Spatial Analysis of Pulmonary Tuberculosis in Antananarivo Madagascar: Tuberculosis-Related Knowledge,Attitude and Practice

Introduction

Tuberculosis infection may remain latent, but the disease is nevertheless a serious public health issue. Various epidemiological studies on pulmonary tuberculosis have considered the spatial component and taken it into account, revealing the tendency of this disease to cluster in particular locations. The aim was to assess the contribution of Knowledge Attitude and Practice (KAP) to the distribution of tuberculosis and to provide information for the improvement of the National Tuberculosis Program.

Methods

We investigated the role of KAP to distribution patterns of pulmonary tuberculosis in Antananarivo. First, we performed spatial scanning of tuberculosis aggregation among permanent cases resident in Antananarivo Urban Township using the Kulldorff method, and then we carried out a quantitative study on KAP, involving TB patients. The KAP study in the population was based on qualitative methods with focus groups.

Results

The disease still clusters in the same districts identified in the previous study. The principal cluster covered 22 neighborhoods. Most of them are part of the first district. A secondary cluster was found, involving 18 neighborhoods in the sixth district and two neighborhoods in the fifth. The relative risk was respectively 1.7 (p<10⁻⁶) in the principal cluster and 1.6 (p<10⁻³) in the secondary cluster. Our study showed that more was known about TB symptoms than about the duration of the disease or free treatment. Knowledge about TB was limited to that acquired at school or from relatives with TB. The attitude and practices of patients and the population in general indicated that there is still a stigma attached to tuberculosis.

Conclusion

This type of survey can be conducted in remote zones where the tuberculosis-related KAP of the TB patients and the general population is less known or not documented; the findings could be used to adapt control measures to the local particularities.     

High prevalence of intestinal parasite infestations among stunted and control children aged 2 to 5 years old in two neighborhoods of Antananarivo,Madagascar

BackgroundThis study aimed to compare the prevalence of intestinal parasite infestations (IPIs) in stunted children, compared to control children, in Ankasina and Andranomanalina Isotry (two disadvantaged neighborhoods of Antananarivo, Madagascar), to characterize associated risk factors and to compare IPI detection by real-time PCR and standard microscopy techniques.Methodology/Principal findingsFecal samples were collected from a total of 410 children (171 stunted and 239 control) aged 2–5 years. A single stool sample per subject was examined by simple merthiolate-iodine-formaldehyde (MIF), Kato-Katz smear and real-time PCR techniques. A total of 96.3% of the children were infested with at least one intestinal parasite. The most prevalent parasites were Giardia intestinalis (79.5%), Ascaris lumbricoides (68.3%) and Trichuris trichiura (68.0%). For all parasites studied, real-time PCR showed higher detection rates compared to microscopy (G. intestinalis [77.6% (n = 318) versus 20.9% (n = 86)], Entamoeba histolytica [15.8% (n = 65) versus 1.9% (n = 8)] and A. lumbricoides [64.1% (n = 263) versus 50.7% (n = 208)]). Among the different variables assessed in the study, age of 4 to 5 years (AOR = 4.61; 95% CI, (1.35–15.77)) and primary and secondary educational level of the mother (AOR = 12.59; 95% CI, (2.76–57.47); AOR = 9.17; 95% CI, (2.12–39.71), respectively) were significantly associated with IPIs. Children drinking untreated water was associated with infestation with G. intestinalis (AOR = 1.85; 95% CI, (1.1–3.09)) and E. histolytica (AOR = 1.9; 95% CI, (1.07–3.38)). E. histolytica was also associated with moderately stunted children (AOR = 0.37; 95% CI, 0.2–0.71). Similarly, children aged between 4 and 5 years (AOR = 3.2; 95% CI (2.04–5.01)) and living on noncemented soil types (AOR = 1.85; 95% CI, (1.18–2.09)) were associated with T. trichiura infestation.Conclusions/SignificanceThe prevalence of IPIs is substantial in the studied areas in both stunted and control children, despite the large-scale drug administration of antiparasitic drugs in the country. This high prevalence of IPIs warrants further investigation. Improved health education, environmental sanitation and quality of water sources should be provided.     

Etiology and clinical characteristics of influenza-like illness (ILI) in outpatients in Beijing, June 2010 to May 2011

Background

Since May 2009, exposure of the population of Beijing, China to pH1N1 has resulted in an increase in respiratory illnesses. Limited information is available on the etiology and clinical characteristics of the influenza-like illness (ILI) that ensued in adults following the pH1N1 pandemic.

