Congenital Heart Disease Referred for Surgery: Analysis and Epidemiological Description in the Cardiology Department of CHU Ignace Deen

Introduction: Congenital heart disease includes all cardiac and vascular malformations. It accounts for approximately one third of all congenital malformations and is a public health problem, particularly in developing countries. The aim of this study was to analyze the epidemiological, clinical and paraclinical aspects of congenital heart disease. Methods: This was a retrospective descriptive and analytical study based on the records of 135 patients referred for surgery and followed up in the cardiology department of the Ignace Deen University Hospital, collected in November 2022. Results: Hospital prevalence was 5%. The mean age was 71 months, ranging from 1 month to 19 years. The age group over 24 months was the most represented (62%). The M/F sex ratio was 1.36. Urban origin was predominant (58%). The rate of children not attending school or dropping out was high (16%). Siblings with fewer than 4 children were the most common (88%). A heart murmur was the most frequent sign (78%), followed by cyanosis (36%) and heart failure (29%). The association between heart murmurs and CHD was proven with a p-value Conclusion: CHDs represent the main indication for paediatric cardiac surgery and follow-up (95%). We stress the importance of implementing a screening and management strategy for congenital heart disease.

Epidemiological, Clinical Aspects and Factors Associated with Typical Gastroesophageal Reflux Disease in the General Population of Parakou, Republic of Benin

Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant impair in quality of life was observed in 27 patients (96.43%). Conclusion: Typical GERD is relatively common in the general population of Parakou in the Republic of Benin. It often affects young males. Among the risk factors identified, the most common are carbonated drinks, spicy meals and diabetes. GERD significantly impairs quality of life. Raising awareness about the disease and its associated factors is necessary among the general population.

Clinical epidemiology and disease burden of nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD) is defined as the presence of hepatic fat accumulation after the exclusion of other causes of hepatic steatosis, including other causes of liver disease, excessive alcohol consumption, and other conditions that may lead to hepatic steatosis. NAFLD encompasses a broad clinical spectrum ranging from nonalcoholic fatty liver to nonalcoholic steatohepatitis(NASH), advanced fibrosis, cirrhosis, and finally hepatocellular carcinoma(HCC). NAFLD is the most common liver disease in the world and NASH may soon become the most common indication for liver transplantation. Ongoing persistence of obesity with increasing rate of diabetes will increase the prevalence of NAFLD, and as this population ages, many will develop cirrhosis and end-stage liver disease. There has been a general increase in the prevalence of NAFLD, with Asia leading the rise, yet the United States is following closely behind with a rising prevalence from 15% in 2005 to 25% within 5 years. NAFLD is commonly associated with metabolic comorbidities, including obesity, type Ⅱ diabetes, dyslipidemia, and metabolic syndrome. Our understanding of the pathophysiology of NAFLD is constantly evolving. Based on NAFLD subtypes, it has the potential to progress into advanced fibrosis, end-stage liver disease and HCC. The increasing prevalence of NAFLD with advanced fibrosis, is concerning because patients appear toexperience higher liver-related and non-liver-related mortality than the general population. The increased morbidity and mortality, healthcare costs and declining health related quality of life associated with NAFLD makes it a formidable disease, and one that requires more in-depth analysis.

Transmission Dynamics and Optimal Control Strategies of a Hand-Foot-Mouth Disease Model with Treatment and Vaccination Interventions

In this article, the transmission dynamics of a Hand-Foot-Mouth disease model with treatment and vaccination interventions are studied. We calculated the basic reproduction number and proved the global stability of disease-free equilibrium when R0 R0 > 1. Meanwhile, we obtained the optimal control strategies minimizing the cost of intervention and minimizing the infected person. We also give some numerical simulations to verify our theoretical results.

Recent trends in the epidemiology of inflammatory bowel diseases:Up or down?

Inflammatory bowel disease (IBD) is traditionally con- sidered to be common in the Western world, and its incidence has sharply increased since the early 1950s. In contrast, until the last decade, low prevalence and incidence rates have been reported from other parts of the world including Eastern Europe, South America, Asia and the Pacific region. Recent trends indicate a change in the epidemiology of IBD with previously low incidence areas now reporting a progressive rise in the incidence, while in West European and North American countries the figures have stabilized or slightly increased, with decreasing incidence rates for ulcerative colitis. Some of these changes may represent differences in diagnostic practices and increasing awareness of the disease. The quality of studies is also variable. Additional epidemio- logic studies are needed to better define the burden of illness, explore the mechanism of association with envi- ronmental factors, and identify new risk factors.

