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Current Opinion in Infectious Diseases - Current Table Of Contents
Editorial introductions.
Page: viiDOI: 10.1097/QCO.0b013e3283117e55
Charles Anthony Hart: 25 February 1948 - 21 September 2007.
Page: 453DOI: 10.1097/QCO.0b013e328313ba91Authors: Beeching, Nick
Tuberculosis in the developing world: recent advances in diagnosis with special consideration of extensively drug-resistant tuberculosis.
Page: 454DOI: 10.1097/QCO.0b013e32830ce783Authors: Grandjean, Louis a; Moore, David AJ b
NEJM — Collection Updates for Infectious Diseases
CLINICAL DECISIONS: Management of Skin and Soft-Tissue Infection
A 20-year-old college basketball player presents to the emergency department with a 2-day history of a red, painful area on his right buttock. He reports that there was no specific...
REVIEW ARTICLE: Infection in Solid-Organ Transplant Recipients
Jay A. Fishman, M.D.Increasingly potent immunosuppressive agents have dramatically reduced the incidence of rejection of transplanted organs while increasing patients' susceptibility to opportunistic infections and cancer.12 At the same time, patterns of opportunistic...
IMAGES IN CLINICAL MEDICINE: Peripheral Smear with
Parul Bhargava, M.B., B.S. and Lorinda P. Longhi, B.S., M.T.A 53-year-old man with crohn's disease, short-bowel syndrome that required total parenteral nutrition, a history of recurrent catheter infections, hypertension, chronic renal insufficiency, and mitral regurgitation presented with fevers of...
Centers for Disease Control and Prevention
CDC Recommends Shingles Vaccine
People age 60 and older should be vaccinated against shingles, or herpes zoster, a condition often marked by debilitating chronic pain...
New CDC Study Finds Arthritis Can be a Barrier for Adults Seeking to Manage Diabetes through Physical Activity
More than half of adults with diagnosed diabetes also have arthritis, a painful condition that can be a barrier to physical activity—an important health strategy for managing diabetes...
Falls a Leading Cause of Injury-Related Emergency Department Visits for Infants Each Year, CDC Study Shows
Half of the estimated 328,500 infants 12 months of age or younger who were treated for injuries in hospital emergency departments each year from 2001 to 2004 were injured as a result of a fall, according to a study by the Centers for Disease Control and Prevention.
BMC Infectious Diseases - Latest articles
Increasing the frequency of hand washing by healthcare workers does not lead to commensurate reductions in staphylococcal infection in a hospital ward.
Clive B Beggs, Simon J Shepherd and Kevin G Kerr Tue, 02 Sep 2008 00:00:00 -0000
Background: Hand hygiene is generally considered to be the most important measure that can be applied to prevent the spread of healthcare-associated infection (HAI). Continuous emphasis on this intervention has lead to the widespread opinion that HAI rates can be greatly reduced by increased hand hygiene compliance alone. However, this assumes that the effectiveness of hand hygiene is not constrained by other factors and that improved compliance in excess of a given level, in itself, will result in a commensurate reduction in the incidence of HAI. However, several researchers have found the law of diminishing returns to apply to hand hygiene, with the greatest benefits occurring in the first 20% or so of compliance, and others have demonstrated that poor cohorting of nursing staff profoundly influences the effectiveness of hand hygiene measures. Collectively, these findings raise intriguing questions about the extent to which increasing compliance alone can further reduce rates of HAI. Methods: In order to investigate these issues further, we constructed a deterministic Ross-Macdonald model and applied it to a hypothetical general medical ward. In this model the transmission of staphylococcal infection was assumed to occur after contact with the transiently colonized hands of HCWs, who, in turn, acquire contamination only by touching colonized patients. The aim of the study was to evaluate the impact of imperfect hand cleansing on the transmission of staphylococcal infection and to identify, whether there is a limit, above which further hand hygiene compliance is unlikely to be of benefit. Results: The model demonstrated that if transmission is solely via the hands of HCWs, it should, under most circumstances, be possible to prevent outbreaks of staphylococcal infection from occurring at a hand cleansing frequencies 40% should be enough to prevent outbreaks of staphylococcal infection occurring, if transmission is solely via the hands of HCWs. Furthermore we identified a non-linear relationship between hand cleansing efficacy and frequency, suggesting that it is important to maximise the efficacy of the hand cleansing process.
