2011年东莞市登革热与基孔肯雅热监测结果分析

目的:尽早发现登革热与基孔肯雅热病例,及时采取有效防控措施。方法:对2011年6月20日-2011年8月31日东莞市应急监测病例及疫情监测病例血清样品,采用荧光PCR检测登革热与基孔肯雅热病毒核酸,登革热核酸检测阴性者,再用ELISA法检测登革热病毒IgM抗体。结果:共收集及检测248份合格血清样品。其中,应急监测病例血清234份,检测结果均为阴性;疫情监测病例血清14份,检出2份为登革热IgM抗体阳性,1份为登革热核酸阳性,为IV型;确诊2例为登革热输入性病例。结论:通过实验室应急监测,发现了登革热病例,及时控制了疫情的传播扩散。     

Prevention of Zika virus infection: Knowledge,attitudes, and practices of pregnant women in Korea

Abstract

This study was performed to investigate the association of knowledge, attitudes, and preventive practices for the prevention of Zika virus infection. The study sample consisted of 185 pregnant women in Korea. The Zika virus-related knowledge and attitude of pregnant women significantly affected preventive practices. The younger pregnant women and pregnant women who had not taken the influenza vaccine had lesser preventive practices of the Zika virus, thereby necessitating educating them and emphasizing good preventive practices. Our results suggest that systematic education and effective prevention programs for Zika virus will contribute to the prevention of infection.     

一起登革热和一起基孔肯雅热暴发疫情的对比分析

目的 了解登革热和基孔肯雅热这两种伊蚊传播疾病的流行病学特征和临床特征异同点,为预防控制这两种疾病提供依据.方法 采用问卷调查和查阅患者就诊资料的方法,搜集东莞市2010年发生的一起登革热和一起基孔肯雅热社区暴发疫情的流行病学特征和临床特征资料并进行对比分析.结果 两起疫情共同点为:输入性疫情;发生在夏秋季节;具有一定的家庭聚集性;发生疫情的社区蚊媒密度高;采取以杀灭成蚊和清除伊蚊孳生地为主的综合性防控措施可有效控制疫情;登革热和基孔肯雅热临床表现类似,以发热、疼痛为主.两起疫情的不同点:与登革热暴发疫情相比,基孔肯雅热暴发疫情强度更大、扩散范围更广、家庭聚集性更强,但疫情持续时间短;在临床表现方面,基孔肯雅热患者关节痛、皮疹、肌肉痛的发生率高于登革热患者,而登革热患者头痛、白细胞减少、血小板减少的发生率高于基孔肯雅热患者.结论 登革热和基孔肯雅热的流行病学和临床特征类似.但与登革热相比,基孔肯雅热传播能力更强;病人更常见关节痛、皮疹,而白细胞、血小板则多正常.     

Clinical characteristics and predictive score of dengue vs. chikungunya virus infections

BackgroundChikungunya (CHIKV) and dengue viruses (DENV) are two arboviruses with epidemic potential and similar clinical presentations. The potential life-threatening risk associated with DENV justifies an immediate biological assessment and medical follow-up which may be delayed for CHIKV.ObjectivesTo compare the clinical variables that would help differentiate patients infected with CHIKV or DENV, and then to compute a predictive score.Patients and methodRetrospective case-control study comparing CHIKV-infected patients diagnosed by RT-PCR in 2014 with patients infected with DENV diagnosed by positive NS1 antigen test in 2013. Children aged < 15 years and pregnant women were excluded. Clinical and biological variables were compared, and a multivariate analysis was performed. A clinical score was developed using the β coefficients to differentiate the infections.ResultsOver the study period 168 patients infected with CHIKV were compared with 452 patients with DENV. The clinical variables independently associated with CHIKV was joint and back pain, and those associated with DENV were headache, muscle pain, nausea/vomiting, diarrhea, and hemorrhagic signs. The clinical score had 98% sensitivity for DENV and a ROC curve of 0.96.ConclusionThese two infections have a similar clinical presentation but the use of the proposed clinical score during the acute phase of the disease would make it possible to identify cases of DENV during a CHIKV epidemic to suggest adequate patient management.     

