Space‐time clusters of dengue fever in Bangladesh

Objective To examine the space‐time clustering of dengue fever (DF) transmission in Bangladesh using geographical information system and spatial scan statistics (SaTScan). Methods We obtained data on monthly suspected DF cases and deaths by district in Bangladesh for the period of 2000–2009 from Directorate General of Health Services. Population and district boundary data of each district were collected from national census managed by Bangladesh Bureau of Statistics. To identify the space‐time clusters of DF transmission a discrete Poisson model was performed using SaTScan software. Results Space‐time distribution of DF transmission was clustered during three periods 2000–2002, 2003–2005 and 2006–2009. Dhaka was the most likely cluster for DF in all three periods. Several other districts were significant secondary clusters. However, the geographical range of DF transmission appears to have declined in Bangladesh over the last decade. Conclusion There were significant space‐time clusters of DF in Bangladesh over the last decade. Our results would prompt future studies to explore how social and ecological factors may affect DF transmission and would also be useful for improving DF control and prevention programs in Bangladesh.     

Health-related quality of life in urban African Americans with type 2 diabetes

OBJECTIVE: To examine the association of socioeconomic barriers, familial barriers, and clinical variables with health-related quality of life (HRQL). METHODS: A cross-sectional study was conducted of 186 African Americans with type 2 diabetes recruited from 2 primary care clinics in East Baltimore, Maryland. Physical functioning, social functioning, mental health, and general health were measured using the Medical Outcomes Study 36-item short form. Socioeconomic (money, housing, street crime) and familial (family problems, caretaker responsibilities) barriers were assessed by standardized interview. Insulin use, comorbid disease, and measured abnormalities in body mass index, hemoglobin A1c (HbA1c), blood pressure, lipids, and renal function were investigated. RESULTS: Mean HRQL scores were: physical functioning, 61 +/- 29; social functioning, 76 +/- 26; mental health, 69 +/- 21; and general health, 48 +/- 21. Linear regression analyses revealed that each barrier to care was significantly associated with lower scores in 1 or more HRQL domain. As number of socioeconomic and familial barriers increased from 0 to 5, HRQL scores decreased by 18 for social functioning, 21 for general health, 23 for physical functioning, and 28 for mental health (all P for trend <.01). Clinical variables significantly associated with reduced HRQL were obesity, impaired renal function, insulin use, and comorbid disease. Blood pressure, lipids, and HbA1c were not significantly associated with HRQL. CONCLUSIONS: An independent, graded relationship was found between socioeconomic and familial barriers to care and HRQL. This relationship was at least as strong as the association between HRQL and the clinical variables more likely to be perceived by participants as causing symptomatic distress or impacting lifestyle.     

柳州市城乡中小学生伤害现状比较分析

目的分析柳州市市区与乡村中小学生伤害的种类、原因、地点、学段、性别分布及其城乡差异,为开展伤害预防提供科学依据。方法采用分层整群抽样方法于2007年11月对柳州市18所中小学校3600人进行问卷调查。结果市区伤害发生率为12.34%,低于乡村的36.79%,差异有统计学意义（χ2=265.91,Р〈0.01）。伤害类型顺位市区前四位为跌伤〉碰伤〉交通伤〉动物咬伤;乡村学生前四位为跌伤〉碰伤〉刀割伤〉交通伤。伤害原因市区学生前三位为玩耍（31.72%）、课间或课外活动（13.81%）、体育课（10.82%）;乡村学生前三位为玩耍（24.94%）、做家务（12.47%）和体育课（12.47%）。结论可根据受教育对象的学习阶段、性别、城乡差异等特点,以及目标人群中最易发生的与伤害相关的危险行为,制定针对性预防措施。     

The association between gut microbiome and anthropometric measurements in Bangladesh

