http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Wed, 27 Mar 2013 13:50:29 +0000 http://www.hindawi.com/isrn/epidemiology/2013/502638/ The aim of this study was to assess the Leptospira prevalence in small animals in Cotonou, the capital of Benin. Rodents and shrews were captured in urban and periurban settings and determined as species of the genera Rattus, Mastomys, and Crocidura. Kidney specimens of 90 animals were examined using a real-time PCR assay specific for leptospires that belong to pathogenic species. Leptospiral DNA was amplified from kidney tissues ranging from 13.3% (8/60) in Rattus rattus to 100.0% (1/1) in Crocidura spp. with an average of 18.9% (17/90) of the animals caught at 15 locations. Clade-specific Taqman PCR on 10 samples placed six of these within clade 1 comprising the species L. kirschneri, L. interrogans, L. meyeri, and L. noguchii and four within clade 2 consisting of species L. weilii, L. alexanderi, L. borgpetersenii, and L. santarosai. Phylogenetic analysis of partial sequences of the amplicons of seven samples of these 10 samples revealed that four of the clade 1 samples could equally be assigned to L. interrogans and L. kirschneri and three samples from clade 2 belonged to L. borgpetersenii. Results presented in the paper indicate that small mammals present a major public health risk for acquiring leptospirosis in Cotonou, Benin and will contribute to a raised awareness amongst health care workers and decision makers and hence promote appropriate clinical management of cases. G. Houemenou, A. Ahmed, R. Libois, and R. A. Hartskeerl Copyright © 2013 G. Houemenou et al. All rights reserved. Thu, 07 Mar 2013 09:15:14 +0000 http://www.hindawi.com/isrn/epidemiology/2013/876724/ Background. To elucidate the association between maternal age at first delivery and cardiovascular health in women. Material and Method. A nationally representative survey, comprising 3,937 Finnish women aged 30–99 years with information on most of the potential cardiovascular disease (CVD) risk factors. Weighting survey analyses and logistic regression were performed. Results. Women who had their first delivery at age 25 or less had about five times higher odds ratio for myocardial infarction (fully adjusted OR: 4.82; 95% CI: 1.39–16.75) and about 2-fold higher odds ratio of arrhythmia (fully adjusted OR: 1.82; 95% CI: 1.13–2.92) compared to those who were 31–35 years at their first delivery. Each one year younger maternal age at first delivery predicted a higher risk of myocardial infarction (age-adjusted ; 95% CI: 1.06–1.18), hypertension (age-adjusted ; 95% CI: 1.03–1.07), arrhythmia (age-adjusted OR = 1.03; 95% CI: 1.01–1.05), angina pectoris (age-adjusted OR = 1.06; 95% CI: 1.02–1.10), and heart failure (age-adjusted ; 95% CI: 1.01–1.10). Conclusion. Maternal earlier age at first delivery is related to subsequent development of CVD, especially myocardial infarction. Our findings suggest a need for additional care and monitoring for CVD and its risk factors in women who had their first delivery at young ages. Elham Kharazmi, Mahdi Fallah, and Riitta Luoto Copyright © 2013 Elham Kharazmi et al. All rights reserved. Mon, 04 Mar 2013 09:26:32 +0000 http://www.hindawi.com/isrn/epidemiology/2013/720760/ Universally, hypertension is a major public health problem. Identification of risk factors for hypertension supports intervention policies to minimize the disease morbidity and mortality. The main objective is to fill a gap in research literature by establishing baseline information for hypertension risk factors among Palestinians. Methods. A case control study was conducted at UNRWA health care services in Gaza Strip. A proportional systematic random sample of 120 cases matched with sex, and locality to 120 controls were chosen. Data was collected using a questionnaire which included socio-demographic data, lifestyle, and health profile. Collected data was analyzed using SPSS V13. Results. The most common modifiable risk factors of hypertension were physical inactivity (76.7% versus 15.9%), obesity (67.5% versus 29.2%), diabetes mellitus (19.2% versus 7.5%), and ex-smoking (15.5% versus 1%). Cases and controls show statistical significant differences in values for the lipid profile. Hypertension was significantly associated with low socio economic status, education, and employment. The most common non-modifiable risk factors were age, and family history (85.8% versus 71.7%). Multiple logistic analysis controlling for age showed that significant predictors of hypertension were obesity, physical inactivity, low monthly income and family history. Conclusion. Most of the identified hypertension risk factors are preventable. Y. Abed and S. Abu-Haddaf Copyright © 2013 Y. Abed and S. Abu-Haddaf. All rights reserved. Tue, 12 Feb 2013 08:54:54 +0000 http://www.hindawi.com/isrn/epidemiology/2013/345618/ Predicting disease transmission on complex networks has attracted considerable recent attention in the epidemiology community. In this paper, we develop a low-dimensional system of nonlinear ordinary differential equations to model the susceptible-exposed-infectious-recovered (SEIR) epidemics on random network with arbitrary degree distributions. Both the final size of epidemics and the time-dependent behaviors are derived within our simple framework. The underlying network is represented by the configuration model, which appropriately accounts for the heterogeneity and finiteness of the degree observed in a variety of real contact networks. Moreover, a