The invaders: Phylogeography of dengue and chikungunya viruses Aedes vectors, on the South West islands of the Indian Ocean

Aedes albopictus and Aedes aegypti are the two main worldwide arbovirus vectors that have experienced invasion phases. Aedes aegypti is a pantropical species that spread centuries ago whereas Ae. albopictus started the main wave of invasion in the 1980s. Both species have been at various times on the different islands in Southwestern Indian Ocean (SWIO). This area provides an opportunity to examine the extent to which mosquitoes colonization patterns are influenced by different introductory events likely linked with human settlement and migration between the islands. To explore this hypothesis, we propose a CO1-based phylogeny using a large sampling of fresh Ae. albopictus, Ae. aegypti, and Ae. mascarensis, and 50-year-old dry specimens originating from different Indian Ocean islands.Our data allow us to hypothesize the existence of at least two waves of invasion for Ae. albopictus in the islands of SWIO. The first one most likely occurred several centuries ago with establishments in Madagascar, Mauritius and Reunion Island. The other one that appears to currently still on-going, reached almost all the islands of SWIO during the 1990s or later. The low genetic diversity found between the ancient invasive strain and the contemporary one, indicates with great certainty that Ae. albopictus is not indigenous to the islands of SWIO. Recently, in Madagascar, an invasive lineage of Ae. albopictus has expanded all over the island while Ae. aegypti populations have declined in urban areas. Three clusters of Aedes aegypti have been observed, two fitting with the wild form Ae. aegypti formosus and the other one fitting with the more domestic form Ae. ae. aegypti. Sequence of Ae. mascarensis, endemic to Mauritius suggest that this species might belong to Ae. aegypti species and on this basis we propose to classify it as a sub species or form of Ae. aegypti species.Given the increase of human population flux on these islands, the occurrence of these vectors and their ability to spread quickly are of high importance of arbovirus transmission and the epidemicity of the associated diseases in these islands.     

Diarrhoeal disease: Knowledge,attitudes and practices in an Aboriginal community

This study was carried out in an Australian Aboriginal community in South Australia on the knowledge, attitudes and practices relating to diarrhoea] disease. Suggestions were sought on appropriate interventions. Dietary causes (including alcohol), factors relating to drinking water, poor environmental hygiene, infective agents and teething were considered by community member to be important in the causation of diarrhoea. Poor personal and domestic hygiene, and the lack of adequate bathing, toilet and laundry facilities were not considered to be important contributory factors. This may reflect the Aboriginal view of hygiene derived from many years of desert living as nomadic hunter-gatherers. The study provides valuable information to enable the selection of appropriate interventions for the control of diarrhoeal disease in this community.     

广东地区蝙蝠携带登革热病毒、寨卡病毒以及狂犬病病毒的流行病学调查

目的 了解广东地区蝙蝠携带狂犬病病毒、寨卡病毒以及登革热病毒情况。方法 2014-2016年分别在广州市和湛江市部分地区采集蝙蝠,取其血清和脑组织标本,采用实时荧光定量聚合酶链式反应法（real-time quantitative polymerase chain reaction,qRT-PCR）、巢式聚合酶链反应（nested polymerase chain reaction,Nested PCR）,酶联免疫吸附测定（enzyme linked immunosorbent assay,ELISA）和细胞培养分离检测所采标本中的狂犬病病毒、登革热病毒和寨卡病毒的感染情况。结果 采集蝙蝠共174只,分属2科3个种：果蝠科的犬蝠属（Cynopterus sphinx）33只、蝙蝠科的普通伏翼属（Pipistrellusabramus）9只及高头蝠属（Scotophiluskuhlii）132只。分别取得血清、脑组织各174份。在犬蝠脑标本中检出登革热病毒阳性1份,阳性率0.06%（1/174）,寨卡病毒、狂犬病病毒均未检出。结论 广东两个地区的3种蝙蝠作为寨卡病毒、登革热病毒和狂犬病病毒宿主的可能性较小。     

Knowledge,attitudes, and practices regarding drug interactions among community pharmacists

Journal of Public Health - This study aimed to explore the knowledge, attitude, and practice that community pharmacists of Lebanon hold with regard to checking for drug interactions. This...     

Knowledge,attitudes, and practices regarding ticks and tick-borne diseases,Finland

Tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are endemic in Finland, with tens and thousands of cases, respectively, reported annually. We performed a field survey to investigate people’s knowledge, attitudes and practices (KAP) regarding ticks, tick-borne diseases, and prevention strategies.The KAP were assessed using a pre-validated anonymous questionnaire consisting of 39 questions and statements. On two consecutive days in July 2016, convenience sampling was used in the cities of Parainen and Kotka, located in high-risk areas of tick-borne diseases, particularly of TBE. In attitudes and practices sections, each question was scored and analysed with ordered logistic regression model.In total, 101 individuals responded. The TBE vaccination rate among respondents was 40%. The best known preventive measures were having vaccination against TBE (88%), and wearing long sleeves and pants against ticks (81%). Two-thirds incorrectly identified the ring-like rash as a symptom of TBE. Of all respondents, 78% could not exclude that TBE can be treated with antibiotics; 55% that vaccine protects against LB; and 46% that it protects against ticks. The minority (14%) believed tick repellents to be effective. Among preventive behaviour, the quick removal of an attached tick was most frequently applied (97%). Repellents were used by 21% when visiting tick-infested areas. Significant associations were found between the vaccination status and having a correct belief that the vaccine protects against TBE (P < 0.001) but not against ticks (P < 0.05), or LB (P < 0.001).KAP is a quick and easy tool to get a rough estimation on people’s awareness regarding ticks and tick-borne diseases. We identified gaps in knowledge and misbeliefs. Our results can be used in public health communication tools on tick-borne diseases, especially those on intervention strategies.     

First evidence of chikungunya virus infection in Assam, Northeast India

During June-September 2008, an illness characterized by fever, headache and joint pain was reported in Assam state, northeast India. It presented characteristic features resembling chikungunya or dengue virus infection based on clinical symptoms. Dengue and chikungunya IgM antibody was detected in 10.0% (28/280) and 3.6% (10/280) patients respectively. The chikungunya positive patients did not travel to and from any endemic region confirming indigenous transmission. Persistent arthralgia and hearing loss has been observed in a recovered patient. Entomological surveys revealed the presence of vectors viz. Aedes aegypti and Aedes albopictus. This is the maiden report of chikungunya occurrence in Northeast India.     

Knowledge, attitudes, and screening practices among older men regarding prostate cancer

OBJECTIVES: This study determined population-based rates of reported prostate cancer screening and assessed prostate cancer-related knowledge, attitudes, and screening practices among men in New York aged 50 years and older. METHODS: Two telephone surveys were conducted. One was included in the 1994 and 1995 statewide Behavioral Risk Factor Surveillance System interviews, and the other was a community-level survey that targeted Black men (African-American Men Survey). Prevalence estimates were computed for each survey, and prostate cancer screening practices were assessed with logistic regression models. RESULTS: Overall, fewer than 10% of the men in each survey perceived their prostate cancer risk to be high; almost 20% perceived no risk of developing the disease. Approximately 60% of the men in each survey reported ever having had a prostate-specific antigen (PSA) test. In both surveys, physician advice was significantly associated with screening with a PSA test or a digital rectal examination. Also, race was significantly associated with screening in the statewide survey. CONCLUSIONS: Many New York men appear to be unaware of risk factors for prostate cancer. However, a substantial percentage reported having been screened for the disease; physician advice may have been a major determining factor in their decision to be tested.     

Knowledge, attitudes, and practices of food service staff regarding food hygiene in Shiraz, Iran.

BACKGROUND: The practice of safety measures by the food service staff in hospitals is necessary for the prevention of food-borne outbreaks. Hospitalized patients are more vulnerable to potential hazards, and neglecting these principles can lead to increased morbidity and mortality. METHODS: We assessed the knowledge, attitudes, and practices of food service staff regarding food hygiene in government and private hospitals in Shiraz, Iran. Two questionnaires were designed, one for food service staff and the other for supervisors. Thirty-one hospitals were approached, and the response rate was 99.5%. Four models were developed regarding knowledge, attitudes, and practices, and a multiple logistic regression analysis was performed. Comparison among the government and private hospitals was done. RESULTS: This study showed that personnel had little knowledge regarding the pathogens that cause food-borne diseases and the correct temperature for the storage of hot or cold ready-to-eat foods. Older personnel had better attitudes and practices. Females practiced safety measures less often than did males. Personnel working in hospitals with fewer than 300 beds also had better practices. Most of the personnel had positive attitudes, but disparity between attitude and practice was noted. CONCLUSION: There is a dire need for education and increased awareness among food service staff regarding safe food handling practices.     

Knowledge, attitudes, and behaviors regarding piperacillin-tazobactam prescribing practices: results from a multicenter study.

We investigated knowledge, attitudes, and behaviors of prescribers concerning piperacillin-tazobactam use at 4 Emory University-affiliated hospitals. Discussions during focus groups indicated that the participants' perceived knowledge of clinical criteria for appropriate piperacillin-tazobactam use was inadequate. Retrospective review of medical records identified inappropriate practices. These findings have influenced ongoing interventions aimed at optimizing piperacillin-tazobactam use.