Epidemiology Research Today is a free monthly online journal that collates and summarizes the latest research about Epidemiology, including details on twin studies, statistics, environmental and genetic factors.
Changing epidemiology of Clostridium difficile infection following the introduction of a national ribotyping based surveillance scheme in England.
Wilcox MH, Shetty N, Fawley WN, Shemko M, Coen P, Birtles A, Cairns M, Curran MD, Dodgson KJ, Green SM, Hardy KJ, Hawkey PM, Magee JG, Sails AD, Wren MW
Department of Microbiology, Leeds Teaching Hospitals Trust & University of Leeds.
Background. Marked increases Clostridium difficile infection (CDI) incidence, driven by epidemic strain spread, is a global phenomenon.Methods. The C. difficile Ribotyping Network (CDRN) was established in 2007, as part of enhanced CDI surveillance in England, to facilitate the recognition and control of epidemic strains. We report on changes in CDI epidemiology in England in the first three years of CDRN.Results. CDRN received 12,603 faecal specimens, comprising significantly (P<0.05) increasing numbers and proportions of national CDI cases in 2007/08 (n=2109, 3.8%), 2009/10 (n=4774, 13.2%) and 2009/10 (n=5720, 22.3%). C. difficile recovery rate was 90%, yielding 11,294 isolates for ribotyping. Rates of nine of the 10 most common ribotypes changed significantly (P<0.05) during 2007-10. C. difficile ribotype 027 predominated, but decreased markedly from 55% to 36% and 21% in 2007/08, 2008/09 and 2009/10, respectively. The largest regional variations in prevalence occurred for ribotypes 027, 002, 015 and 078. Cephalosporin and fluoroquinolone use in CDI cases was reported significantly (P<0.05) less frequently during 2007-10. Mortality data were subject to potential reporting bias, but there was a significant decrease in CDI associated deaths during 2007-10, which may have been due to multiple factors, including reduced prevalence of ribotype 027.Conclusion. Access to C. difficile ribotyping was associated with significant changes in the prevalence of epidemic strains, especially ribotype 027. These changes coincided with markedly reduced CDI incidence and related mortality in England. CDI control programs should include prospective access to C. difficile typing and analysis of risk factors for CDI and outcomes.
Published 12 July 2012 in Clin Infect Dis.
Articles on Epidemiology published 11 July 2012:
Epidemiology and Clinical Aspects of HPV in Head and Neck Cancers. Head Neck Pathol, 6: 16-24.
Human papillomavirus (HPV) infection is now established as a major etiologic factor for oropharyngeal cancers. Case-control studies conducted around the world show strong and consistent associations of markers of HPV exposure with risk of oropharyngeal cancers (range of odds ratios [OR] for oral oncogenic HPV infections = 3.6-230.0, ORs for HPV16 L1 antibodies = 2.3-182.0, and ORs for HPV16 E6/E7 antibodies = 9.2-231.0. HPV-positive oropharyngeal cancers are epidemiologically distinct ... [Abstract] [Full-text]
Chikungunya virus is a mosquito-transmitted RNA virus and emerging as a pathogen that has a major public health impact because of the high morbidity including high fever, headache, rash, nausea, vomiting, myalgia, arthralgia with or without neurological manifestation or fulminant hepatitis. One hundred fifty one patient samples were analyzed during the year 2006-2008, and compared conventional tests and CCRT-PCR (cell culture RT PCR). The conventional tests included ELISA, inoculation into ... [Abstract] [Full-text]
OBJECTIVE:: The standard adjuvant treatment for men with stage I testicular seminoma remains controversial within the literature. We analyzed survival rates in men with stage I seminoma who underwent adjuvant radiation therapy (RT) or observation (OB) after orchiectomy. METHODS:: Data were obtained from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute from 1973 to 2003. The primary end points were overall survival (OS) and cause-specific survival (CSS). ... [Abstract] [Full-text]
Structural and functional alterations affecting the aging kidney predispose to an increased risk of acute renal failure (ARF) in the elderly. This is a common problem becoming more relevant because of an increase in life expectancy. The epidemiology of ARF in the elderly is far from being well assessed, because of the lack of uniform definition criteria, variable etiology, coexistence of several comorbidities, and the various clinical settings and geographic areas where the condition is ... [Abstract] [Full-text]
SUMMARY When every individual has an equal chance of mating with other individuals, the population is classified as panmictic. Amongst metazoan parasites of animals, local-scale panmixia can be disrupted due to not only non-random mating, but also non-random transmission among individual hosts of a single host population or non-random transmission among sympatric host species. Population genetics theory and analyses can be used to test the null hypothesis of panmixia and thus, allow one to draw ... [Abstract] [Full-text]
Nasopharyngeal carcinoma in Indonesia: epidemiology, incidence,signs, and symptoms at presentation. Chin J Cancer, 31(4): 185-96.
Among all head and neck (H&N) cancers, nasopharyngeal carcinoma (NPC) represents a distinct entity regarding epidemiology, clinical presentation, biological markers, carcinogenic risk factors, and prognostic factors. NPC is endemic in certain regions of the world, especially in Southeast Asia, and has a poor prognosis. In Indonesia, the recorded mean prevalence is 6.2/100 000, with 13 000 yearly new NPC cases, but otherwise little is documented on NPC in Indonesia. Here, we report on a ... [Abstract] [Full-text]
Modelling the impact of extended vaccination strategies on the epidemiology of pertussis. Epidemiol Infect, 140(8): 1503-14.
SUMMARY The aim of this study was to investigate the optimal pertussis booster vaccination strategy for The Netherlands. A realistic age-structured deterministic model was designed. Assuming a steady-state situation and correcting for underreporting, the model was calibrated using notification data from the period 1996-2000. Several sensitivity analyses were performed to explore the impact of different assumptions for parameters surrounded by uncertainty (e.g. duration of protection after ... [Abstract] [Full-text]
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