Rabies trend in China (1990-2007) and post-exposure prophylaxis in the Guangdong province
Han Si, Zhong-Min Guo, Yuan-Tao Hao, Yu-Ge Liu, Ding-Mei Zhang, Shao-Qi Rao and Jia-Hai Lu Thu, 21 Aug 2008 00:00:00 -0000
Background: Rabies is a major public-health problem in developing countries such as China. Although the recent re-emergence of human rabies in China was noted in several epidemiological studies, little attention was paid to the reasons behind this phenomenon paralleling the findings of the previous reports. The purpose of this study is thus first to characterize the current trends of human rabies in China from 1990 to 2007, and then to define better recommendations for improving the post-exposure prophylaxis (PEP) schedules delivered to rabies patients. Methods: The most updated epidemiological data for 22527 human rabies cases from January 1990 to July 2007, retrieved from the surveillance database of reportable diseases managed by the Ministry of Health of China, were analysed. To investigate the efficiency for the post-exposure treatment of rabies, the details of 244 rabies patients, including their anti-rabies treatment of injuries or related incidents, were ascertained in Guangdong provincial jurisdiction. The risk factors to which the patients were predisposed or the regimens given to 80 patients who received any type of PEP were analysed to identify the reasons for the PEP failures. Results: The results from analysis of the large number of human rabies cases showed that rabies in China was largely under control during the period 1990-1996. However, there has been a large jump in the number of reported rabies cases since 2001 up to a new peak (with an incidence rate of 0.20 per 100000 people) that was reached in 2004, and where the level has remained until present. Then, we analysed the PEP in 244 rabies cases collected in the Guangdong province in 2003 and 2004, and found that 67.2% of the patients did not seek medical services or did not receive any PEP. Further analysis of PEP for the 80 rabies patients who received any type of PEP indicated that almost all of the patients did not receive proper or timely treatment on the wounds or post-exposure vaccination or rabies immunoglobulins.
Neonatal tetanus in Turkey; what has changed in the last decade?
Bunyamin Dikici, Hakan Uzun, Ebru Yilmaz-Keskin, Taskin Tas, Ali Gunes, Halil Kocamaz, Capan Konca and Mehmet A Tas Tue, 19 Aug 2008 00:00:00 -0000
Background: Neonatal tetanus (NT) is still considered as one of the major causes of neonatal death in many developing countries. The aim of the present study was to assess the characteristics of sixty-seven infants with the diagnosis of neonatal tetanus followed-up in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, between 1991 and 2006, and to draw attention to factors that may contribute (or may have contributed) to the elimination of the disease in Diyarbakir. Methods: The data of sixty-seven infants whose epidemiological and clinical findings were compatible with neonatal tetanus were reviewed. Patients were stratified into two groups according to whether they survived or not to assess the effect of certain factors in the prognosis. Factors having a contribution to the higher rate of tetanus among newborn infants were discussed. Results: A total of 55 cases of NT had been hospitalized between 1991 and 1996 whereas only 12 patients admitted in the last decade. All of the infants had been delivered at home by untrained traditional birth attendants (TBA), and none of the mothers had been immunized with tetanus toxoid during her pregnancy. Twenty-eight (41.8%) of the infants died during their follow-up. Lower birth weight, younger age at onset of symptoms and at the time admission, the presence of opisthotonus, risus sardonicus and were associated with a higher mortality rate. Conclusion: Although the number of neonatal tetanus cases admitted to our clinic in recent years is lower than in the last decade efforts including appropriate health education of the masses, ensurement of access to antenatal sevices and increasing the rate of tetanus immunization among mothers still should be made in our region to achieve the goal of neonatal tetanus elimination.
Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa
Andrew A Adjei, Henry B Armah, Foster Gbagbo, Isaac Boamah, Clement Adu-Gyamfi and Isaac Asare Mon, 18 Aug 2008 00:00:00 -0000
Background: Human herpesvirus 8 (HHV-8), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are prevalent in Africa, but less common elsewhere and the modes of transmission are still subject to debate. Generally, they rarely cause disease in the immunocompetent host but are highly oncogenic when associated with immunosuppression. Although the high prevalence of HHV-8, CMV and EBV has been well documented in Africa, such data are sparse from Ghana. Methods: Serum samples from 3275 HIV-seronegative healthy blood donors and 250 HIV-AIDS patients were tested for antibodies specific for HHV-8, CMV and EBV by IgG ELISA assays. Differences in seropositivity rates by gender and age were evaluated using the Chi-square test with Yates correction. Results: Of the 3275 HIV-seronegative healthy blood donors tested, 2573 (78.6%) were males and 702 (21.4%) were females, with ages ranging from 18 to 65 years (median 32.6; mean 31.2; mode 30). Of the 250 HIV-AIDS patients tested, 140 (56%) were males and 110 (44%) were females, with ages ranging from 17 to 64 years (median 30.8; mean 30.3; mode 28). Among the HIV-seronegative healthy blood donors, overall seroprevalence of HHV-8, CMV and EBV was 23.7%, 77.6% and 20.0%, respectively. Among the HIV-AIDS patients, overall seroprevalence of HHV-8, CMV and EBV was 65.6%, 59.2% and 87.2%, respectively. The seroprevalence of HHV-8 (p 0.05) for all three infections among HIV-seronegative healthy blood donors and HIV-AIDS patients in Ghana. Conclusion: The results presented herein indicate that HHV-8, CMV and EBV infections are hyperendemic in both HIV-seronegative and HIV-seropositive Ghanaians, and suggest primarily a horizontal route of transmission of these three viral infections in Ghana.