Peripheral artery disease in patients with diabetes:Epidemiology,mechanisms,and outcomes

Peripheral artery disease(PAD) is the atherosclerosis of lower extremity arteries and is also associated with atherothrombosis of other vascular beds,including the cardiovascular and cerebrovascular systems.The presence of diabetes mellitus greatly increases therisk of PAD,as well as accelerates its course,making these patients more susceptible to ischemic events and impaired functional status compared to patients without diabetes.To minimize these cardiovascular risks it is critical to understand the pathophysiology of atherosclerosis in diabetic patients.This,in turn,can offer insights into the therapeutic avenues available for these patients.This article provides an overview of the epidemiology of PAD in diabetic patients,followed by an analysis of the mechanisms by which altered metabolism in diabetes promotes atherosclerosis and plaque instability.Outcomes of PAD in diabetic patients are also discussed,with a focus on diabetic ulcers and critical limb ischemia.

The Emergence, Epidemiology, and Etiology of Haff Disease

Haff disease is a type of human rhabdomyolysis characterized by the sudden onset of unexplained muscular rigidity and an elevated serum creatine kinase level within 24 h after consuming cooked aquatic products. Here, we reviewed a previous study on Haff disease and summarized the clinical manifestations,epidemiological characteristics, and etiological data to confirm the incidence and global epidemiology of the disease and identify the most common seafood vectors. Future directions for Haff disease study will include further prospective etiological studies and the development of prevention and control strategies.

Epidemiology of inflammatory bowel disease in South America: A systematic review

BACKGROUND The worldwide epidemiology of inflammatory bowel disease(IBD)is rapidly changing.Increasing Crohn’s disease(CD)and ulcerative colitis(UC)incidence and prevalence have been recorded in developing regions such as Asia,Africa and Eastern Europe where it was previously thought to be uncommon.Whether this is also the case in South America is not well known.Demonstration that developing regions worldwide have increasing IBD incidence would indicate that environmental change plays a significant role in the development of IBD.AIM To report the incidence,prevalence and disease characteristics of CD and UC within the South American continent.METHODS A systematic review was conducted by searching published studies in major international and regional databases(MEDLINE,EMBASE and Scopus)between January 1990 and December 2018.Outcomes considered were incidence,prevalence,phenotype,environmental and genetic factors,ethnicity and gender.A pair of independent reviewers screened and reviewed all identified articles.RESULTS One hundred and sixty two citations were initially retrieved with 18 studies included in this systematic review.The majority of included studies were from Brazil(n=13,72%).The incidence of UC ranged from 4.3-5.3/100000 personyears whilst the incidence of CD ranged from 0.74-3.5/100000 person-years.Prevalence ranged from 15.0-24.1/100000 inhabitants for UC and from 2.4-14.1/100000 inhabitants for CD.The incidence and prevalence of both UC and CD has increased significantly in Brazil over the past 21 years.Pancolitis was the most common disease distribution in patients with UC whilst colonic involvement was the most common distribution in CD.People residing in urban areas were at higher risk of developing both CD and UC.CONCLUSION The IBD burden in South America is increasing at a rate possibly even greater than other developing regions around the world.There is a paucity of highquality epidemiological studies and further robust and representative data are required to further explore modifiable risk factors and disease phenotypes.

Epidemiology and inflammatory bowel diseases

The role of alcohol in causing or aggravating the pathogenesis of inflammatory bowel disease is unclear.For finding a conclusive answer for this valuable question we conducted this review.Only two studies were identified that successfully fulfilled our inclusive criteria.Usual consumption of alcohol reduced the risk compared with less frequent use(odds ratio = 0.57,95%CI:0.37-0.86).Light alcoholic drinking has protective effects against development of ulcerative colitis.But this inverse association disappeared when smoking was included.

