An epidemiologic study of for a Visceral Leishmaniasis outbreak in saltwater marsh area

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2015-03-24T19:16:43Z No. of bitstreams: 1 Souza VMM Estudo epidemiologico....pdf: 101990 bytes, checksum: cb22c495af31b8606ac8cf8dd2a44b7d (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2015-03-24T19:28:22Z (GMT) No. of bitstreams: 1 Souza VMM Estudo epidemiologico....pdf: 101990 bytes, checksum: cb22c495af31b8606ac8cf8dd2a44b7d (MD5)Made available in DSpace on 2015-03-24T19:28:22Z (GMT). No. of bitstreams: 1 Souza VMM Estudo epidemiologico....pdf: 101990 bytes, checksum: cb22c495af31b8606ac8cf8dd2a44b7d (MD5) Previous issue date: 2006Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Escola de Medicina Veterinária. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilUniversidade Federal da Bahia. Escola de Medicina Veterinária. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Núcleo de Apoio àPesquisa da Associação Obras Sociais Irmã Dulce. Salvador, BA, Brasilmanguezal previamente indene e determinar a prevalência da infecção canina sugerindo alguns fatores de risco associados a esta infecção. O estudo foi realizado no município de Salinas da Margarida, Bahia. Ao todo foram avaliados 558 cães, revelando uma prevalência de infecção em cães de 10%. Os dados foram colhidos através de questionários padronizados e previamente testados. A sorologia foi feita utilizando-se teste imunoenzimático (ELISA), e os cães soropositivos foram eliminados. As variáveis que apresentaram correlação com a infecção canina nas análises ajustadas para idade e multivariada foram: presença de raposas no peridomicílio, idade do cão, local onde o cão dormia e hábito de banhar o cão freqüentemente.The objective of this study was to evaluate an outbreak of visceral leishmaniasis in a saltwater marsh area without previous cases and to determine the prevalence of canine infection, suggesting potential risk factors associated with this infection. The study was carried out at the city of Salinas da Margarida, Bahia. We examined 558 dogs, yielding a prevalence of infection of 10%. The data were gathered using a standardized questionnaire, previously tested. The sorology was done using an enzyme immunoassay (ELISA), and all seropositive dogs for anti-Leishmania antibodies were promptly eliminated. The variables associated with6 canine infection in the age-adjusted or multivariate analyses were: presence of foxes in the neighborhood, dog’s age, place where the dog sleeps and habit of bathing the dog frequently

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)