Abstract: Introduction. This study aimed to explore the predictors of mortality from scrub typhus infection in patients requiring intensive care unit (ICU) admission. Materials and Methods. A retrospective study was conducted on 120 patients with serum ELISA IgM positive for scrub typhus (optical density ≥ 0.5) admitted at the medical ICU of Chitwan Medical College Teaching Hospital between April 2016 and September 2017. Data was extracted from patient medical records and electronic database of the hospital. The outcome measurement was mortality (Yes/No) due to the infection. A multivariate binary logistic regression analysis () using potential variables from bivariate analysis () was adjusted to predict the mortality. Results. The mortality rate was 20% (24/120). Factors associated with mortality, as found using bivariate analysis, were heart rate> 100/minute (), systolic blood pressure < 90 mmHg (), diastolic blood pressure < 60 mmHg (), serum creatinine> 1.4 mg/dl (), acute kidney injury requiring dialysis (), acute respiratory distress syndrome (), and shock requiring vasopressor (). Regression analysis showed age (odds ratio [OR] = 1.063; 95% CI = 1.010–1.118; ) and serum creatinine (OR = 1.063; 95% CI = 1.010–1.118; ) as significant predictors of poor outcome. Conclusion. Older age and high serum creatinine were found to be independent predictors of poor outcome in patients with scrub typhus admitted in medical ICU. PubDate: Sun, 03 Jun 2018 00:00:00 +000
Abstract: Bovine anaplasmosis is an infectious disease of cattle caused by the obligate intercellular bacterium, Anaplasma marginale, and it primarily occurs in tropical and subtropical regions of the world. In this study, an age-structured deterministic model for the transmission dynamics of bovine anaplasmosis was developed; the model incorporates symptomatic and asymptomatic cattle classes. Sensitivity analysis was carried out to determine the parameters with the highest impact on the reproduction number. The dominant parameters were the bovine natural and disease-induced death rates, disease progression rate in adult cattle, the mechanical devices transmission probability and contact rates, the pathogen contamination, and decay rates on the mechanical devices. The result of the sensitivity analysis suggests that control strategies to effectively prevent/control the spread of bovine anaplasmosis should focus on these parameters according to their positive or negative effect as seen from the sensitivity index. Following the results of the sensitivity analysis, three control strategies were investigated, namely, bovine-culling, safety-control, and universal. In addition to these strategies, three effectiveness levels (low, medium, and high) were considered for each control strategy using the cumulative number of newly infected cases in both juvenile and adult cattle as measure function. The universal strategy (comprising both cattle-culling and safety-control strategies) is only marginally better at reducing the number of infected cattle compare to the safety-control strategy. This result suggests that efforts should be aimed at improving and maintaining good hygiene practices; furthermore, the added benefit of culling infected cows is only minimal and not cost-efficient. PubDate: Wed, 02 May 2018 00:00:00 +000
Abstract: Toxoplasma gondii is an important foodborne protozoan that can be transmitted through infected blood containing tachyzoite form of the parasite. The current study aimed to evaluate the prevalence of T. gondii infection and related risk factors among healthy blood donors in Boyer-Ahmad County, southwest Iran. Blood samples were taken from 285 healthy blood donors who voluntarily agreed to participate in this study. Sera and buffy coat were isolated from the blood samples for serological and molecular evaluations. The sera were tested for anti-T. gondii antibodies (both IgG and IgM), using a commercial ELISA kit. The buffy coat of seropositive cases was evaluated for detection of T. gondii DNA by PCR. Moreover, a structured questionnaire, containing socioepidemiological data and possible risk factors, was filled out by each participant during sample collection. Anti-T. gondii antibodies were detected in sera of 48/285 (16.8%) participants. Only two of the subjects (0.7%) were seropositive for both IgG and IgM antibodies. T. gondii DNA was not detected in buffy coat of any of the seropositive cases. Risk factors such as contact with soil (OR, 9.7; 95% CI, 4.9–19.4) and consumption of semicooked meat (OR, 2.5; 95% CI, 1.2–5.03) were statistically associated with seropositivity to T. gondii. The seroprevalence rate of T. gondii antibodies in the blood donors of Boyer-Ahmad County was not high in comparison with other regions in Iran. In this study, consumption of undercooked meats, job, and contact with soil were independent risk factors associated with T. gondii infection, which can be considered as potential sources of T. gondii infection. PubDate: Sun, 15 Apr 2018 00:00:00 +000