Schistosomiasis transmission at high altitude crater lakes in Western Uganda
Rubaihayo John, Moghusu Ezekiel, Clouds Philbert and Abaasa Andrew Mon, 11 Aug 2008 00:00:00 -0000
Background: Contrary to previous reports which indicated no transmission of schistosomiasis at altitude >1,400 m above sea level in Uganda, in this study it has been established that schistosomiasis transmission can take place at an altitude range of 1487–1682 m above sea level in western Uganda. Methods: An epidemiological survey of intestinal schistosomiasis was carried out in school children staying around 13 high altitude crater lakes in Western Uganda. Stool samples were collected and then processed with the Kato-Katz technique using 42 mg templates. Thereafter schistosome eggs were counted under a microscope and eggs per gram (epg) of stool calculated. A semi-structured questionnaire was used to obtain demographic data and information on risk factors. Results: 36.7% of the pupils studied used crater lakes as the main source of domestic water and the crater lakes studied were at altitude ranging from 1487–1682 m above sea level. 84.6% of the crater lakes studied were infective with over 50% of the users infected.The overall prevalence of Schistosoma mansoni infection was 27.8% (103/370) with stool egg load ranging from 24–6048 per gram of stool. 84.3%( 312) had light infections (400 egg/gm of stool). Prevalence was highest in the age group 12–14 years (49.5%) and geometric mean intensity was highest in the age group 9–11 years (238 epg). The prevalence and geometric mean intensity of infection among girls was lower (26%; 290 epg) compared to that of boys (29.6%; 463 epg) (t = 4.383, p < 0.05). Though 61%(225) of the pupils interviewed were aware of the existence of the disease, 78% (290)didn't know the mode of transmission and only 8% (30) of those found infected were aware of their infection status. In a multivariate logistic regression model, altitude and water source (crater lakes) were significantly associated with infection.Conclusion and recommendationsThe altitudinal threshold for S. mansoni transmission in Uganda has changed and use of crater water at an altitude higher than 1,400 m above sea level poses a risk of acquiring S. mansoni infection in western Uganda. However, further research is required to establish whether the observed altitudinal threshold change is as a result of climate change or other factors. It is also necessary to establish the impact this could have on the epidemiology of schistosomiasis and other vector-borne diseases in Uganda. In addition, sensitisation and mass treatment of the affected community is urgently required.
The Recent-Transmission of Mycobacterium tuberculosis Strains among Iranian and Afghan Relapse Cases: a DNA-fingerprinting using RFLP and spoligotyping
Parissa-Farnia, Mohammad Reza Masjedi, Mohammad Varahram, Mehdi Mirsaeidi, Mojtaba Ahmadi, Mehdi Khazampour, Payam Tabarsi, Parvaneh Baghei, Mojtaba Marjane, Muslam Bahadori, Abolhasan Zia Zarifi and Ali Akbar Velayati Wed, 06 Aug 2008 00:00:00 -0000
Background: Relapse of tuberculosis (TB) may develop as the result of reactivation of the endogenous primary infection, or as a result of a exogenous reinfection. This survey evaluated the rate of reactivation versus recent transmission among Iranian and Afghan relapse cases. Methods: The sputum specimens were digested, examined microscopically for acid-fast bacilli, and inoculated into Löwenstein-Jensen slants by standard procedures. Thereafter, the susceptibility and identification tests were performed on culture positive specimens. Subsequently, the strains that were identified as Mycobacterium tuberculosis (258 isolates) were subjected to IS6110 restriction fragment length polymorphism (RFLP) and spoligotyping. Additional patient's information was collected for further epidemiological analysis. Patients whose isolates had identical genotyping patterns were considered a cluster with recent transmission episode. Results: Out of 258 available isolates, 72(28%) had multi-drug resistant (MDR-TB) in ratio and 42 (16.2%) had other resistant. Notably, 38 of MDR-TB cases (52%) were isolated from Afghan patients. By IS6110-RFLP typing method, 65 patients (25%) were clustered in 29 clusters. In cluster cases, the intra-community transmissions between Iranian and Afghan patients were 41%. All MDR-TB patients in clusters had either Haarlem I or Beijing characteristic. The risk factors like sex, family history, close contact, living condition, PPD test result and site of TB infection were not associated with clustering. Although, the MDR-TB strains were more frequent in non-cluster cases (31%) than cluster one(18%) (P < 0.05). Majority of M. tuberculosis strains isolated from non-cluster cases were belong to EAI3 (51; 30%) and CASI(32;18.6%) superfamilies. Conclusion: During the studied period, reactivation of a previous infection remain the more probable cause of recurrence. Although, the evidence of intra- community transmission between Iranian and Afghan TB cases, highlighted the impact of afghan immigrants in national tuberculosis control program (NTP) of Iran.