Meta-analysis on the epidemiology of gastroesophageal reflux disease in China

BACKGROUND No large-scale epidemiological survey on the prevalence of gastroesophageal reflux disease(GERD)in China has been conducted.China has a large population and a complex geographical environment.It is important to understand the prevalence and spatial distribution of GERD in China.AIM To explore the prevalence and the spatial,temporal,and population distributions of GERD in the natural Chinese population.METHODS We searched Chinese and English databases for literature on the prevalence of GERD in the natural Chinese population.The prevalence of GERD was pooled using a random-effects meta-analysis model.Subgroup analysis was performed according to time,region,and population.We used ArcGIS software to draw statistical maps and trend analysis charts.Spatial autocorrelation analysis was carried out using Geoda software.Spearman correlation analysis was used to assess the spatial distribution relationship between GERD and upper digestive tract tumours.RESULTS Altogether,70 studies involving 276014 individuals from 24 provinces of China were included.The overall pooled prevalence of GERD was 8.7%(95%CI:7.5%-9.9%)in China's Mainland.Over the past two decades,the prevalence of GERD in China has increased from 6.0%to 10.6%.GERD was more common in people aged 40-60,with body mass index≥24,and of Uygur ethnicity.The prevalence was higher in the west and east than in the centre,and there may be a local spatial autocorrelation between the Qinghai-Tibet Plateau and the southeast.GERD was correlated with gastric(r=0.421,P=0.041)and oesophageal tumours(r=0.511,P=0.011)in spatial distribution.CONCLUSION GERD is becoming common in China.The prevalence differs by region and population.The development of appropriate strategies for the prevention and treatment of GERD is needed.

Molecular Epidemiology of Enteroviruses Associated with Hand, Foot, and Mouth Disease in the Mainland of China

Hand, foot, and mouth disease （HFMD） is a common contagious illness which occurs worldwide both sporadically and in epidemics. The disease mainly affects, children and the typical symptoms, which may resolve spontaneously, include mucocutaneous papulovesicular lesions on the hands, feet, mouth, and buttocks. In rare cases, however, the patients may also develop neurological complications such as neurogenic pulmonary edema,

Disease Control, Prevention and On-Farm Biosecurity: The Role of Veterinary Epidemiology

Domesticated and non-domesticated animals, including wildlife, deliver significant financial and nonfinancial benefits to the human community;however, disease can have a dramatic impact on the morbidity, mortality, and productivity of these animal populations and hence can directly and indirectly affect the human communities associated with them. This manuscript provides an overview of the important features to consider for the prevention and control of disease, with a focus on livestock diseases,and highlights the key role veterinary epidemiology plays in this endeavor. Measures of disease frequency and the type of epidemiological studies required to identify risk factors for diseases are summarized,with a focus on the use of these in the implementation of measures to control disease. The importance of biosecurity in maintaining disease-free flocks/herds is discussed and the steps taken to implement good biosecurity measures are outlined. It is concluded that a sound knowledge of veterinary epidemiology is required when developing control programs for disease and implementing biosecurity programs at a farm, regional, and national level.

Epidemiology and clinical course of Crohn's disease:Results from observational studies

The authors review the clinical outcome in patients with Crohn's disease(CD)based on studies describing the natural course of the disease.Population-based studies have demonstrated that the incidence rates and prevalence rates for CD have increased since the mid-1970s.The authors search for English language articles from 1980 until 2011.Geographical variations,incidence,prevalence,smoking habits,sex,mortality and medications are investigated.An increasing incidence and prevalence of CD have been found over the last three decades.The disease seems to be most common in northern Europe and North America,but is probably increasing also in Asia and Africa.Smoking is associated with an increased risk of developing CD.Age <40 at diagnosis,penetrating/stricturing complications,need for systemic steroids,and disease location in terminal ileum are factors associated with higher relapse rates.A slight predominance of women diagnosed with CD has been found.Ileocecal resection is the most commonly performed surgical procedure,and within the first five years after the diagnosis about one third of the patients have had intestinal surgery.Smoking is associated with a worse clinical course and withincreased risk of flare-ups.In most studies the overall mortality is comparable to the background population.To date,the most effective treatment options in acute flares are glucocorticosteroids and tumor necrosis factor(TNF)-α-blockers.Azathioprine/methotrexate and TNF-α-blockers are effective in maintaining remission.