Abstract: Objective. We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers’ (HCWs) compliance with hand hygiene (HH). Settings. Medical and postoperative cardiac surgery units. Design. Prospective cohort study. Subject. The study included 40 HCWs. Intervention. Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH. A 2nd interview was held 6 weeks later to obtain handprint culture after HH. A 3rd interview was held to obtain a handprint culture before HH. One month before implementation of handprint cultures and during the 12-week study period, monitoring of HCWs for compliance with HH was observed by 2 independent observers. Main Results. There was a significant improvement in HH compliance following handprint culture interview (). The frequency of positive cultures, obtained from patients with suspected healthcare-associated infections, significantly declined (blood cultures: ; wound cultures: p = 0,003; sputum cultures: ). Conclusion. The visual message of handprint bacterial growth before and after HH seems an effective method to improve HH compliance. PubDate: Mon, 05 Mar 2018 06:59:53 +000
Abstract: Background. Antibiotic overprescribing is the major driving force for the emergence of antibiotics resistance. The aim of this study was to assess antibiotics prescribing at primary healthcare facilities in Addis Ababa, Ethiopia. Methods. The study was conducted in six public health centers found in Addis Ababa City. Data was collected retrospectively from a total of 900 prescriptions and selected medical charts of patients in the health centers in 2016. Data was entered and analyzed using EPI Info 7 and SPSS 20, respectively. Descriptive statistics and logistic regression analysis were used to analyze the data. Results. One or more antibiotics were prescribed in 56.0% of the prescriptions. Antibiotics accounted for 46.0% of the total cost of medicines prescribed. Amoxicillin was the most frequently (44.8%) prescribed antibiotic and upper respiratory tract infection was the most common (24.5%) diagnosis for prescribing antibiotics. Laboratory investigation was done for only about 27% of the cases for which antibiotics were prescribed. Conclusion. There was a high rate of antibiotics prescribing in the health centers often empirically which might exacerbate the antimicrobial resistance situation in the country. Large-scale study should be conducted to fully understand the prescribing pattern and identify the associated factors thereby design and implement appropriate interventions. PubDate: Wed, 28 Feb 2018 00:00:00 +000
Abstract: This study aimed to determine the prevalence of H. pylori infections among schoolchildren and investigate the associations between H. pylori seropositivity and existence of gastrointestinal symptoms. Methods. A prospective cross-sectional study was conducted during a period from January to December 2012 at Kassala state, east of Sudan. Schoolchildren from different primary schools were enrolled in the study. Sociodemographic characteristics and gastrointestinal symptoms were recorded from each child. A rapid immunochromatographic test was performed for the detection of H. pylori IgG antibodies. Data on patient demographic characteristics, clinical diagnosis, and findings of H. pylori infection were analyzed by simple descriptive statistics. Results. Among 431 schoolchildren, H. pylori seropositivity was found to be 21.8%. The majority of children (79; 84%) had BMI below the normal range. The most frequent symptoms associated with H. pylori infections were nausea (25.5%), followed by gastric pain (24.5%) and heart pain (20.2%). There were statistically significant differences in H. pylori seropositivity between boys and girls (). Conclusions. The prevalence of H. pylori infection among schoolchildren in Kassala city has been documented. Although the majority of the disease was associated with several gastrointestinal symptoms, the role of infection in the etiology of abdominal symptoms needs further investigations. PubDate: Mon, 15 Jan 2018 10:11:09 +000
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