Current Opinion in Infectious Diseases - Current Table Of Contents
Editorial introductions.
Page: viiDOI: 10.1097/QCO.0b013e3283117e55
Charles Anthony Hart: 25 February 1948 - 21 September 2007.
Page: 453DOI: 10.1097/QCO.0b013e328313ba91Authors: Beeching, Nick
Tuberculosis in the developing world: recent advances in diagnosis with special consideration of extensively drug-resistant tuberculosis.
Page: 454DOI: 10.1097/QCO.0b013e32830ce783Authors: Grandjean, Louis a; Moore, David AJ b
Subscribe to Infectious_Diseases RSS feed 
Editorial introductions.
Page: viiDOI: 10.1097/QCO.0b013e3283117e55
Charles Anthony Hart: 25 February 1948 - 21 September 2007.
Page: 453DOI: 10.1097/QCO.0b013e328313ba91Authors: Beeching, Nick
Tuberculosis in the developing world: recent advances in diagnosis with special consideration of extensively drug-resistant tuberculosis.
Page: 454DOI: 10.1097/QCO.0b013e32830ce783Authors: Grandjean, Louis a; Moore, David AJ b
NEJM — Collection Updates for Infectious Diseases
CLINICAL DECISIONS: Management of Skin and Soft-Tissue Infection
A 20-year-old college basketball player presents to the emergency department with a 2-day history of a red, painful area on his right buttock. He reports that there was no specific...
REVIEW ARTICLE: Infection in Solid-Organ Transplant Recipients
Jay A. Fishman, M.D.Increasingly potent immunosuppressive agents have dramatically reduced the incidence of rejection of transplanted organs while increasing patients' susceptibility to opportunistic infections and cancer.12 At the same time, patterns of opportunistic...
IMAGES IN CLINICAL MEDICINE: Peripheral Smear with
Parul Bhargava, M.B., B.S. and Lorinda P. Longhi, B.S., M.T.A 53-year-old man with crohn's disease, short-bowel syndrome that required total parenteral nutrition, a history of recurrent catheter infections, hypertension, chronic renal insufficiency, and mitral regurgitation presented with fevers of...
Centers for Disease Control and Prevention
CDC Recommends Shingles Vaccine
People age 60 and older should be vaccinated against shingles, or herpes zoster, a condition often marked by debilitating chronic pain...
New CDC Study Finds Arthritis Can be a Barrier for Adults Seeking to Manage Diabetes through Physical Activity
More than half of adults with diagnosed diabetes also have arthritis, a painful condition that can be a barrier to physical activity—an important health strategy for managing diabetes...
Falls a Leading Cause of Injury-Related Emergency Department Visits for Infants Each Year, CDC Study Shows
Half of the estimated 328,500 infants 12 months of age or younger who were treated for injuries in hospital emergency departments each year from 2001 to 2004 were injured as a result of a fall, according to a study by the Centers for Disease Control and Prevention.
BMC Infectious Diseases - Latest articles
Increasing the frequency of hand washing by healthcare workers does not lead to commensurate reductions in staphylococcal infection in a hospital ward.
Clive B Beggs, Simon J Shepherd and Kevin G Kerr Tue, 02 Sep 2008 00:00:00 -0000
Background: Hand hygiene is generally considered to be the most important measure that can be applied to prevent the spread of healthcare-associated infection (HAI). Continuous emphasis on this intervention has lead to the widespread opinion that HAI rates can be greatly reduced by increased hand hygiene compliance alone. However, this assumes that the effectiveness of hand hygiene is not constrained by other factors and that improved compliance in excess of a given level, in itself, will result in a commensurate reduction in the incidence of HAI. However, several researchers have found the law of diminishing returns to apply to hand hygiene, with the greatest benefits occurring in the first 20% or so of compliance, and others have demonstrated that poor cohorting of nursing staff profoundly influences the effectiveness of hand hygiene measures. Collectively, these findings raise intriguing questions about the extent to which increasing compliance alone can further reduce rates of HAI. Methods: In order to investigate these issues further, we constructed a deterministic Ross-Macdonald model and applied it to a hypothetical general medical ward. In this model the transmission of staphylococcal infection was assumed to occur after contact with the transiently colonized hands of HCWs, who, in turn, acquire contamination only by touching colonized patients. The aim of the study was to evaluate the impact of imperfect hand cleansing on the transmission of staphylococcal infection and to identify, whether there is a limit, above which further hand hygiene compliance is unlikely to be of benefit. Results: The model demonstrated that if transmission is solely via the hands of HCWs, it should, under most circumstances, be possible to prevent outbreaks of staphylococcal infection from occurring at a hand cleansing frequencies 40% should be enough to prevent outbreaks of staphylococcal infection occurring, if transmission is solely via the hands of HCWs. Furthermore we identified a non-linear relationship between hand cleansing efficacy and frequency, suggesting that it is important to maximise the efficacy of the hand cleansing process.