generalized model where the infectious state of individual can be skipped is treated in brief. Yilun Shang Copyright © 2013 Yilun Shang. All rights reserved. Mon, 24 Dec 2012 13:00:56 +0000 http://www.hindawi.com/isrn/epidemiology/2013/635971/ The etiology of Guillain Barré Syndrome (GBS) is not fully clarified, and there is a lack of agreement concerning its putative epidemic character. The low incidence rate of this disease is a disadvantage for employing the traditional statistical methods used in the analysis of epidemics. The objective of this paper is to clarify the GBS epidemic behavior applying a nonlinear time series identification approach. The authors obtained one time series of GBS and nine series of classical infectious epidemics (5 national and 4 international). These data were processed with advanced techniques of statistical time series analysis. This paper shows that GBS behaves similar to the other time series of classical epidemic studied. It corresponds to a nonlinear dynamics, with a point attractor. The spectral analysis pointed to an annual periodicity, and preference for the warmest month of the year was found. These results might suggest that Guillain Barré Syndrome has an epidemic behavior. The adequacy of nonlinear methods for analyzing the dynamics of epidemics, particularly those with low incidence rate, such as GBS was revealed. Zurina Lestayo O'Farrill, José Luís Hernández Cáceres, and Esperanza O'Farrill Mons Copyright © 2012 Zurina Lestayo O'Farrill et al. All rights reserved. Tue, 04 Dec 2012 11:37:31 +0000 http://www.hindawi.com/isrn/epidemiology/2013/750857/ The mathematical model discussed in this paper presents a technique to estimate the length of the cancer’s silent growth period. The methodology described utilizes information obtained from observed cancer incidence to reconstruct what is cautiously believed to be the period of time from malignant cancer initiation to diagnosis. Analyses show a decreasing hazard for cancer indicating that the longer a patient survives, the more likely they are to reach the upper limit of their natural lifespan. Based on previous research, the Weibull distribution has been used to describe the mechanisms of cancer development. In contrast to the memoryless exponential distribution which assumes a constant failure rate, the shape of the Weibull distribution is dependent on past events and preserves a memory of prior survival. This provides a simple but powerful way to characterize how the unobserved experience of cancer relates to the observed as a function to estimate the time between onset and diagnosis. The results indicate a window of opportunity for early intervention when cancer is most treatable. The method presented provides useful information to identify cancers with high mortality and prolonged periods of undetected growth to distinguish types of dire public health concern. Diana L. Nadler and Igor G. Zurbenko Copyright © 2013 Diana L. Nadler and Igor G. Zurbenko. All rights reserved. Mon, 26 Nov 2012 14:50:12 +0000 http://www.hindawi.com/isrn/epidemiology/2013/970386/ This work was aimed at determining the epidemiological implications of deer fly biting in Southeastern Nigeria and ascertaining the circadian and monthly biting pattern and the transmission potential of Chrysops in the area. Human-landing catches were carried out for 52 weeks by a catching team of four. A total of 930 female Chrysops sp. was caught; biting peaked during the months of June through August. The highest monthly biting rate (MBR) was 353 bites per person per month in July 2006. The annual biting rate (ABR) was 3,317 bites per person per year. The overall infective rate was 3.8%. A total of 314 L3s was recorded with a mean of 9.8 L3s per infective Chrysops. The highest monthly transmission potential (MTP) was 389 infective bites per month observed in July 2006. The annual transmission potential (ATP) was 1,265 infective bites per person per year. Parous rate was 29.3% and was higher during dry months of October through February. The circadian biting activities showed two peaks: between 07:00 and 10:00 hours and between 15:00 and 17:00 hours. The epidemiological implications of deer fly biting in the area are multifaceted. Resources must not be spared in bringing an end to their menace. Emmanuel Chukwunenye Uttah Copyright © 2013 Emmanuel Chukwunenye Uttah. All rights reserved. Mon, 26 Nov 2012 14:35:44 +0000 http://www.hindawi.com/isrn/epidemiology/2013/703230/ We combine the Leslie model and its derivatives with the classical compartmental SIRS models to build a model of transmission of infected diseases, in a population of hosts, whether opened or closed systems. We calculate the basic reproductive rate R0. Under certain conditions, when , there is a disease-free equilibrium that is locally asymptotically stable. In contrast, when , this equilibrium is unstable. Then, through an example, we show how we can define public health strategies to tackle an endemic. Finally we carry a global sensitivity analysis based on this basic reproduction rate to exhibit the most influential parameters of our model that are applied to influenza. Etienne Kouokam, Jean-Daniel Zucker, Franklin Fondjo, and Marc Choisy Copyright © 2013 Etienne Kouokam et al. All rights reserved. Mon, 26 Nov 2012 14:14:17 +0000 http://www.hindawi.com/isrn/epidemiology/2013/452085/ Multiple congenital anomalies (MCAs) are defined as two or more unrelated major structural malformations that cannot be explained by an underlying syndrome or