BCG vaccination and pulmonary tuberculosis in Quebec

The BCG vaccination program officially set up in 1949 in the Province of Quebec has been retrospectively evaluated for the period from 1956 to 1961. Two series of age groups were studied, 0-14 and 15-29, each comprising populations of several hundred thousand. At the beginning and the end of the period, the rates of primary vaccination were, in percentages of viable births, from 40 to 47.8 and, in cumulative percentages, for the 0 to 14 year age group, from 39.98 to 53.41, and for the 0 to 29 year age group, from 29.22 to 45.98.During this period, the ratios between the yearly rates of incidence of new cases of pulmonary tuberculosis per 100,000 in vaccinated and non-vaccinated individuals ranged from 1-2.5 to 1-3.5 within the age group 0-14 years and from 1-4.5 to 1-7 within the age group 15-29 years. When only the incidence of the more severe forms of tuberculosis is considered, the ratios ranged from 1-3.7 to 1-6.0 for the younger group and from 1-5.3 to 1-7.6 for the older one.Mortality from pulmonary tuberculosis was practically non-existent in the vaccinated groups and decreased from 2.5 to 1.3 per 100,000 population in the non-vaccinated groups.     

Outbreaks of alimentary bacterial infections reported in CSR between 1979 and 1982

Outbreaks of alimentary infections of bacterial origin (dg 002--typhoid or paratyphoid fever; dg 003--infections due to other Salmonella species; dg 004--bacillary dysentery; dg 005--alimentary intoxications; dg 008--intestinal infections due to other bacteria; dg 009--intestinal infections of unknown etiology) which had been reported in the Czech socialist republic from 1979 to 1982 are overviewed and analyzed. The outbreaks of alimentary infections were analyzed by the number of epidemic episodes reported annually, by the number of cases involved, by the geographical and seasonal distribution pattern, by the place of onset, and by the mode of spread of infectious agents. Hospital-related salmonelloses were further analyzed by the serotype of Salmonellae responsible for these nosocomial infections. Outbreaks of water-borne alimentary infections were analyzed by the type of contaminated water source. Changes and trends in the epidemiology of alimentary bacterial infections encountered between 1979 and 1982 are discussed in detail. This study confirms that a systematic analysis of these outbreaks should constitute an integral part of the alimentary infections surveillance program for it may help assess the risk of population exposure to the varied causes of these infections.     

HIV infection among Quebec women giving birth to live infants.

This is the first anonymous unlinked seroprevalence study in Canada to use serum samples from newborns to determine the seroprevalence rate of human immunodeficiency virus (HIV) infection among childbearing women. Of the 68,808 samples tested 42 were confirmed as positive, for an overall crude seroprevalence rate of 6.1 per 10,000 live births (95% confidence interval [CI] 4.4 to 8.3), or 1 woman in 1638. Women who lived on Montreal island had an overall rate of 17.9 per 10,000 live births (95% CI 12.2 to 25.4), or 1 woman in 559. We observed a significant association between revenue index and seroprevalence; the rates were as high as 46.4 per 10,000 live births (95% CI 18.7 to 95.3), or 1 woman in 216, for Montreal island postal code areas with revenue indexes 20% or more below the provincial median. Extrapolation of the data suggested that 56 women with HIV infection gave birth to a live infant during 1989 in Quebec. Even though attempts to generalize the data from childbearing women to women of childbearing age have an inherent conservative bias, the results of our study suggest that 988 women (95% CI 713 to 1336) aged 15 to 44 years in Quebec had HIV infection in 1989. The actual number is likely substantially higher. The need for well-designed, creative interventions to prevent further HIV transmission to women is evident. Planning for the provision of medical and psychosocial services sensitive to specific needs of women who are already infected should start immediately.     

腹股沟疝无张力修补72例报告

目的 探讨腹股沟疝无张力修补的临床效果.方法 回顾性总结我院2003年10月～2007年12月行无张力疝修补术治疗腹股沟斜疝、直疝患者72例的临床资料.其中单侧腹股沟斜疝51例,双侧斜疝3例,单侧直疝16例,2例同侧腹股沟斜疝、直疝并存;行平片无张力修补26例,预成形网塞无张力修补46例.结果 随访6～24个月,无手术死亡病例,术后无复发.结论 无张力修补术是治疗腹股沟疝可靠、安全的术式.     

Incidence of cystic fibrosis in Saguenay-Lac-St.-Jean (Quebec, Canada).

The incidence of cystic fibrosis (CF) in Saguenay-Lac-St.-Jean, a geographically isolated region of Quebec, was estimated to be 1 in 902 during the period 1975-1988. The carrier rate was calculated to be 1 in 15 inhabitants. The high incidence of CF in Saguenay-Lac-St.-Jean is probably the result of a founder effect and genetic drift for one or more mutations. Historical, demographic, and social factors also may have contributed to the high incidence.     