Rabies trend in China (1990-2007) and post-exposure prophylaxis in the Guangdong province
Han Si, Zhong-Min Guo, Yuan-Tao Hao, Yu-Ge Liu, Ding-Mei Zhang, Shao-Qi Rao and Jia-Hai Lu Thu, 21 Aug 2008 00:00:00 -0000
Background: Rabies is a major public-health problem in developing countries such as China. Although the recent re-emergence of human rabies in China was noted in several epidemiological studies, little attention was paid to the reasons behind this phenomenon paralleling the findings of the previous reports. The purpose of this study is thus first to characterize the current trends of human rabies in China from 1990 to 2007, and then to define better recommendations for improving the post-exposure prophylaxis (PEP) schedules delivered to rabies patients. Methods: The most updated epidemiological data for 22527 human rabies cases from January 1990 to July 2007, retrieved from the surveillance database of reportable diseases managed by the Ministry of Health of China, were analysed. To investigate the efficiency for the post-exposure treatment of rabies, the details of 244 rabies patients, including their anti-rabies treatment of injuries or related incidents, were ascertained in Guangdong provincial jurisdiction. The risk factors to which the patients were predisposed or the regimens given to 80 patients who received any type of PEP were analysed to identify the reasons for the PEP failures. Results: The results from analysis of the large number of human rabies cases showed that rabies in China was largely under control during the period 1990-1996. However, there has been a large jump in the number of reported rabies cases since 2001 up to a new peak (with an incidence rate of 0.20 per 100000 people) that was reached in 2004, and where the level has remained until present. Then, we analysed the PEP in 244 rabies cases collected in the Guangdong province in 2003 and 2004, and found that 67.2% of the patients did not seek medical services or did not receive any PEP. Further analysis of PEP for the 80 rabies patients who received any type of PEP indicated that almost all of the patients did not receive proper or timely treatment on the wounds or post-exposure vaccination or rabies immunoglobulins.
Neonatal tetanus in Turkey; what has changed in the last decade?
Bunyamin Dikici, Hakan Uzun, Ebru Yilmaz-Keskin, Taskin Tas, Ali Gunes, Halil Kocamaz, Capan Konca and Mehmet A Tas Tue, 19 Aug 2008 00:00:00 -0000
Background: Neonatal tetanus (NT) is still considered as one of the major causes of neonatal death in many developing countries. The aim of the present study was to assess the characteristics of sixty-seven infants with the diagnosis of neonatal tetanus followed-up in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, between 1991 and 2006, and to draw attention to factors that may contribute (or may have contributed) to the elimination of the disease in Diyarbakir. Methods: The data of sixty-seven infants whose epidemiological and clinical findings were compatible with neonatal tetanus were reviewed. Patients were stratified into two groups according to whether they survived or not to assess the effect of certain factors in the prognosis. Factors having a contribution to the higher rate of tetanus among newborn infants were discussed. Results: A total of 55 cases of NT had been hospitalized between 1991 and 1996 whereas only 12 patients admitted in the last decade. All of the infants had been delivered at home by untrained traditional birth attendants (TBA), and none of the mothers had been immunized with tetanus toxoid during her pregnancy. Twenty-eight (41.8%) of the infants died during their follow-up. Lower birth weight, younger age at onset of symptoms and at the time admission, the presence of opisthotonus, risus sardonicus and were associated with a higher mortality rate. Conclusion: Although the number of neonatal tetanus cases admitted to our clinic in recent years is lower than in the last decade efforts including appropriate health education of the masses, ensurement of access to antenatal sevices and increasing the rate of tetanus immunization among mothers still should be made in our region to achieve the goal of neonatal tetanus elimination.
Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa
Andrew A Adjei, Henry B Armah, Foster Gbagbo, Isaac Boamah, Clement Adu-Gyamfi and Isaac Asare Mon, 18 Aug 2008 00:00:00 -0000
Background: Human herpesvirus 8 (HHV-8), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are prevalent in Africa, but less common elsewhere and the modes of transmission are still subject to debate. Generally, they rarely cause disease in the immunocompetent host but are highly oncogenic when associated with immunosuppression. Although the high prevalence of HHV-8, CMV and EBV has been well documented in Africa, such data are sparse from Ghana. Methods: Serum samples from 3275 HIV-seronegative healthy blood donors and 250 HIV-AIDS patients were tested for antibodies specific for HHV-8, CMV and EBV by IgG ELISA assays. Differences in seropositivity rates by gender and age were evaluated using the Chi-square test with Yates correction. Results: Of the 3275 HIV-seronegative healthy blood donors tested, 2573 (78.6%) were males and 702 (21.4%) were females, with ages ranging from 18 to 65 years (median 32.6; mean 31.2; mode 30). Of the 250 HIV-AIDS patients tested, 140 (56%) were males and 110 (44%) were females, with ages ranging from 17 to 64 years (median 30.8; mean 30.3; mode 28). Among the HIV-seronegative healthy blood donors, overall seroprevalence of HHV-8, CMV and EBV was 23.7%, 77.6% and 20.0%, respectively. Among the HIV-AIDS patients, overall seroprevalence of HHV-8, CMV and EBV was 65.6%, 59.2% and 87.2%, respectively. The seroprevalence of HHV-8 (p 0.05) for all three infections among HIV-seronegative healthy blood donors and HIV-AIDS patients in Ghana. Conclusion: The results presented herein indicate that HHV-8, CMV and EBV infections are hyperendemic in both HIV-seronegative and HIV-seropositive Ghanaians, and suggest primarily a horizontal route of transmission of these three viral infections in Ghana.
Schistosomiasis transmission at high altitude crater lakes in Western Uganda
Rubaihayo John, Moghusu Ezekiel, Clouds Philbert and Abaasa Andrew Mon, 11 Aug 2008 00:00:00 -0000
Background: Contrary to previous reports which indicated no transmission of schistosomiasis at altitude >1,400 m above sea level in Uganda, in this study it has been established that schistosomiasis transmission can take place at an altitude range of 1487–1682 m above sea level in western Uganda. Methods: An epidemiological survey of intestinal schistosomiasis was carried out in school children staying around 13 high altitude crater lakes in Western Uganda. Stool samples were collected and then processed with the Kato-Katz technique using 42 mg templates. Thereafter schistosome eggs were counted under a microscope and eggs per gram (epg) of stool calculated. A semi-structured questionnaire was used to obtain demographic data and information on risk factors. Results: 36.7% of the pupils studied used crater lakes as the main source of domestic water and the crater lakes studied were at altitude ranging from 1487–1682 m above sea level. 84.6% of the crater lakes studied were infective with over 50% of the users infected.The overall prevalence of Schistosoma mansoni infection was 27.8% (103/370) with stool egg load ranging from 24–6048 per gram of stool. 84.3%( 312) had light infections (400 egg/gm of stool). Prevalence was highest in the age group 12–14 years (49.5%) and geometric mean intensity was highest in the age group 9–11 years (238 epg). The prevalence and geometric mean intensity of infection among girls was lower (26%; 290 epg) compared to that of boys (29.6%; 463 epg) (t = 4.383, p < 0.05). Though 61%(225) of the pupils interviewed were aware of the existence of the disease, 78% (290)didn't know the mode of transmission and only 8% (30) of those found infected were aware of their infection status. In a multivariate logistic regression model, altitude and water source (crater lakes) were significantly associated with infection.Conclusion and recommendationsThe altitudinal threshold for S. mansoni transmission in Uganda has changed and use of crater water at an altitude higher than 1,400 m above sea level poses a risk of acquiring S. mansoni infection in western Uganda. However, further research is required to establish whether the observed altitudinal threshold change is as a result of climate change or other factors. It is also necessary to establish the impact this could have on the epidemiology of schistosomiasis and other vector-borne diseases in Uganda. In addition, sensitisation and mass treatment of the affected community is urgently required.
