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Hospital-Based Surveillance for Viral Hemorrhagic Fevers and Hepatitides in Ghana  [PDF]
Joseph Humphrey Kofi Bonney,Mubarak Osei-Kwasi,Theophilus Korku Adiku,Jacob Samson Barnor,Robert Amesiya,Chrysantus Kubio,Lawson Ahadzie,Stephan ?lschl?ger,Michaela Lelke,Beate Becker-Ziaja,Meike Pahlmann,Stephan Günther
PLOS Neglected Tropical Diseases , 2013, DOI: 10.1371/journal.pntd.0002435
Abstract: Background Viral hemorrhagic fevers (VHF) are acute diseases associated with bleeding, organ failure, and shock. VHF may hardly be distinguished clinically from other diseases in the African hospital, including viral hepatitis. This study was conducted to determine if VHF and viral hepatitis contribute to hospital morbidity in the Central and Northern parts of Ghana. Methodology/Principal Findings From 2009 to 2011, blood samples of 258 patients with VHF symptoms were collected at 18 hospitals in Ashanti, Brong-Ahafo, Northern, Upper West, and Upper East regions. Patients were tested by PCR for Lassa, Rift Valley, Crimean-Congo, Ebola/Marburg, and yellow fever viruses; hepatitis A (HAV), B (HBV), C (HCV), and E (HEV) viruses; and by ELISA for serological hepatitis markers. None of the patients tested positive for VHF. However, 21 (8.1%) showed anti-HBc IgM plus HBV DNA and/or HBsAg; 37 (14%) showed HBsAg and HBV DNA without anti-HBc IgM; 26 (10%) showed anti-HAV IgM and/or HAV RNA; and 20 (7.8%) were HCV RNA-positive. None was positive for HEV RNA or anti-HEV IgM plus IgG. Viral genotypes were determined as HAV-IB, HBV-A and E, and HCV-1, 2, and 4. Conclusions/Significance VHFs do not cause significant hospital morbidity in the study area. However, the incidence of acute hepatitis A and B, and hepatitis B and C with active virus replication is high. These infections may mimic VHF and need to be considered if VHF is suspected. The data may help decision makers to allocate resources and focus surveillance systems on the diseases of relevance in Ghana.
An entomological surveillance system based on open spatial information for participative dengue control
Regis, Leda;Souza, Wayner V.;Furtado, André F.;Fonseca, Cláudio D.;Silveira Jr., José C.;Ribeiro Jr., Paulo J.;Melo-Santos, Maria Alice V.;Carvalho, Marilia S.;Monteiro, Antonio M.V.;
Anais da Academia Brasileira de Ciências , 2009, DOI: 10.1590/S0001-37652009000400004
Abstract: aedes aegypti is a very efficient disseminator of human pathogens. this condition is the result of evolutionary adaptations to frequent haematophagy, as well as to the colonization of countless types of habitats associated with environmental and cultural factors that favor the proliferation of this mosquito in urban ecosystems. studies using sensitive methods of monitoring demonstrate that the methods of surveillance used in the brazilian program do not show the high degrees of the infestation of cities by this vector. to increase the capacity of the health sector, new tools are needed to the practice of surveillance, which incorporate aspects of the vector, place and human population. we describe here the smcp-aedes - monitoring system and population control of aedes aegypti, aiming to provide an entomological surveillance framework as a basis for epidemiological surveillance of dengue. the smcp-aedes is uphold in the space technology information, supported by the intensive use of the web and free software to collect, store, analyze and disseminate information on the spatial-temporal distribution of the estimated density for the population of aedes, based on data systematically collected with the use of ovitraps. planned control interventions, intensified where and when indicated by the entomological surveillance, are agreed with the communities, relying on the permanent social mobilization.
First report on entomological field activities for the surveillance of West Nile disease in Italy
Luciano Toma,Micaela Cipriani,Maria Goffredo,Roberto Romi
Veterinaria Italiana , 2008,
Abstract: West Nile virus (WNV) is neuropathogenic for birds, horses and humans and is maintained in natural cycles between birds and mosquitoes, particularly the Culex genus; horses and humans are considered to be incidental hosts. A surveillance plan was implemented in Italy in 1998, following a limited outbreak of WNV equine encephalomyelitis and a WNV outbreak in France very close to the Italian border. This plan to assess the risks of the virus being introduced again included entomological surveillance performed in 15 study areas considered ‘at risk’ of WNV introduction in the country. Entomological surveys conducted in Italy from 2003 to 2007 resulted in the capture of a total of 28 798 mosquitoes, of which there were 14 765 adults and 14 033 larvae belonging to 22 species. According to the literature, eight of the species identified have been found to be naturally infected with WNV or were successfully infected in the laboratory in some parts of Europe and in the United States, namely: Aedes albopictus (Skuse, 1897) (= Stegomiya albopicta), Aedes vexans (Meigen, 1830), Anopheles maculipennis Meigen, 1818, Coquillettidia richiardii (Ficalbi, 1889), Culex modestus Ficalbi, 1889, Culex pipiens Linnaeus, 1758, Culex theileri Theobald, 1903 and Ochlerotatus caspius (Pallas, 1771) (= Aedes caspius).