Annual Change of Primary Resistance to Clarithromycin among Helicobacter pylori Isolates from 1996 through 2008 in Japan

Background: Recent studies have shown that the combination of proton pump inhibitor, amoxicillin and clarithromycin is one of the best choices for Helicobacter pylori eradication therapy. However, increasing number of cases of H. pylori infection showing resistance to clarithromycin therapy has been reported and this is currently the main cause of eradication failure. We investigated the annual changes of the antimicrobial susceptibility to clarithromycin, amoxicillin and minocycline during a period of 12 years in Japan. Methods: This study comprised 3521 patients (mean age (SD), 55.4 (13.7) years‐old, 2467 males and 1054 females) positive for H. pylori as assessed by microaerobic bacterial culture from 1996 through 2008. All patients were previously untreated for H. pylori and were enrolled in the study to assess primary resistance to the three antibiotics. Results: The overall primary resistance to clarithromycin, amoxicillin and minocycline were 16.4%, (577/3521), 0.03% (1/3521) and 0.06% (2/3521), respectively. From1996 through 2004, the resistance rate to clarithromycin increased gradually to approximately 30% and then it remained without marked fluctuation since 2004. Analysis by gender showed a significant increase (p < .0001) in resistance rate to clarithromycin among females (217/1057, 20.6%) compared to males (360/2467, 14.6%). Analysis by age, disclosed significantly (p < .0001) higher resistance rate to clarithromycin in patients of more than 65‐years‐old compared to the younger population. Conclusions: The resistance rate of H. pylori infection to clarithromycin in Japan has increased gradually to approximately 30% from 1996 through 2004, and remained unchanged since 2004. Elderly and females were at high risk of having resistance to clarithromycin. Our results suggested that the level of clarithromycin resistance in Japan has now risen to the point where it should no longer be used as empiric therapy.     

Founder effect in familial hyperchylomicronemia among French Canadians of Quebec

Familial hyperchylomicronemia has reached a high prevalence in the French Canadian population of eastern Quebec. The birth places of 58 carriers identified through the birth of one affected child clustered in three regions. The genealogies of these 58 individuals showed that no founder was common to all of them. Three sets of founders were found, one for each region, with little overlapping between two regions. These results strongly suggest that more than one mutation, introduced by the French migrants in the 17th century, are segregating in the French Canadian population. Perche, a region situated between Paris and Normandy, appeared to be the most likely putative center of diffusion of at least one mutation in the lipoprotein lipase gene segregating in the modern-day French Canadian population of Quebec.     

2006—2015年隆安县新报告HIV/AIDS流行病学特征分析

目的分析2006—2015年隆安县新报告HIV/AIDS病例流行病学特征,为艾滋病防控工作提供依据。方法采用描述流行病学方法,分析2006—2015年隆安县新报告HIV/AIDS病例信息资料。结果 2006—2015年新报告HIV/AIDS病例共计1 066例,其中HIV感染者594例,AIDS患者472例,死亡344例。男性占73.64%;职业以农民为主占88.56%;年龄主要集中在≥50岁人群,占72.89%。传播途径以性传播为主,性传播共1 028例,占96.43%。结论 2006—2015年隆安县HIV/AIDS病例主要集中在50岁以上的农民,性传播为主要传播途径。     

Survival of AIDS according to injecting drug use among Puerto Rican AIDS patients.

This paper aims to: 1/ describe IDU's and non-IDU's according to age, gender, AIDS criteria and antiretroviral therapy; and 2/ assess survival differences between IDU's and non-IDU's according to age, gender, AIDS diagnosis criteria and antiretroviral therapy. This study is a survival study of a longitudinal cohort. The sample was composed of 1,258 AIDS patients of a cohort of HIV-infected adults who sought medical care at either the Immunology clinic of Bayamon or the Ramon Ruiz Arnau University Hospital between 1992 and 1999. The variables studied were: survival time of AIDS, intravenous drug use, age, gender, AIDS defining criteria and antiretroviral therapy (yes/no). The results have been that IDU's had lower survival than non-IDU's. Significant differences in the survival functions (IDU's vs non-IDU's) were found among male patients, older patients, patients with immunological criteria and patients with antiretroviral therapy. The survival among these variables was lower in IDU's than non-IDU's. This study suggested that decreased survival of IDU's may be related to later diagnosis and decreased access to drug therapy. Clinical endeavors should take into consideration the variables related to IDU's survival to develop health programs in order to enhance the quality of life and the survival of the AIDS patients.     

Genetic diversity among Mycobacterium tuberculosis isolates from Mexican patients

Forty-six isolates of the Mycobacterium tuberculosis complex were typified by PCR of the IS6110 region and by Mycobacterium bovis specific primers JB21/JB22. Isolate MVG01 was typified as M. bovis, being the first record of a case of human tuberculosis caused by this species in Mexico. RAPD-PCR was used to describe the genetic diversity of the remaining 45 M. tuberculosis complex isolates. The corrected genotypic diversity value calculated for the analyzed population was 0.96, the estimated mean gene diversity was 0.235, and the corrected Shannon-Weiner index was 2.15. All allele-loci combinations generated showed significant linkage disequilibria. The distribution of genetic variation was analyzed both by the unweighted pair group method with arithmetic averages clustering and by principal coordinates analysis. Unweighted pair group method with arithmetic averages clustering resulted in a tree with four main clusters and one unclustered strain (MVG20), the principal coordinates analysis strain distribution pattern being consistent with this grouping. The obtained results suggest that the studied isolates belong to a clonal population having significant genetic diversity. Our genetic diversity results are comparable with those reported for other populations of M. tuberculosis, although only three RAPD primers were used.     

