Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: McCrickard LS[original query] |
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Cholera mortality during urban epidemic, Dar es Salaam, Tanzania, August 16, 2015-January 16, 2016
McCrickard LS , Massay AE , Narra R , Mghamba J , Mohamed AA , Kishimba RS , Urio LJ , Rusibayamila N , Magembe G , Bakari M , Gibson JJ , Eidex RB , Quick RE . Emerg Infect Dis 2017 23 (13) S154-7 In 2015, a cholera epidemic occurred in Tanzania; most cases and deaths occurred in Dar es Salaam early in the outbreak. We evaluated cholera mortality through passive surveillance, burial permits, and interviews conducted with decedents' caretakers. Active case finding identified 101 suspected cholera deaths. Routine surveillance had captured only 48 (48%) of all cholera deaths, and burial permit assessments captured the remainder. We interviewed caregivers of 56 decedents to assess cholera management behaviors. Of 51 decedents receiving home care, 5 (10%) used oral rehydration solution after becoming ill. Caregivers reported that 51 (93%) of 55 decedents with known time of death sought care before death; 16 (29%) of 55 delayed seeking care for >6 h. Of the 33 (59%) community decedents, 20 (61%) were said to have been discharged from a health facility before death. Appropriate and early management of cholera cases can reduce the number of cholera deaths. |
Disparities in severe shigellosis among adults - Foodborne Diseases Active Surveillance Network, 2002-2014
McCrickard LS , Crim SM , Kim S , Bowen A . BMC Public Health 2018 18 (1) 221 BACKGROUND: Shigella causes approximately 500,000 illnesses, 6000 hospitalizations, and 40 deaths in the United States annually, but incidence and populations at risk for severe shigellosis among adults are unclear. This study describes severe shigellosis among US adults. METHODS: We analyzed Foodborne Diseases Active Surveillance Network data for infections caused by Shigella among adults >/=18 years old during 2002-2014. Criteria to define severe shigellosis included hospitalization, bacteremia, or death. We estimated annual incidence of shigellosis per 100,000 among adult populations, and conducted multivariable mixed-effects logistic regression to assess associations between severe shigellosis, demographic factors and Shigella species among adults with shigellosis. RESULTS: Among 9968 shigellosis cases, 2764 (28%) were severe. Restricting to cases due to S. sonnei and S. flexneri, median annual incidence of severe shigellosis among adults was 0.56 and highest overall incidence was among black males 18-49 years old (1.58). Among adults with shigellosis, odds of severe disease were higher among males than females aged 18-49 years old (OR [95% CI] = 1.32 [1.15-1.52], p < 0.001) and among males than females with S. flexneri infections (OR [95% CI] =1.39 [1.10-1.75], p = 0.005). The odds of severe shigellosis were higher among blacks than whites (OR [95% CI] = 1.36 [1.22-1.52], p < 0.001). CONCLUSIONS: Among adults, men 18-49 years old, particularly blacks, have the highest incidence of severe shigellosis. Among adults with shigellosis, severe shigellosis was associated with being male in age group 18-49 years, with infections caused by S. flexneri, and with black race. Future research should assess associations between severe shigellosis and sexual practices, antimicrobial resistance, comorbidities, and access to care. |
Notes from the field: Ongoing cholera epidemic - Tanzania, 2015-2016
Narra R , Maeda JM , Temba H , Mghamba J , Nyanga A , Greiner AL , Bakari M , Beer KD , Chae SR , Curran KG , Eidex RB , Gibson JJ , Handzel T , Kiberiti SJ , Kishimba RS , Lukupulo H , Malibiche T , Massa K , Massay AE , McCrickard LS , McHau GJ , Mmbaga V , Mohamed AA , Mwakapeje ER , Nestory E , Newton AE , Oyugi E , Rajasingham A , Roland ME , Rusibamayila N , Sembuche S , Urio LJ , Walker TA , Wang A , Quick RE . MMWR Morb Mortal Wkly Rep 2017 66 (6) 177-178 On August 15, 2015, the Tanzanian Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) was notified about a case of acute watery diarrhea with severe dehydration in a patient in Dar es Salaam. Vibrio cholerae O1, biotype El tor, serotype Ogawa, was isolated from the patient’s stool and an investigation was initiated. MOHCDGEC defined a suspected cholera case as the occurrence of severe dehydration or death from acute watery diarrhea in a person aged ≥5 years, or acute, profuse watery diarrhea with or without vomiting in a person aged ≥2 years in a region with an active cholera outbreak. A confirmed cholera case was defined as isolation of V. cholerae O1 from the stool of a person with suspected cholera. Tanzania’s first reported cholera epidemic was in 1974 with intermittent outbreaks since then; the largest epidemic occurred in 1997, with 40,249 cases and 2,231 deaths (case fatality rate [CFR] was 5.5%) (1). | As of November 26, 2016, the current epidemic continues, affecting 23 (92%) of 25 regions in mainland Tanzania (excluding the Zanzibar archipelago), with a cumulative reported case count of 23,258 and a cumulative CFR of 1.5%. The median number of reported cholera cases per week was 271 (range = 5–1,240) (Figure). Approximately half of all reported cases have been from four regions: Dar es Salaam (5,104; 22%), Morogoro (3,177; 14%), Mwanza (2,311; 10%), and Mara (2,299; 10%). Of 511 stool specimens tested during August 17, 2015–March 18, 2016 at the National Health Laboratory-Quality Assurance Training Center in Dar es Salaam, 268 (52%) were positive for V. cholerae; all specimens were serogroup O1, biotype El tor, serotype Ogawa. Antimicrobial resistance (AMR) testing revealed sensitivity to cotrimoxazole, ceftriaxone, tetracycline, ciprofloxacin, and chloramphenicol, and resistance to nalidixic acid and ampicillin. |
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