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Numbers of Leptotrombidium (Leptotrombidium) deliense (Acarina: trombiculidae) and prevalence of Rickettsia tsutsugamushi in adjacent habitats of peninsular Malaysia

Roberts LW, Muul I, Robinson DM

Southeast Asian J. Trop. Med. Public Health, 1977 Jun;8(2):207-13.
PMID: 411177

Numbers of L. (L.) deliense larvae were determined in adjacent habitats over a 16 month period. Both R. argentiventer and R. tiomanicus were highly efficient hosts for L. (L.) deliense. R. argentiventer was host to significantly greater numbers of chiggers per rat than was R. tiomanicus. The 2 habitats were similar in numbers of chiggers collected. No consistent correlation was apparent between numbers of chiggers and any single weather factor, but the chigger population seemed to be adversely affected by a 2 month period during which total evaporation greatly exceeded total rainfall. Direct fluorescent antibody examination of tissues from unfed L. (L.) deliense showed that 2 of 420 larvae (0.5%) contained organisms morphologically resembling R. tsutsugamushi. Considering the vector load and numbers of chiggers being returned to the ground by a given host, a rate of 0.5% appeared adequate to account for the prevalence rate of R. tsutsugamushi observed in the 2 host species.
EpiNet study of incidence of status epilepticus in Auckland, New Zealand: Methods and preliminary results

Bergin PS, Brockington A, Jayabal J, Scott S, Litchfield R, Roberts L, et al.

Epilepsia, 2018 10;59 Suppl 2:144-149.
PMID: 30159885 DOI: 10.1111/epi.14478

The EpiNet project has been commenced to facilitate investigator-led collaborative research in epilepsy. A new Web-based data collection tool has been developed within EpiNet to record comprehensive data regarding status epilepticus and has been used for a study of status epilepticus in Auckland, New Zealand. All patients aged >4 weeks who presented to any of the five public hospitals and the major private hospital within Auckland city (population = 1.61 million) with an episode of status epilepticus between April 6, 2015 and April 5, 2016 were identified using multiple overlapping sources of information. For this study, status epilepticus was defined as any seizure exceeding 10 minutes in duration, or repeated seizures lasting >10 minutes without recovery between seizures. Patients who had either convulsive or nonconvulsive status epilepticus were included. Episodes of status epilepticus were classified according to the 2015 International League Against Epilepsy ILAE status epilepticus classification. A total of 477 episodes in 367 patients were considered as definite or probable status epilepticus; 285 episodes (62%) lasted >30 minutes, which is the duration that has previously been used for epidemiological studies of status epilepticus.
Status epilepticus in Auckland, New Zealand: Incidence, etiology, and outcomes

Bergin PS, Brockington A, Jayabal J, Scott S, Litchfield R, Roberts L, et al.