The Recent-Transmission of Mycobacterium tuberculosis Strains among Iranian and Afghan Relapse Cases: a DNA-fingerprinting using RFLP and spoligotyping
Parissa-Farnia, Mohammad Reza Masjedi, Mohammad Varahram, Mehdi Mirsaeidi, Mojtaba Ahmadi, Mehdi Khazampour, Payam Tabarsi, Parvaneh Baghei, Mojtaba Marjane, Muslam Bahadori, Abolhasan Zia Zarifi and Ali Akbar Velayati Wed, 06 Aug 2008 00:00:00 -0000
Background: Relapse of tuberculosis (TB) may develop as the result of reactivation of the endogenous primary infection, or as a result of a exogenous reinfection. This survey evaluated the rate of reactivation versus recent transmission among Iranian and Afghan relapse cases. Methods: The sputum specimens were digested, examined microscopically for acid-fast bacilli, and inoculated into Löwenstein-Jensen slants by standard procedures. Thereafter, the susceptibility and identification tests were performed on culture positive specimens. Subsequently, the strains that were identified as Mycobacterium tuberculosis (258 isolates) were subjected to IS6110 restriction fragment length polymorphism (RFLP) and spoligotyping. Additional patient's information was collected for further epidemiological analysis. Patients whose isolates had identical genotyping patterns were considered a cluster with recent transmission episode. Results: Out of 258 available isolates, 72(28%) had multi-drug resistant (MDR-TB) in ratio and 42 (16.2%) had other resistant. Notably, 38 of MDR-TB cases (52%) were isolated from Afghan patients. By IS6110-RFLP typing method, 65 patients (25%) were clustered in 29 clusters. In cluster cases, the intra-community transmissions between Iranian and Afghan patients were 41%. All MDR-TB patients in clusters had either Haarlem I or Beijing characteristic. The risk factors like sex, family history, close contact, living condition, PPD test result and site of TB infection were not associated with clustering. Although, the MDR-TB strains were more frequent in non-cluster cases (31%) than cluster one(18%) (P < 0.05). Majority of M. tuberculosis strains isolated from non-cluster cases were belong to EAI3 (51; 30%) and CASI(32;18.6%) superfamilies. Conclusion: During the studied period, reactivation of a previous infection remain the more probable cause of recurrence. Although, the evidence of intra- community transmission between Iranian and Afghan TB cases, highlighted the impact of afghan immigrants in national tuberculosis control program (NTP) of Iran.
Current Opinion in Infectious Diseases - Current Table Of Contents
Editorial introductions.
Page: viiDOI: 10.1097/QCO.0b013e3283117e55
Charles Anthony Hart: 25 February 1948 - 21 September 2007.
Page: 453DOI: 10.1097/QCO.0b013e328313ba91Authors: Beeching, Nick
Tuberculosis in the developing world: recent advances in diagnosis with special consideration of extensively drug-resistant tuberculosis.
Page: 454DOI: 10.1097/QCO.0b013e32830ce783Authors: Grandjean, Louis a; Moore, David AJ b
Sites:
A Focus on Infectious Diseases: /Find Infectious Disease health articles and videos and other Infectious Disease health topicsBioMed Central: Offers the current infectious disease reports.
Clinical Infectious Diseases, Electronic Edition: Published by the University of Chicago for the Infectious Diseases Society of America. Features news, articles, and practice guidelines.
Communicable Disease and Immunizations: Communicable Diseases and Immunizations webpage including fact sheets on diseases.
Communicable Disease and Public Health: A journal published by the Health Protection Agency in association with the Scottish Centre for Infection and Environmental Health. Find back and current issues and info about the CDPH.
Diagnosis and Management of Infectious Diseases: A complete guide to the diagnosis and management of all infectious diseases and an account of medically relevant viruses, bacteria, fungi and parasites
Disease Outbreak News: Information about disease outbreaks anywhere in the world, searchable by time period, with archives by disease; from the Communicable Disease Surveillance and Response (CSR), World Health Organization.
eMedicine Health: Lymph glands (also called nodes) are a part of your lymphatic system, which is one of your body's barriers to infection and plays a role in the immune responses. When ...
eMedicine Health - Finger Infection: Injury or infection to a finger or fingers is a common problem. Infection can range from mild to potentially serious. Often these infections start out small and are relatively easy ...
eMedicine Health - Sepsis: Learn about sepsis (blood infection) in which the number of people dying from it has doubled in the last 20 years. Causes of sepsis include pneumonia, bladder, kidney, or urinary tract infection, cellulitis, appendicitis, and meningitis.
Emerging Infectious Diseases Journal: Extensive e-journal from the CDC.
Health Protection Agency: Infections: Health Protection Agency Centre for Infections
Infections - MCW HealthLink: MCW HealthLink articles on Infections/Infectious Diseases
Infectious Disease Control Unit: Infectious Disease Control Unit Home Page
Infectious Disease News: Online version of the magazine. Includes breaking news, archives, online seminars, and specialty forums.
Infectious Diseases: Articles in .pdf format - requiring Adobe Acrobat reader. Plus a link directory.
Infectious Diseases in Children: Online version of the journal. Includes case studies, articles, and monographs.
Infectious Diseases Society of America: Includes information about the IDSA, a career center, newsroom, practice guidelines, and journals and publications.