Methods

Clinical and epidemiological data of ILI in adults was collected. A total of 279 throat swabs were tested for twelve respiratory viruses using multiplex RT-PCR. Clinical characteristics of influenza A in outpatients versus test-negative patients were compared using Pearson''s χ2 and the Mann-Whitney U test. 190 swabs were tested for pH1N1 by virus isolation. Consultation rates for ILI were compared between 2009 and 2010.

Results

One or two virus were detected in 29% of the samples. Influenza A virus (FLU-A) accounted for 22.9% (64/279). Other viruses were present at a frequency less than 3.0%. Cough was significantly associated with Influenza A virus infection (χ2, p<0.001). The positive rate of FLU-A was consistent with changes in the ILI rate during the same period and there was a significant reduction in the incidence of ILI in 2010 when compared to 2009. During the 2010–2011 influenza season, the incidence peaked in January 2011 in Beijing and north China.

Conclusions

Exposure to pH1N1 had no impact on typical influenza seasonal peaks, although FLU-A remained the predominant virus for 2010 in Beijing. Symptomatically, cough was associated with FLU-A infection. The positive rate of influenza virus was consistent with changes in the ILI rate during the same period and there was a significant reduction in the incidence of ILI in 2010 when compared to that of 2009.     

2009－2014年玉溪市流感样病例监测的病原学分析

摘要：目的 了解玉溪市2009－2014 年流感流行特征和流感流行优势毒株的变化规律,为制定预防和控制策略提供依据。方法 采用MDCK细胞进行流感样病例标本的病毒分离培养,最后采用流感分型试剂进行病毒型别鉴定。结果 2009－2014年玉溪市流感实验室共监测流感样病例3 248例,阳性标本489份,阳性率为15.06%,新甲型H1N1、H3N2、B型流感分别占43.97%、28.22%和25.36%,学生和离退人员阳性病例分别占52.15%和14.11%;哨点医院流感样病例标本阳性检出率低于暴发疫情,差异有统计学意义（χ2=301.14,P＜0.01);每年10月到次年3月出现流行高峰,2009年10月至2011年3月以新甲型H1N1流感为主,2011年4月至2012年3月以B型流感为主,2012年4月至2013年3月以A（H3N2）型流感为主;2013年4月至2014年3月以B型流感为主。结论 玉溪市流感病毒优势毒株是甲型H1N1、H3N2、B型流感,优势毒株在2009－2014 年发生了四次转变,其进一步变异的可能性仍然存在,加强流感样病例病原学与重点人群疫情监测有重要意义。     

Abstracts of Posters Presented at Issol '02, Oaxaca,Mexico, June 30 to July 5, 2002

Origins of Life and Evolution of Biospheres -     

Distribution of ichthyoplankton in the eastern Peter the Great Bay,Sea of Japan,in June and July of 2007

Comparison of the results of ichthyoplankton surveys conducted at 97 stations in the eastern part of the Peter the Great Bay of the Sea of Japan, in June–July 2007 with the similar research data of the 1950s shows that at present, as was the case 50 years ago, flatfish eggs belonging mainly to the yellowfin sole Limanda aspera and brown sole Pleuronectes herzensteini prevail in the local ichthyoplankton (up to 86%). The highest concentrations of these species’ eggs were recorded in the Vostok Bay and Strelok Bay. The spawning activity of flatfish in 2007 is found to be lower than in the mid 1900s, but the significance of the eastern part of the Peter the Great Bay for flatfish reproduction remains large. The importance of long-term monitoring in this area, which is being subjected to steadily growing anthropogenic impacts, is also proven.     

2008-2009年南京地区儿童肺炎支原体感染情况分析

目的了解2008年至2009年南京地区儿童呼吸道肺炎支原体（MP）的感染情况。方法应用MP快速培养法对南京地区2008年1月至2009年12月980例急性呼吸道感染患儿的咽拭子标本进行MP培养检测。结果 980例急性呼吸道感染患儿的咽拭子标本中MP培养阳性384例,总阳性率为39.2%。其中〈3岁、35岁、〉5岁各年龄组患儿中MP阳性率分别是36.9%,38.5%和43.3%;不同季度MP感染的检出率分别是：春季（13月）45.7%,夏季（46月）24.8%,秋季（79月）20.4%,冬季（1012月）50.3%,其中冬、春两季MP感染的检出率明显高于其他两季（P〈0.01）。结论 MP为南京地区儿童急性呼吸道感染的重要病原体,各年龄儿童普遍易感;冬、春两季高发。