Showing papers by "Calum N. L. Macpherson published in 2018"

Ultrasound and Cystic Echinococcosis.

Abstract: The introduction of imaging techniques in clinical practice 40 years ago changed the clinical management of many diseases, including cystic echinococcosis (CE). For the first time cysts were clearly seen before surgery. Among the available imaging techniques, ultrasound (US) has unique properties that can be used to study and manage cystic echinococcosis. It is harmless, can image almost all organs and systems, can be repeated as often as required, is portable, requires no patient preparation, is relatively inexpensive and guides diagnosis, treatment and follow-up without radiation exposure and harm to the patient. US is the only imaging technique which can be used in field settings to assess CE prevalence because it can be run even on solar power or a small generator in remote field locations. Thanks to US classifications, the concept of stage-specific treatments was introduced and because US is repeatable, the scientific community has gained a clearer understanding of the natural history of the disease. This paper reviews the scope of US in CE, describes its strengths and weaknesses compared to other imaging techniques and its relationship with serodiagnosis and discusses sonographic features that may be helpful in differential diagnosis.

The identification of risk factors for chronic chikungunya arthralgia in Grenada, West Indies: A cross-sectional cohort study

Abstract: Background Chikungunya virus (CHIKV) is a re-emerging arboviral pathogen. In 2014, an explosive CHIKV outbreak occurred in Grenada, West Indies, infecting approximately 60% of the population. In approximately 50% of cases, CHIKV infection transitions to painful arthralgia that can persist for years. Elucidation of the risk factors for chronic disease is imperative to the development of effective risk management strategies and specific therapeutics. Methods We conducted a cross-sectional study of 240 people who were tested for CHIKV during the outbreak. We administered questionnaires to examine demographic, behavioral, psychological, social, and environmental factors to identify associations with chronic disease. Physical examinations were performed and persistent symptoms were recorded. Results Ethnicity and socioeconomic status were not associated with risk of chronic joint pain. Female sex increased risk, and age was demonstrated to be predictive of chronic CHIKV sequelae. Mosquito avoidance behaviors did not reduce risk. Patients suffering joint pains, generalized body ache, and weakness in the extremities during acute infection were more likely to develop chronic arthralgia, and an increased duration of acute disease also increased risk. Conclusions These data demonstrate that chronic CHIKV affects people across the ethnic and socioeconomic spectrum, and it is not reduced by vector avoidance activity. Increased duration of acute symptoms, in particular acute joint pain, was strongly correlated with the risk of persistent arthralgia, thus effective clinical management of acute CHIKV disease could reduce burden of chronic CHIKV.

Clinical, Serological, and Molecular Observations from a Case Series Study during the Asian Lineage Zika Virus Outbreak in Grenada during 2016

Abstract: This paper describes the spatial and temporal distribution of cases, demographic characteristics of patients, and clinical manifestations of Zika virus (ZIKV) during the 2016 outbreak in Grenada. The first reported case was recorded in St. Andrew Parish in April, and the last reported case was seen in November, with peak transmission occurring in the last week of June, based on test results. Data were collected from a total of 514 patients, of whom 207 (40%) tested positive for ZIKV. No evidence was found that testing positive for ZIKV infection was related to age, gender, or pregnancy status. Clinical presentation with rash (OR = 2.4, 95% CI = 1.5 to 3.7) or with lymphadenopathy (OR = 1.7, 95% CI = 1.0 to 2.9) were the only reported symptoms consistent with testing positive for ZIKV infection. During the Zika outbreak, the infection rate was 20 clinical cases per 10,000 in the population compared to 41 cases per 10,000 during the chikungunya outbreak in Grenada in 2014 and 17 cases per 10,000 during the dengue outbreak in 2001-2002. Even though the country has employed vector control programs, with no apparent decrease in infection rates, it appears that new abatement approaches are needed to minimize morbidity in future arbovirus outbreaks.

Production-level risk factors for syncytial hepatitis in farmed tilapia (Oreochromis niloticus L).

