Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of e...Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of entry of goods such as ports is not well known in Ghana. This study investigated the ecology, distribution and risk of transmission of viral haemorrhagic fevers by Aedes mosquitoes around the port areas of Tema, Southern Ghana. The mosquitoes from this study were collected using human landing catches, ovitraps and larval collections for a period of six months. A total of 1092 containers were inspected in both seasons and of these, 237 (21.7%) were positive for mosquito larvae or pupae in rainy season while 181 (16.6%) were positive in dry season. A total of 6498 mosquitoes were collected and identified morphologically using taxonomic keys. 6038 (92.9%) were Aedes aegypti, 337 (5.2%) were Culex spp. and 123 (1.9%) were Anopheles gambiae. The Ae. aegypti larvae were found breeding in a series of water-holding containers which included disposed plastic containers, earthenware pots, car tyres, plastic barrels, plastic basins, buckets, metal drums, jerrycans and poly tank. A high proportion of Aedes aegypti eggs were found in the ovitraps during the rainy season than in the dry season in the study sites. Ae. aegypti was the most common mosquitoes biting mostly outdoors (65.6%) with more bites occurring in the rainy season (63.6%) in the two residential sites (Tema Community One and Tema New Town). The risk of transmission of viral haemorrhagic fever in the study sites was assessed using House Index, Container Index, Breteau Index and was found to be higher in Tema New town area with seasonal variations within the sites. The man-vector contact rates for the two residential sites were also found to be higher in rainy season than the dry season. These observations indicate that the risk of transmission of viral haemorrhagic fevers in the study areas is high especially in the rainy season. The implications of the findings in the formulation of future vector control programmes around the port areas in the country are discussed in the paper.展开更多
Objective: It demonstrates the correlation of the viral hemorrhagic fever with kidney failure and the treatment as well as the outcome. Method: A PubMed search of the English literature from 1999 to 2019 was performed...Objective: It demonstrates the correlation of the viral hemorrhagic fever with kidney failure and the treatment as well as the outcome. Method: A PubMed search of the English literature from 1999 to 2019 was performed using “viral hemorrhagic fever, Case Report, Renal Failure” as the subject. The inclusion criteria were the following: 1) case report and case series of two or more patients;2) the report detailed the clinical presentation and reported the status of the renal system;3) the report described the management of renal failure if any;and 4) the etiology of the infection is known and is one of the known agents of viral hemorrhagic fever, listed on the centers of disease control website. We excluded infections related to vaccination related to viral hemorrhagic fever. Result: We found the mean age of these patients was 41.5. The male to female ratio was about 3.5:1. Dengue and Hantaviruses constituted 70.5% of patients. The overall mortality of the study cohort was 32.2%. Half of the patients had acute kidney injury and required renal replacement therapy. The chi-square statistic is 0.41;The p-value is 0.51;The chi-square statistic is 6.4254. Overall mortality was 32.3% in one cohort of 78 patients. The illness goes through several stages [1] [2] of clinical features and some viruses in the group have a high case fatality rate. Conclusions: Early diagnosis with aggressive supportive care is critical for improving clinical outcomes. Renal involvement is common. Amongst the cohort reviewed, of patients who had acute kidney injury, half of the patients required renal replacement support. However, some viruses cause greater kidney injury than others, for instance, kidney injury is more severe in Dengue hemorrhagic fevers when compared to Hantaviruses. Simultaneous management of public health by prevention and control of outbreaks is particularly important.展开更多