Epilepsia, 2019 08;60(8):1552-1564.
PMID: 31260104 DOI: 10.1111/epi.16277

OBJECTIVE: To determine the incidence, etiology, and outcome of status epilepticus (SE) in Auckland, New Zealand, using the latest International League Against Epilepsy (ILAE) SE semiological classification.
METHODS: We prospectively identified patients presenting to the public or major private hospitals in Auckland (population = 1.61 million) between April 6, 2015 and April 5, 2016 with a seizure lasting 10 minutes or longer, with retrospective review to confirm completeness of data capture. Information was recorded in the EpiNet database.
RESULTS: A total of 477 episodes of SE occurred in 367 patients. Fifty-one percent of patients were aged <15 years. SE with prominent motor symptoms comprised 81% of episodes (387/477). Eighty-four episodes (18%) were nonconvulsive SE. Four hundred fifty episodes occurred in 345 patients who were resident in Auckland. The age-adjusted incidence of 10-minute SE episodes and patients was 29.25 (95% confidence interval [CI] = 27.34-31.27) and 22.22 (95% CI = 20.57-23.99)/100 000/year, respectively. SE lasted 30 minutes or longer in 250 (56%) episodes; age-adjusted incidence was 15.95 (95% CI = 14.56-17.45) SE episodes/100 000/year and 12.92 (95% CI = 11.67-14.27) patients/100 000/year. Age-adjusted incidence (10-minute SE) was 25.54 (95% CI = 23.06-28.24) patients/100 000/year for males and 19.07 (95% CI = 16.91-21.46) patients/100 000/year for females. The age-adjusted incidence of 10-minute SE was higher in Māori (29.31 [95% CI = 23.52-37.14]/100 000/year) and Pacific Islanders (26.55 [95% CI = 22.05-31.99]/100 000/year) than in patients of European (19.13 [95% CI = 17.09-21.37]/100 000/year) or Asian/other descent (17.76 [95% CI = 14.73-21.38]/100 000/year). Seventeen of 367 patients in the study died within 30 days of the episode of SE; 30-day mortality was 4.6%.
SIGNIFICANCE: In this population-based study, incidence and mortality of SE in Auckland lie in the lower range when compared to North America and Europe. For pragmatic reasons, we only included convulsive SE if episodes lasted 10 minutes or longer, although the 2015 ILAE SE classification was otherwise practical and easy to use.
Historical epidemiology of hepatitis C virus in select countries-volume 4

Maaroufi A, Vince A, Himatt SM, Mohamed R, Fung J, Opare-Sem O, et al.

J Viral Hepat, 2017 10;24 Suppl 2:8-24.
PMID: 29105285 DOI: 10.1111/jvh.12762

Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.
The present and future disease burden of hepatitis C virus infections with today's treatment paradigm: Volume 4

Chan HLY, Chen CJ, Omede O, Al Qamish J, Al Naamani K, Bane A, et al.

J Viral Hepat, 2017 10;24 Suppl 2:25-43.
PMID: 29105283 DOI: 10.1111/jvh.12760

Factors influencing the morbidity and mortality associated with viremic hepatitis C virus (HCV) infection change over time and place, making it difficult to compare reported estimates. Models were developed for 17 countries (Bahrain, Bulgaria, Cameroon, Colombia, Croatia, Dominican Republic, Ethiopia, Ghana, Hong Kong, Jordan, Kazakhstan, Malaysia, Morocco, Nigeria, Qatar and Taiwan) to quantify and characterize the viremic population as well as forecast the changes in the infected population and the corresponding disease burden from 2015 to 2030. Model inputs were agreed upon through expert consensus, and a standardized methodology was followed to allow for comparison across countries. The viremic prevalence is expected to remain constant or decline in all but four countries (Ethiopia, Ghana, Jordan and Oman); however, HCV-related morbidity and mortality will increase in all countries except Qatar and Taiwan. In Qatar, the high-treatment rate will contribute to a reduction in total cases and HCV-related morbidity by 2030. In the remaining countries, however, the current treatment paradigm will be insufficient to achieve large reductions in HCV-related morbidity and mortality.
Strategies to manage hepatitis C virus infection disease burden-Volume 4

Chen DS, Hamoudi W, Mustapha B, Layden J, Nersesov A, Reic T, et al.

J Viral Hepat, 2017 10;24 Suppl 2:44-63.
PMID: 29105286 DOI: 10.1111/jvh.12759

The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 17 countries in Africa, Asia, Europe, Latin America and the Middle East, and interventions for achieving the Global Health Sector Strategy on viral hepatitis targets-"WHO Targets" (65% reduction in HCV-related deaths, 90% reduction in new infections and 90% of infections diagnosed by 2030) were considered. Scaling up treatment and diagnosis rates over time would be required to achieve these targets in all but one country, even with the introduction of high SVR therapies. The scenarios developed to achieve the WHO Targets in all countries studied assumed the implementation of national policies to prevent new infections and to diagnose current infections through screening.