Whole-genome sequencing in French Canadians from Quebec

Genome-wide association studies (GWAS) have had a tremendous success in the identification of common DNA sequence variants associated with complex human diseases and traits. However, because of their design, GWAS are largely inappropriate to characterize the role of rare and low-frequency DNA variants on human phenotypic variation. Rarer genetic variation is geographically more restricted, supporting the need for local whole-genome sequencing (WGS) efforts to study these variants in specific populations. Here, we present the first large-scale low-pass WGS of the French-Canadian population. Specifically, we sequenced at ~5.6× coverage the whole genome of 1970 French Canadians recruited by the Montreal Heart Institute Biobank and identified 29 million bi-allelic variants (31 % novel), including 19 million variants with a minor allele frequency (MAF) <0.5 %. Genotypes from the WGS data are highly concordant with genotypes obtained by exome array on the same individuals (99.8 %), even when restricting this analysis to rare variants (MAF <0.5, 99.9 %) or heterozygous sites (98.9 %). To further validate our data set, we showed that we can effectively use it to replicate several genetic associations with myocardial infarction risk and blood lipid levels. Furthermore, we analyze the utility of our WGS data set to generate a French-Canadian-specific imputation reference panel and to infer population structure in the Province of Quebec. Our results illustrate the value of low-pass WGS to study the genetics of human diseases in the founder French-Canadian population.     

Incidence of plasmid DNA in Salmonella strains isolated from clinical sources in Ontario, Canada, during 1979 and 1980

Gel electrophoresis of DNA from 70 clinical strains of Salmonella revealed a heterogenous plasmid population. Plasmid DNA, ranging in molecular weight from 1.4 X 10(6) to 145 X 10(6), was demonstrated in 26 of 32 antibiotic-resistant strains. Several resistant strains carried up to six plasmids; however, of these, five strains which were multiply resistant contained a single plasmid of molecular weight 54 X 10(6) to 145 X 10(6). Only one incompatibility group H2 (IncH2) plasmid (pDT28) was detected in a strain of S. heidelberg; thus, this represents a reduction in the prevalence of these plasmids in Ontario Salmonella strains since 1974. The pDT28 plasmid resembled other IncH2 plasmids by its high molecular weight (145 X 10(6) ) and by virtue of its temperature-sensitive mode of transfer, resistance to tellurium, and inhibition of coliphage development. Of the 38 antibiotic-susceptible Salmonella strains, approximately half contained plasmids, ranging in molecular weight from 1.4 X 10(6) to 60 X 10(6). The plasmid-containing antibiotic-susceptible strains carried either a group of two to four small plasmids, with molecular weights less than 4.5 X 10(6), or a single large plasmid of molecular weight 23 X 10(6) or 60 X 10(6).     

Epidemiological patterns of tuberculosis in Croatia in the period 1996-2005

The last comprehensive publication on tuberculosis in Croatia and the earliest impact of war, besides the yearly routine reports, was done in 1996 in Croatian. We were, therefore, interested to explore incidence trends and to highlight the early post-war tuberculosis epidemiological patterns in the next ten years period (1996-2005). A retrospective analysis of epidemiological data on all registered tuberculosis cases in Croatia searching the databases of 21 Croatian Public Health Institutes and the National Tuberculosis Registry was made. During the study period, the total tuberculosis incidence rates in Croatia dropped from 45 to 25.8/100 000 inhabitants. The average highest age-specific rates were recorded in the age group > or = 65 years being in decrease in all age groups. Paediatric cases (0-14 years) represented 4.5% of all cases. Tuberculosis cases among males were recorded in 64% cases, and 83.6% were indigenous population. Tuberculosis was bacteriologically confirmed in 67.7% cases. A low proportion of drug resistance (3.3%) was recorded. During 1985-2005, 56 tuberculosis cases among 242 AIDS cases were reported. Tuberculosis mortality showed a decreasing trend (p < 0.001). However, tuberculosis has still had the highest mortality rates among infectious diseases in Croatia. Despite the War chain of events and tuberculosis programmatic changes, tuberculosis incidence rates in Croatia have been decreasing but they are still far away from national target, incidence rate of 10/100 000 declared in 1998 and much higher than in European Union and Western Europe. Tuberculosis among children, resistance to tuberculosis drugs and HIV prevalence, significant problems in many European countries, have not caused problems in tuberculosis control in Croatia. This favourable epidemiological situation must be kept and improved through strengthened tuberculosis control measures.