 y-old. Those aged 25-44 years old and ≥45, have significantly less RR than the baseline category, RR 0.5228 (95%CI 0.46-0.59) and 0.3069 (95%CI 0.27-0.34). Conclusions: The findings confirmed that groups most at risk were children aged 5 to 14 years. Modelling and predicting dengue epidemiology are still a need in multiple countries, especially those at risk of newer epidemics, as is the case of Zulia and Venezuela

Risk of Dengue Incidence in Children and Adolescents in Zulia, Venezuela, using a Negative Binomial Generalized Linear Mixed Model

Introduction: Dengue is the most important arboviral disease. Its incidence has increased 30-fold over the last 50 years, causing global concerns. Studies have showed children to be the most vulnerable. Methods: Observational study using dengue cases from Zulia state, Venezuela, modelling through a Negative Binomial Generalized Linear Mixed Model (GLMM) accounting for heterogeneity in the variance via a hierarchical Bayesian framework, was done. We assessed risk factors such as age and sex. The Bayesian framework enabled the estimation of Relative Risk (RR) and a Binomial regression was run using the WinBUGS software. Results: During 2002-2008, there were 49,330 cases of dengue in Zulia state, Venezuela. Most of them (18.71%) in 2007. The model revealed that children aged from 5 to 14 y-old had 1.59-higher risk (95%CI 1.41-1.79) compared with those aged from 0-4 y-old. Those aged 25-44 years old and ≥45, have significantly less RR than the baseline category, RR 0.5228 (95%CI 0.46-0.59) and 0.3069 (95%CI 0.27-0.34). Conclusions: The findings confirmed that groups most at risk were children aged 5 to 14 years. Modelling and predicting dengue epidemiology are still a need in multiple countries, especially those at risk of newer epidemics, as is the case of Zulia and Venezuela

Síndrome de Fiebre Severa con Trombocitopenia como Problema de Salud Pública Emergente

La trombocitopenia, como la fiebre y la anemia, son signos que en todos los casos debe aclararse su etiología, estos en su mayoría, suelen estar asociados a enfermedades infecciosas, especialmente tropicales y zoonóticas. La primera se presenta por falta de producción o por aumento en la destrucción de las plaquetas. Las plaquetas son células extremadamente importantes para los organismos vertebrados, pues son ellas las que previenen e interrumpen las hemorragias, actuando en la formación de coágulos y participando en la coagulación sanguínea. En años pasados se ha descrito un síndrome, de etiología viral, que recibe el nombre de Síndrome de Trombocitopenia con Fiebre Severa (SFTS). El Síndrome de Trombocitopenia con Fiebre Severa es una enfermedad infecciosa transmitida por garrapatas (arbovirus), con una alta tasa de letalidad

Síndrome de Fiebre Severa con Trombocitopenia como Problema de Salud Pública Emergente

La trombocitopenia, como la fiebre y la anemia, son signos que en todos los casos debe aclararse su etiología, estos en su mayoría, suelen estar asociados a enfermedades infecciosas, especialmente tropicales y zoonóticas. La primera se presenta por falta de producción o por aumento en la destrucción de las plaquetas. Las plaquetas son células extremadamente importantes para los organismos vertebrados, pues son ellas las que previenen e interrumpen las hemorragias, actuando en la formación de coágulos y participando en la coagulación sanguínea. En años pasados se ha descrito un síndrome, de etiología viral, que recibe el nombre de Síndrome de Trombocitopenia con Fiebre Severa (SFTS). El Síndrome de Trombocitopenia con Fiebre Severa es una enfermedad infecciosa transmitida por garrapatas (arbovirus), con una alta tasa de letalidad

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Sexual transmission of arboviruses: More to explore?

International audienc

Síndrome de Fiebre Severa con Trombocitopenia como Problema de Salud Pública Emergente

La trombocitopenia, como la fiebre y la anemia, son signos que en todos los casos debe aclararse su etiología, estos en su mayoría, suelen estar asociados a enfermedades infecciosas, especialmente tropicales y zoonóticas. La primera se presenta por falta de producción o por aumento en la destrucción de las plaquetas. Las plaquetas son células extremadamente importantes para los organismos vertebrados, pues son ellas las que previenen e interrumpen las hemorragias, actuando en la formación de coágulos y participando en la coagulación sanguínea. En años pasados se ha descrito un síndrome, de etiología viral, que recibe el nombre de Síndrome de Trombocitopenia con Fiebre Severa (SFTS). El Síndrome de Trombocitopenia con Fiebre Severa es una enfermedad infecciosa transmitida por garrapatas (arbovirus), con una alta tasa de letalidad