Background: In the last 6 months, cases of acute hemorrhagic fever (AHF) have been recorded in Sao Tome and Principe (STP). Objective: To identify the clinical, epidemiological and laboratory parameters associated wit...Background: In the last 6 months, cases of acute hemorrhagic fever (AHF) have been recorded in Sao Tome and Principe (STP). Objective: To identify the clinical, epidemiological and laboratory parameters associated with AHF cases found in patients hospitalized in STP. Methods: Descriptive and quantitative analysis of AHF cases hospitalized in STP in the period December 2021 to May 19, 2022 through the variables: demographic data;clinical data;laboratory data and clinical outcome. Results: Analyzed 18 of 22 AHF cases, 50% of them male, mean age 33.7 years, 85.7% residing in the 2 largest districts of the country, 66.7% rural workers, administrative near maritime areas, sailors and domestics. 66.7% were healthy individuals. ≥50% had a fever, asthenia/weakness, myalgia, headache, lethargy, nausea, vomiting, and diarrhea. 22.2% to 33.3% had retro-orbital pain, abdominal pain, decreased consciousness, dyspnea/hypoxia, and cough. In a smaller register (5.6% - 11.1%), exanthema, convulsion, arthralgia, low back pain, chills, and chest pain. Bleeding from the digestive tract was found in 72.2%, followed by vaginal (33.3%), urethral (27.8%), nasal (22.2%), and oral (16.7%). 50% had laboratory confirmation for dengue, and another 50% with suspected clinical diagnosis without laboratory confirmation of the etiologic agent. Despite hemorrhage, 66.7% of confirmed cases were hemodynamically non-severe, and 88.9% of suspected cases were severe. Coinfection with malaria is evidenced in 11.1% of cases. 72.2% recovered and 27.8% died (deaths in 55.5% of suspected cases). Case deaths were male (100%), resident foreigners (40%), tool store employees, sailors and students, healthy (80%), and residing in the largest district in the country (60%). All deaths were hospitalized in serious condition, 80% were hospitalized for hemorrhage and shock, with bleeding arising between day 4 - 5 of illness in 60% and hospitalization on day 5 of illness. 60% died within ≤24 hours of hospitalization. 80% died from shock and multi-organ dysfunction and 20% from respiratory failure. Deaths had thrombocytopenia (100%), renal dysfunction (100%) and significantly increased transaminases (100%), anemia (75%) and leukocytosis (66.7%). 20% had a radiological change of pulmonary infiltrates. Conclusion: Our data reveal the complexity of the pathogens causing AHF and suggest the possible presence of other human pathogens usually unknown in the Santomean geographical territory.展开更多
文摘Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of entry of goods such as ports is not well known in Ghana. This study investigated the ecology, distribution and risk of transmission of viral haemorrhagic fevers by Aedes mosquitoes around the port areas of Tema, Southern Ghana. The mosquitoes from this study were collected using human landing catches, ovitraps and larval collections for a period of six months. A total of 1092 containers were inspected in both seasons and of these, 237 (21.7%) were positive for mosquito larvae or pupae in rainy season while 181 (16.6%) were positive in dry season. A total of 6498 mosquitoes were collected and identified morphologically using taxonomic keys. 6038 (92.9%) were Aedes aegypti, 337 (5.2%) were Culex spp. and 123 (1.9%) were Anopheles gambiae. The Ae. aegypti larvae were found breeding in a series of water-holding containers which included disposed plastic containers, earthenware pots, car tyres, plastic barrels, plastic basins, buckets, metal drums, jerrycans and poly tank. A high proportion of Aedes aegypti eggs were found in the ovitraps during the rainy season than in the dry season in the study sites. Ae. aegypti was the most common mosquitoes biting mostly outdoors (65.6%) with more bites occurring in the rainy season (63.6%) in the two residential sites (Tema Community One and Tema New Town). The risk of transmission of viral haemorrhagic fever in the study sites was assessed using House Index, Container Index, Breteau Index and was found to be higher in Tema New town area with seasonal variations within the sites. The man-vector contact rates for the two residential sites were also found to be higher in rainy season than the dry season. These observations indicate that the risk of transmission of viral haemorrhagic fevers in the study areas is high especially in the rainy season. The implications of the findings in the formulation of future vector control programmes around the port areas in the country are discussed in the paper.