Clustering of childhood mortality in the Kintampo Health and Demographic Surveillance System in Ghana
Obed Ernest A. Nettey,Charles Zandoh,Abubakari Sulemana,Robert Adda
Global Health Action , 2010, DOI: 10.3402/gha.v3i0.5258
Abstract: Background: Childhood mortality in Ghana has generally declined in the last four decades. However, estimates tend to conceal substantial variability among regions and districts. The lack of population-based data in Ghana, as in other less developed countries, has hindered the development of effective programmes targeted specifically at clusters where mortality levels are significantly higher. Objective: This paper seeks to test for the existence of statistically significant clusters of childhood mortality within the Kintampo Health and Demographic Surveillance System (KHDSS) between 2005 and 2007. Design: In this study, mortality rates were generated using mortality data extracted from the health and demographic surveillance database of the KHDSS and exported into STATA. The spatial and spatio-temporal scan statistic by Kulldorff was used to identify significant clusters of childhood mortality within the KHDSS. Results: A significant cluster of villages with high under-five mortality in the south-eastern part of the KHDSS in 2006 was identified. This is a remote location where poverty levels are relatively higher, health facilities are more sparse and these are compounded by poor transport services in case of emergencies. Conclusion: This study highlights the potential of the surveillance platform to demonstrate the spatial dimensions of childhood mortality clustering. It is apparent, though, that further studies need to be carried out in order to explore the underlying risk factors for potential mortality clusters that could emerge later.
Prevalence of Malaria Positive Rapid Diagnostic Test and Antimalarial Treatment in Patients with Fevers in the Accident and Emergency Unit of Effia Nkwanta Regional Hospital, Western Region, Ghana
Verner N. Orish, Jones Ofori-Amoah, Innocent Afeke, Ibrahim Jamfaru, Donatus W. Adongo, Kokou H. Amegan-Aho
Open Access Library Journal (OALib Journal) , 2016, DOI: 10.4236/oalib.1103097
Abstract:
Background: Rapid diagnostic test (RDT) is a simpler, easy to read malaria diagnostic test. It was introduced by the World Health Organization (WHO) to supplement the use of microscopy and can be used alone in areas where microscopy is unavailable. Its introduction was necessary to maintain the WHO test-based treatment protocol for malaria, as dependence of microscopy which is the gold standard is not possible in many areas in Sub-Saharan Africa which lack the wherewithal to run efficient laboratory services. WHO strongly recommends that only patients with parasitological confirmation of malaria should be treated with antimalarial drugs. In this study, the prevalence of malaria positive RDT and antimalarial treatment was evaluated in patients presenting with fevers at the outpatient section of the accident and emergency unit of the Effia Nkwanta Regional Hospital, Ghana. Methodology: This was a retrospective study carried out in the outpatient section of the accident emergency unit of Effia Nkwanta Regional Hospital. The outpatient register was reviewed from October 2014 to March 2015, for patients who came with fever. Data on demographics, malaria RDT status and antimalarial treatment were collected and analyzed. Result: A total of 607 patients with fever had their RDT performed. Of these, 131 (21.58%) were positive for malaria while 467 (78.42%) were negative. Out of the 131 tested positive, 55 represented patients above 12 years and 76 represent children aged 0 to12 years, p = 0.002. Fifty children under the age of 5 years tested positive for malaria whereas 26 were above the age 5 years, p = 0.03. All the 131 positive patients were treated for malaria while 276 out of 476 negative patients were also treated for malaria, p < 0.001. Conclusion: Patients positive for malaria RDT in this study were lower. Children were more positive for malaria than adults, with those under 5 years constituting the majority. This study also shows that indiscriminate malaria prescription is still a problem, a situation that should be tackled immediately, to prevent malaria parasite being resistant to current antimalarial drugs.
Dengue virus type 4 in Niterói, Rio de Janeiro: the role of molecular techniques in laboratory diagnosis and entomological surveillance
Castro, Márcia Gon?alves de;Nogueira, Rita Maria Ribeiro;Filippis, Ana Maria Bispo de;Ferreira, Anielly Alves;Lima, Monique da Rocha Queiroz;Faria, Nieli Rodrigues da Costa;Nogueira, Fernanda de Bruycker;Sim?es, Jaqueline Bastos Santos;Nunes, Priscila Conrado Guerra;Sampaio, Simone Alves;Louren?o-de-Oliveira, Ricardo;Santos, Flávia Barreto dos;
Memórias do Instituto Oswaldo Cruz , 2012, DOI: 10.1590/S0074-02762012000700017
Abstract: in niterói, state of rio de janeiro, dengue virus type 4 (denv-4) was isolated for the first time in march 2011. we analysed the laboratory findings of the first cases and evaluated the use of molecular techniques for the detection of denv-4 in aedes aegypti that were field-caught. conventional reverse transcriptase-polymerase chain reaction (rt-pcr) and simplexatm dengue real-time rt-pcr confirmed denv-4 infection in all cases. additionally, denv-4 was confirmed in a female ae. aegypti with 1.08 x 103 copies/ml of virus, as determined by quantitative real-time rt-pcr. this is the first time the simplexatm dengue real-time assay has been used for the classification of cases of infection and for entomological investigations. the use of these molecular techniques was shown to be important for the surveillance of dengue in humans and vectors.