sequence. The percentage and combination patterns of MCAs were analyzed using the European surveillance of congenital anomalies computer algorithms for nationwide data on congenital anomalies after assisted reproductive technology between 2004 and 2009 in Japan. There were a total of 177,548 pregnancies and 124,846 live births. About 7% (96/1,324) were MCAs. Although most maternal/neonatal outcomes between the isolated cases group and the MCAs group were similar, higher early neonatal death rate was observed in the MCAs group than in the isolated cases group (9.8% versus 3.7%, resp.). Regarding the major organ system subcategory in ICD-10, the rate of MCAs was around 30% in “congenital malformations of eye, ear, face, and neck,” “congenital malformations of the respiratory system,” and “congenital malformations of genital organs.” On the other hand, the rate of MCAs was less than 10% in “congenital malformations of the circulatory system.” The combination patterns of diseases were widely varied. Of them, two or three diseases of the circulatory system, the digestive system, and the musculoskeletal system tended to co-occur in the same individuals. Syuichi Ooki Copyright © 2013 Syuichi Ooki. All rights reserved. Mon, 17 Sep 2012 11:22:11 +0000 http://www.hindawi.com/isrn/epidemiology/2013/145031/ Cutaneous and visceral leishmaniases are endemic in Morocco. Their geographical distribution is well known. It has been related to bioclimatic factors. However, in 2008, two new cutaneous leishmaniasis foci appeared out of the known risk areas. Hence, we have undertaken this entomological survey in five foci situated in different bioclimatic areas to better understand the distribution and the epidemiology of this disease. Results of this study, undertaken during 2011, showed the predominance of Phlebotomus sergenti (55.8%) followed by Ph. perniciosus (12.9%), Ph. longicuspis (12.3%), and Ph. papatasi (12.0%). Ph. sergenti was active during 6 months in subhumid area and 8 months in arid, semiarid, and Saharan areas. Compared to previous studies, our results show a rise in Ph. sergenti abundance and an extension of its activity period. These results could explain the increase in anthroponotic cutaneous leishmaniasis incidence in Morocco and its extension to new nonendemic regions. Ph. perniciosus and Ph. longicuspis have also displayed a large distribution and a long activity period indicating a high potential risk of Leishmania infantum transmission in the studied areas. Chafika Faraj, El Bachir Adlaoui, Souad Ouahabi, Mohamed El Kohli, Mohamed El Rhazi, Lhoussine Lakraa, and Btissam Ameur Copyright © 2013 Chafika Faraj et al. All rights reserved. Mon, 27 Aug 2012 07:51:53 +0000 http://www.hindawi.com/isrn/epidemiology/2013/206120/ Prenatal exposure to maternal cigarette smoke (PEMCS) is one of the most common insults to the developing fetus and has consistently emerged as an important risk factor for excess weight in the offspring. However, no consensus exists on the mechanism of action or duration of impact. This study seeks to further examine the role of PEMCS on overweight status of children up to age 10. Mother and child pairs (𝑛=1183) were analysed from the Québec Longitudinal Study of Child Development (QLSCD) (1998–2010). Multivariable logistic regression models were used to control for confounders and assess mediation. PEMCS was associated with overweight status at age 10 (OR: 1.70; 95% CI: 1.20–2.43) after adjustment for early life exposures and childhood behaviours. This relationship remained robust after adjustment for birth weight and catch-up growth. Other significant predictors included APGAR score, mother’s immigrant and weight status, family type and child energy intake. The elevated risk of excess weight among the offspring of smoking mothers was not accounted for by other known determinants, and PEMCS appears to play a role independent of birth weight and catch-up growth. Our research suggests that young mothers may be an important audience for targeting preventive strategies. Jonathan Gravel, Beth Potter, and Lise Dubois Copyright © 2013 Jonathan Gravel et al. All rights reserved. Tue, 14 Aug 2012 13:37:19 +0000 http://www.hindawi.com/isrn/epidemiology/2013/847283/ Objectives. To describe the incidence of Legionnaires’ disease and factors affecting survival in Denmark from 1993 to 2006. Methods. Retrospective register study using data on episodes of Legionnaires’ disease from notification forms and the National Reference Laboratory, and information on comorbidity from national registers on discharge diagnoses and mortality. Results. The average annual incidence of laboratory confirmed cases was 1.5 per 100000 people. The 30-day case fatality was 19%, ranging from 7% in travellers to 37% in hospital-acquired cases. Patients older than 60 years and patients with underlying disease were more likely-to die, as were patients infected with L. pneumophila serogroup 6. The lowest mortality was seen for L. pneumophila serogroup 1. Conclusion. Increased awareness of the disease, better diagnostics, and appropriate testing and treatment strategies are needed to improve survival. In particular, we focus on the relevance of diagnostic methods, such as polymerase chain reaction (PCR), that detect other serogroups than the urinary antigen tests used that will only reliably detect antigen from L. pneumophila serogroup 1. PCR is faster and more sensitive than culture. G. St-Martin, S. Uldum, and K. Mølbak Copyright © 2013 G. St-Martin et al. All rights reserved.