文摘Objective: It demonstrates the correlation of the viral hemorrhagic fever with kidney failure and the treatment as well as the outcome. Method: A PubMed search of the English literature from 1999 to 2019 was performed using “viral hemorrhagic fever, Case Report, Renal Failure” as the subject. The inclusion criteria were the following: 1) case report and case series of two or more patients;2) the report detailed the clinical presentation and reported the status of the renal system;3) the report described the management of renal failure if any;and 4) the etiology of the infection is known and is one of the known agents of viral hemorrhagic fever, listed on the centers of disease control website. We excluded infections related to vaccination related to viral hemorrhagic fever. Result: We found the mean age of these patients was 41.5. The male to female ratio was about 3.5:1. Dengue and Hantaviruses constituted 70.5% of patients. The overall mortality of the study cohort was 32.2%. Half of the patients had acute kidney injury and required renal replacement therapy. The chi-square statistic is 0.41;The p-value is 0.51;The chi-square statistic is 6.4254. Overall mortality was 32.3% in one cohort of 78 patients. The illness goes through several stages [1] [2] of clinical features and some viruses in the group have a high case fatality rate. Conclusions: Early diagnosis with aggressive supportive care is critical for improving clinical outcomes. Renal involvement is common. Amongst the cohort reviewed, of patients who had acute kidney injury, half of the patients required renal replacement support. However, some viruses cause greater kidney injury than others, for instance, kidney injury is more severe in Dengue hemorrhagic fevers when compared to Hantaviruses. Simultaneous management of public health by prevention and control of outbreaks is particularly important.
文摘Background: In the last 6 months, cases of acute hemorrhagic fever (AHF) have been recorded in Sao Tome and Principe (STP). Objective: To identify the clinical, epidemiological and laboratory parameters associated with AHF cases found in patients hospitalized in STP. Methods: Descriptive and quantitative analysis of AHF cases hospitalized in STP in the period December 2021 to May 19, 2022 through the variables: demographic data;clinical data;laboratory data and clinical outcome. Results: Analyzed 18 of 22 AHF cases, 50% of them male, mean age 33.7 years, 85.7% residing in the 2 largest districts of the country, 66.7% rural workers, administrative near maritime areas, sailors and domestics. 66.7% were healthy individuals. ≥50% had a fever, asthenia/weakness, myalgia, headache, lethargy, nausea, vomiting, and diarrhea. 22.2% to 33.3% had retro-orbital pain, abdominal pain, decreased consciousness, dyspnea/hypoxia, and cough. In a smaller register (5.6% - 11.1%), exanthema, convulsion, arthralgia, low back pain, chills, and chest pain. Bleeding from the digestive tract was found in 72.2%, followed by vaginal (33.3%), urethral (27.8%), nasal (22.2%), and oral (16.7%). 50% had laboratory confirmation for dengue, and another 50% with suspected clinical diagnosis without laboratory confirmation of the etiologic agent. Despite hemorrhage, 66.7% of confirmed cases were hemodynamically non-severe, and 88.9% of suspected cases were severe. Coinfection with malaria is evidenced in 11.1% of cases. 72.2% recovered and 27.8% died (deaths in 55.5% of suspected cases). Case deaths were male (100%), resident foreigners (40%), tool store employees, sailors and students, healthy (80%), and residing in the largest district in the country (60%). All deaths were hospitalized in serious condition, 80% were hospitalized for hemorrhage and shock, with bleeding arising between day 4 - 5 of illness in 60% and hospitalization on day 5 of illness. 60% died within ≤24 hours of hospitalization. 80% died from shock and multi-organ dysfunction and 20% from respiratory failure. Deaths had thrombocytopenia (100%), renal dysfunction (100%) and significantly increased transaminases (100%), anemia (75%) and leukocytosis (66.7%). 20% had a radiological change of pulmonary infiltrates. Conclusion: Our data reveal the complexity of the pathogens causing AHF and suggest the possible presence of other human pathogens usually unknown in the Santomean geographical territory.
基金Supported by grants from the Mega-projects for Infectious Diseases,Ministry of Science and Technology,People's Republic of China(No.2008ZX10004-008)the China-US CDC Cooperative Agreement(No.U19-GH000004)the National Natural Science Foundation of China(No.31070145)~~