International Society for Infectious Diseases: ISID consists of individuals interested in infectious diseases, including specialists, microbiologists, immunologists, epidemiologists, public health workers, parasitologists, virologists, mycologists, and molecular biologists. Find publications, resources, memberships and programs.
Johns Hopkins Infectious Diseases: Physicians/Clinicians: search by bug/drug/diagnosis; find current, concise information on antibiotics for treating infectious diseases; ask questions of Hopkins' experts at Johns Hopkins Infectious Diseases Antibiotics Guide.
Karolinska Institute: Library and Information Center: Compilation of medical microbiology and infectious diseases sites.
Kidshealth: Infections: Every child gets sick from time to time. When your child isn't feeling well, you'll want to know how to recognize the symptoms, how to help, and when to call the doctor. Find out what you need to know about all the common and not-so-common infections.
Medical Microbiology: Online textbook with scientific and medical information on many disease causing organisms.
Medical Microbiology: Neal Chamberlain, PhD Medical Microbiology Educational Site, Kirksville College of Osteopathic Medicine
Mediscover - Infectious Diseases: Content includes topical news from the world or research, recent releases from the world of clinical practice - antivirals, antibiotics and vaccines, regular feature articles, specialist resources.
Medlineplus - Infectious Diseases: Infectious Diseases
Medscape Infectious Diseases: Find Infectious Diseases Continuing Medical Education (CME), Infectious Diseases medical journal articles, MEDLINE, Infectious Diseases medical news, Infectious Diseases conference coverage and comprehensive drug information on Medscape, a free resource for physicians.
Medscape Infectious Diseases Headlines: Latest medical news and information from Medscape.com.
Microbes: in Sickness and in Health: Publication of the National Institute of Allergy and Infectious Diseases.
Microbial Threats to Health: Emergence, Detection, and Response (2003): Covers emerging diseases, resurgence of known pathogens, and the human factors that converge to provide an environment where diseases can spread. Complete 350-page report from the Board on Global Health of the National Academy of Science, in Open Book and PDF formats.
National Center for Infectious Diseases: Homepage for the CDC's National Center for Infectious Diseases. Source for infectious disease information, programs, organizational information.
National Foundation for Infectious Diseases: The National Foundation for Infectious Diseases is dedicated to educating the public and health care professionals about causes, treatment and prevention of infectious diseases.
National Institute of Allergy and Infectious Diseases (NIAID): National Institute of Allergy and Infectious Diseases Home Page
New York State Department of Health: Communicable Diseases: Communicable Disease Fact Sheets
OHSU Health: Infectious Diseases: Detailed information on the most common infectious diseases, including HIV/AIDS, chickenpox, chronic fatigue syndrome, common cold, diphtheria, E. coli, giardiasis, infectious mononucleosis, influenza (flu), lyme disease, malaria, measles, meningitis, mum
Pediatric Investigator Collaborative Network on Infections in Canada: The official Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) website.
Research and Training in Tropical Diseases: Website of the UNICEF-UNDP-World Bank-WHO Special Programme for Research and Training in Tropical Diseases
Scottish Centre for Infection and Environmental Health: This is a holding page for users accessing the HPS website from SCIEH Online.
The Bad Bug Book: This handbook provides basic facts regarding foodborne pathogenic microorganisms and natural toxins.
The American Medical Association's Resources on Infectious Diseases: News and information on infectious diseases and vaccinations.
The Core Center: A freestanding outpatient clinic devoted to the prevention, research and treatment of infectious diseases
The Global Infectious Disease Threat and Its Implications for the United States: Extensive report from the US Central Intelligence Agency.
The Internet Pathology Laboratory for Medical Education: Infection Index: Images of organisms and their effects on organs.
The Lancet: Infectious Diseases: Online version of the journal. Includes full text articles and abstracts. Requires registration to see most of the content. Basic registration is free. Some articles are pay per view.
The Merck Manual - Infectious Diseases: Specific and general clinical information on infectious diseases and their treatment.
The New England Journal of Medicine: Infectious Disease: The Infectious Diseases collection covers topics such as sepsis, meningitis, and pneumonia and includes research articles, case reports, reviews, and editorial commentary.
U.S. Army Medical Research Unit-Kenya: Research and surveillance of tropical diseases, including virology, parasitology, and immunology, to develop and test improved means for predicting, detecting, preventing, and treating infectious disease threats in East Africa.
USAMRIID: The United States Army Medical Research Institute for infectious diseases.
Vads Corner: Emerging viruses, Outbreaks, Haze, Nipah virus, enterovirus 71, Influenza, H5N1 Influenza A, Chikungunya virus, West Nile virus, Dioxin, Arsenic, Medline, Medical Journals.
WHO/OMS - Infectious diseases: Articles from the World Health Organization.
This directory is based on the Open Directory and may have been modified