Ebola virus disease: From epidemiology to prophylaxis

The outbreak of Ebola virus disease(EVD) continues to spread through West Africa. Since the first reported EVD in March 2014, the number of cases has increased rapidly, with the fatality rate of >50%. The most prevalent Ebola virus belongs to the species of Zaire ebolavirus, with a mortality rate as high as 90%. Although there were introduced cases in other continents, Africa is the endemic area where fruit bats and apes are suspected to be Ebola virus carriers. The virus might be transmitted from the host animals to humans if humans consume relative raw and contaminated meats; however, human-to-human transmission via close contact is the major route of current outbreaks. EVD happens at any seasons and affected people of any race in any age groups. Direct contact with body fluids of EVD patients and living in the contaminated environment greatly increase the risk of being infected. Transmission viaaerosol is less possible but the transmission via droplet is possible in humans. Thus, health care providers are facing danger of getting Ebola virus infection. So far, there are limited vaccines, drugs and/or therapies to prevent Ebola virus infection or treat EVD. Medical workers should follow the current standard prophylactic procedures. Military forces can orchestrate efficient care to mass EVD casualties. Although it is necessary to speed up the pace of developing effective vaccine and therapeutics for the prevention and treatment of EVD, public health prophylaxis is the most important issue at present to control the spread of this disease cost-effectively.

Ethnic differences in inflammatory bowel disease: Results from the United Kingdom inception cohort epidemiology study

BACKGROUND The current epidemiology of inflammatory bowel disease(IBD)in the multiethnic United Kingdom is unknown.The last incidence study in the United Kingdom was carried out over 20 years ago.AIM To describe the incidence and phenotype of IBD and distribution within ethnic groups.METHODS Adult patients(>16 years)with newly diagnosed IBD(fulfilling Copenhagen diagnostic criteria)were prospectively recruited over one year in 5 urban catchment areas with high South Asian population.Patient demographics,ethnic codes,disease phenotype(Montreal classification),disease activity and treatment within 3 months of diagnosis were recorded onto the Epicom database.RESULTS Across a population of 2271406 adults,339 adult patients were diagnosed with IBD over one year:218 with ulcerative colitis(UC,64.3%),115 with Crohn's disease(CD,33.9%)and 6 with IBD unclassified(1.8%).The crude incidence of IBD,UC and CD was 17.0/100000,11.3/100000 and 5.3/100000 respectively.The age adjusted incidence of IBD and UC were significantly higher in the Indian group(25.2/100000 and 20.5/100000)compared to White European(14.9/100000,P=0.009 and 8.2/100000,P<0.001)and Pakistani groups(14.9/100000,P=0.001 and 11.2/100000,P=0.007).The Indian group were significantly more likely to have extensive disease than White Europeans(52.7%vs 41.7%,P=0.031).There was no significant difference in time to diagnosis,disease activity and treatment.CONCLUSION This is the only prospective study to report the incidence of IBD in an ethnically diverse United Kingdom population.The Indian ethnic group showed the highest age-adjusted incidence of UC(20.5/100000).Further studies on dietary,microbial and metabolic factors that might explain these findings in UC are underway.

Epidemiology,management,and economic evaluation of screening of gallstone disease among type 2 diabetics:A systematic review

The knowledge of gallstone disease(GSD) is crucial to manage this condition when organizing screening and preventive strategies and identifying the appropriated clinical therapies. Although cholecystectomy still be the gold standard treatment for patients with symptomatic GSD, expectant management could be viewed as a valid therapeutic method for this disorder. If early treatment of GSD decreases the morbidity or avoids further cholecystectomy, it may save clinical care costs in later disease periods sufficiently to offset the screening and early treatment costs. In addition, whether routine screening for GSD is worthwhile depends on whether patients are willing to pay the ultrasonography screening cost that would reduce the risk of cholecystectomy. In this review we discuss the epidemiology, management, and economic evaluation of screening of GSD among type 2 diabetics.