ABSTRACT

Our objective was to investigate the relationship between the gut microbiota and anthropometric measurements among 248 participants from the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh. Our cohort represents a unique population that allows for the investigation of the gut microbiota and anthropometric measurements in lean individuals. We measured height, weight, arm, thigh, hip, and waist circumferences, and collected fecal samples. Microbial DNA was extracted from the stool samples and sequenced by 16S rRNA gene sequencing. We examined associations between relative abundance of individual bacterial taxa from phylum to genus levels and anthropometric measurements. We found that higher BMI, mid-upper arm circumference, waist circumference, and waist-to-hip ratio were associated with a lower alpha diversity of fecal bacteria. Relative abundance of the genus Oscillospira and the family S24-7 were inversely related to all measurements after correction for multiple testing. Relative abundance of genus Acidaminococcus and family Ruminococcaceae were also associated with several measurements. The positive associations of the genus Acidaminococcus with BMI, as well as waist and hip circumferences, were stronger in women than in men. Our data in this lean Bangladeshi population found a correlation between Oscillospira and leanness, as measured using multiple anthropometric measures.     

A Novel Sub-Lineage of Chikungunya Virus East/Central/South African Genotype Indian Ocean Lineage Caused Sequential Outbreaks in Bangladesh and Thailand

In recent decades, chikungunya virus (CHIKV) has become geographically widespread. In 2004, the CHIKV East/Central/South African (ECSA) genotype moved from Africa to Indian ocean islands and India followed by a large epidemic in Southeast Asia. In 2013, the CHIKV Asian genotype drove an outbreak in the Americas. Since 2016, CHIKV has re-emerged in the Indian subcontinent and Southeast Asia. In the present study, CHIKVs were obtained from Bangladesh in 2017 and Thailand in 2019, and their nearly full genomes were sequenced. Phylogenetic analysis revealed that the recent CHIKVs were of Indian Ocean Lineage (IOL) of genotype ECSA, similar to the previous outbreak. However, these CHIKVs were all clustered into a new distinct sub-lineage apart from the past IOL CHIKVs, and they lacked an alanine-to-valine substitution at position 226 of the E1 envelope glycoprotein, which enhances CHIKV replication in Aedes albopictus. Instead, all the re-emerged CHIKVs possessed mutations of lysine-to-glutamic acid at position 211 of E1 and valine-to-alanine at position 264 of E2. Molecular clock analysis suggested that the new sub-lineage CHIKV was introduced to Bangladesh around late 2015 and Thailand in early 2017. These results suggest that re-emerged CHIKVs have acquired different adaptations than the previous CHIKVs.     

佛山城乡居民食品安全意识的差异性分析

对佛山市城乡居民食品安全意识进行调查分析,结果表明:佛山城乡居民的食品安全意识存在统计差异:城市居民购物时以关注食品质量内在信息为主,农村居民购物决策以价格为先,多在集市、小卖部等安全性低的地方购买食品;遇到食品安全问题时,农村居民维权意识较低;尤其是作为初级农产品的生产者,农户对农药、善药等农业投入品的认知模糊,这给初级农产品的安全生产带来很大隐患.造成这些差异的主要原因在于城乡居民在经济收入、文化素质、城乡食品产销渠道以及政府安全监管等方面的差异.相关部门应采取有效措施提高农村居民食品安全意识,确保农村地区的食品安全.     

A Test of the Feasibility of Pneumococcal Vaccination in the Emergency Department

OBJECTIVE: To test the feasibility of pneumococcal immunization in an ED. METHODS: Cook County Hospital has an annual ED census of 120,000. Patients are 75% black and 15% Hispanic. Eighty-two percent of patients are uninsured. Seventy-three percent report no primary physician. Between May 27, 1997, and July 26, 1997, nurses had standing orders that patients meeting CDC-recommended criteria were to be offered pneumococcal immunization. Immunization was recorded in the system-wide registration computer. RESULTS: During the study period, 1,833 patient screenings encounters (13% of all patients) identified 1,493 high-risk patients. Only 10% of screened high-risk patients reported previous pneumococcal immunization. 1,173 were immunized against pneumococcus. Median number of immunizations per nurse per shift was 1.62. Patient through-put was not altered. CONCLUSION: Pneumococcal immunization is both necessary and feasible in a busy ED serving patients with little access to other immunization services.