Entomological surveillance of Chagas disease in Berilo municipality, Jequitinhonha Valley, State of Minas Gerais, Brazil
Assis, Girley Francisco Machado de;Azeredo, Bernardino Vaz de Mello;Gorla, David;Diotaiuti, Liléia;Lana, Marta de;
Revista da Sociedade Brasileira de Medicina Tropical , 2009, DOI: 10.1590/S0037-86822009000600001
Abstract: this study aimed to evaluate the chagas disease control program which has operated since 1982 in the municipality of berilo in the jequitinhonha valley, minas gerais, brazil, based on evaluation of 5,242 domiciliary units (dus) and 7,807 outbuildings over an eight-year period of epidemiological surveillance implanted in 1997. a total of 391 triatomines (280 panstrongylus megistus and 111 triatoma pseudomaculata) were captured, indicating the continued predominance of the former species. however, triatoma pseudomaculata is clearly becoming more important in this region, with intradomiciliary colonies being detected in recent years. entomological parameters, such as dispersion (17%) and intradomiciliary infestation (0.15%) indices, are compatible with the results of the epidemiological surveillance. the majority of dus were of construction type a (plaster over bricks) or c (plaster over adobe). twenty-five percent of the inhabitants of the dus infested by triatomines were reactive in elisa, iha and iif tests for trypanosoma cruzi antigens.
Crimean Congo haemorrhagic fever  [cached]
Ate? Kara
Turk Pediatri Ar?ivi , 2008,
Abstract: Crimean-Congo haemorrhagic fever (CCHF) virüs causes severe disease in humans with a mortality reaching 30%. It has the most extensive geographic distribution among the medically important tick borne viral diseases. Although it is more frequently recovered from animals without any symptoms, sporadic cases or epidemics may also be seen in human beings. Acute course of the disease appears with symptoms of generalized pain, myalgia, fever, nausea, vomiting, abdominal pain, diarrhoea, ecchymoses and bleeding and findings of elevated liver enzymes, thrombocytopenia and leukopenia. The knowledge of the presenting features of haemorrhagic fevers is necessary for the clinician, as early diagnosis and treatment, might potentially decrease mortality and the chance of secondary spread of the infection. Ribavirin has been tried in the treatment of Crimean-Congo haemorrhagic fever. (Turk Arch Ped 2008; 43: 108-18)
Using mortuary statistics in the development of an injury surveillance system in Ghana
London,Jason; Mock,Charles; Abantanga,Francis A.; Quansah,Robert E.; Boateng,K.A.;
Bulletin of the World Health Organization , 2002, DOI: 10.1590/S0042-96862002000500005
Abstract: objective: to develop, in a mortuary setting, a pilot programme for improving the accuracy of records of deaths caused by injury. methods: the recording of injury-related deaths was upgraded at the mortuary of the komfo anokye teaching hospital, kumasi, ghana, in 1996 through the creation of a prospectively gathered database. findings: there was an increase in the number of deaths reported annually as attributable to injury from 72 before 1995 to 633 in 1996-99. injuries accounted for 8.6% of all deaths recorded in the mortuary and for 12% of deaths in the age range 15-59 years; 80% of deaths caused by injury occurred outside the hospital and thus would not have been indicated in hospital statistics; 88% of injury-related deaths were associated with transport, and 50% of these involved injuries to pedestrians. conclusions: injury was a significant cause of mortality in this urban african setting, especially among adults of working age. the reporting of injury-related deaths in a mortuary was made more complete and accurate by means of simple inexpensive methods. this source of data could make a significant contribution to an injury surveillance system, along with hospital records and police accident reports.
Using mortuary statistics in the development of an injury surveillance system in Ghana  [cached]
London Jason,Mock Charles,Abantanga Francis A.,Quansah Robert E.
Bulletin of the World Health Organization , 2002,
Abstract: OBJECTIVE: To develop, in a mortuary setting, a pilot programme for improving the accuracy of records of deaths caused by injury. METHODS: The recording of injury-related deaths was upgraded at the mortuary of the Komfo Anokye Teaching Hospital, Kumasi, Ghana, in 1996 through the creation of a prospectively gathered database. FINDINGS: There was an increase in the number of deaths reported annually as attributable to injury from 72 before 1995 to 633 in 1996-99. Injuries accounted for 8.6% of all deaths recorded in the mortuary and for 12% of deaths in the age range 15-59 years; 80% of deaths caused by injury occurred outside the hospital and thus would not have been indicated in hospital statistics; 88% of injury-related deaths were associated with transport, and 50% of these involved injuries to pedestrians. CONCLUSIONS: Injury was a significant cause of mortality in this urban African setting, especially among adults of working age. The reporting of injury-related deaths in a mortuary was made more complete and accurate by means of simple inexpensive methods. This source of data could make a significant contribution to an injury surveillance system, along with hospital records and police accident reports.
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