Epidemiology of inflammatory bowel diseases in the state of Rio Grande do Sul,Brazil

BACKGROUND This is the first study on the epidemiology of inflammatory bowel diseases(IBDs)in Rio Grande do Sul(RS),the southernmost state of Brazil with the country’s fifth largest population.Crohn’s disease(CD)and ulcerative colitis(UC)are collectively termed IBDs.They have high incidence and prevalence rates in highincome countries,although in recent years there has been a change in the classic geographical distribution of IBDs,with growing rates in traditionally lowincidence regions.AIM To estimate the incidence and prevalence of IBDs in the RS state,Brazil,between 2014 and 2019.METHODS This is a cross-sectional descriptive observational study.Patients with IBD who had initiated treatment and met the inclusion criteria of the RS state free drug distribution program were included.Data were obtained from registration or renewal records of the RS state specialty pharmacy.The male,female,and total populations were estimated according to mid-year data from the Brazilian Institute of Geography and Statistics,which served as a reference for calculating the incidence and prevalence rates of IBDs during the study period.Results were described using mean,standard deviation,and range.RESULTS We included 1082 patients with IBD,of whom 57.5%were female and 42.5% were male.Patients with CD accounted for 72.45% of the sample,and those with UC accounted for 27.54%.IBD prevalence during the study period was 9.51 per 100000 population,of which 6.89 corresponded to people with CD and 2.62,to people with UC.Incidence rates per 100000 population/year were 2.54 in 2014,2.61 in 2015,1.91 in 2016,0.80 in 2017,0.83 in 2018,and 0.96 in 2019.The mean IBD incidence rate per 100000 population was 1.61,of which 1.17 corresponded to CD and 0.44,to UC.The mean age was 41 years,and patients were mostly aged 30-40 years.Prevalence by region was higher in the state capital metropolitan area:12.69 per 100000 population.CONCLUSION Our results demonstrated an IBD prevalence of 9.51% and incidence of 1.61 per 100000 population.The patients were predominantly female,and CD was more prevalent than UC.

Epidemiology and disease outcome in inflammatory bowel disease:observations from the European Collaborative Study

ＩＮＴＲＯＤＵＣＴＩＯＮＥｐｉｄｅｍｉｏｌｏｇｙｉｓｃｏｎｃｅｒｎｅｄｗｉｔｈｔｈｅｓｔｕｄｙｏｆｄｉｓｔｒｉｂｕｔｉｏｎａｎｄｄｅｔｅｒｍｉｎａｎｔｓｏｆｄｉｓｅａｓｅｉｎｔｈｅｐｏｐｕｌａｔｉｏｎ．Ｉｔｃａｎｂｅａｌｓｏａｐｐｌｉｅｄｔｏｓｔｕｄ...

Epidemiology of Venous Thrombo-Embolic Disease in Yaounde: A Cross-Sectional Study in Sub-Saharan Africa

Background: Venous thromboembolic disease (VTE) is one of the main causes of cardiovascular death and a public health problem worldwide. It is?one of the most complications in admitted patients, particularly inlow-income settings. The epidemiological data on VTE are still lacking. Methods: We carried out a cross-sectional study in three hospitals in Yaoundé. We retrospectively reviewed records of patients admitted for VTE from January 2013 to December 2017. We collected data on socio-demography, clinical presentation, venous Doppler/pulmonary CT scan, and outcome. Results: We included 93 patients (43 males) with VTE. Their mean age was 53.3 ± 16.6 years. There were 46 (49.5%) cases of Deep Vein Thrombosis (DVT), 36 (38.7%) cases of Pulmonary Embolism (PE), and 11 (11.8%) cases of PE associated with DVT. The main risk factors were obesity/overweight (58.1%), immobility (43%), HIV infection (22.6%), prior admission (22.6%), and long trip (19.4%). The most frequent clinical presentation for PE was dyspnea (100%), tachypnea (87.2%), and chest pain (70.2%). For DVT, limb pain (93%), calf stiffness (86%), limb volume > 3 cm (82.4%) were the most common presentation. There were 9 (9.7%) in-hospital deaths. Mean hospital stay was 20.7 ± 30.8 days. Conclusion:VTE is underdiagnosed in our setting. Obesity and immobility were the main risk factors. Dyspnea and tachypnea were the main clinical presentation for PE whereas limb pain and calf stiffness were the main symptoms for DVT. In-hospital mortality is still high.