Abstract: Syncytial hepatitis (SHT) is an emerging viral disease of tilapia characterized by significant morbidity and mortality. This study aimed to establish the production-level risk factors associated with presence and severity of SHT. Production factors were analysed during multiple outbreaks of SHT that occurred between 2011 and 2013 on a single tilapia farm in Ecuador and compared with the year 2010 before the SHT outbreaks. Relative risks, t tests, modified Poisson and forward stepwise linear regression analyses were performed using EPIINFO™. Compared to other strains, Chitralada had an elevated risk of SHT [RR = 2.1 (95%CI 1.8-2.4)]. Excessive mortality associated with the presence (and severity) of SHT increased by 611 (365), 6,814 (5,768) and 388 (340) deaths per 100,000 fry when stocking density, dissolved oxygen and pond production cycles were raised by 1 fish/m2 , 1 mg/L and 1 cycle, respectively. Excessive mortality associated with the presence (and severity) of SHT decreased by 337 (258) and 1,354 (1,025) deaths per 100,000 when stocking weight and water temperature increased by 1 g and 1°C, respectively. Time (season and stocking year) was not significantly associated with SHT. This study shows that some production factors increase the risk incidence and severity of SHTon a farm.

Incidence and Risk Factors of Wildlife-Associated Human Injuries in Queen Elizabeth National Park, Uganda: A Retrospective Cohort Study

Abstract: Human-wildlife conflicts, leading to fatal or non-fatal human injuries, constitute a global public health issue. This paper identifies the types of human-wildlife conflicts, and the incidence and risk factors of wildlife-associated human injuries in Queen Elizabeth National Park (QENP), Uganda, between 2006 and 2010. Seventy-one individuals participated in four focus group discussions (FGD) while 90 participants were surveyed using interviewer-administered questionnaires, retrospectively. Data obtained from FGDs were organized into themes, whereas the incidence of human injury caused by wildlife and relative risks were calculated, using EPIINFO™ at a level of significance of α = 0.05. Based on FGDs, wildlife-associated human injuries ranked third worst form of human-wildlife conflict behind crop and livestock destruction. The data showed an upward trend in the incidence of wildlife-related human injuries, with an average of 80 wildlife-associated human injuries per 1,000 persons per year. Compared to other economic activities, fishing [RR = 1.7; 95%CI (1.1 - 2.5)] and farming [RR = 1.5; 95%CI (1.0 - 2.3)] had a 70% and 50% greater risk of wildlife-associated human injury, respectively. Nocturnal and dry season activities were twice as risky [RR=2.0; 95%CI (1.0 - 4.0)] and [RR=2.6; 95%CI (1.4 - 5.0)] compared to day time and wet season activities, respectively. Males and respondents aged between 18 - 25 years, who were involved in fishing and farming, were at greater risk of wildlife-associated human injuries compared to females and other age groups, respectively. Hippos were the most single frequent cause of human injuries (27%), followed by elephants (22%), and crocodiles (19%). The incidence of wildlife-associated human injury showed increasing trends in QENP during the study period. Economic activities, as well as temporal variations were significantly associated with the incidence of wildlife-associated human injuries, and they were modified gender and age of respondent.

Evaluation of the Grenada Sports for Health Program

Abstract: Objective: The study served to measure basic health outcome measures to help guide the continued implementation of the community exercise component of the Grenada Sports for Health program. Design & Methods: The study population consisted of Grenadian citizens enrolled in three different community exercise programs as part of the Royal Grenada Police Force, Point Saline and La Sagesse, Grenville, Gouyave and Tanteen community exercise program. Initial data collection for this prospective cohort study began during March of 2011 and continued data collection through quarterly assessments was continued to June/ July 2014 and June/July 2016. The health indicators for the Sports for Health program were designed to monitor and analyse program participants’ physical health indicators, such as Body Mass Index (BMI), Waist to Hip ratio over time to determine if their participation in the community training program was promoting health benefits by reducing risk factors for non-communicable chronic diseases. Results: During the baseline evaluation period in March, 2011, complete data sets were obtained for 427 participants. During the evaluation period of March 2014, 337 complete data sets were collected from participants from 2011 and during June/July 2016 evaluation, 264 complete data sets were obtained. The BMI, Waist, hip, and waist: hip ratio is presented in Table 1. BMI and Waist: Hip ratio using a Student’s T-test (α=0.05) demonstrated a significant difference between 2011 and 2016 measures (Table 1). Conclusions: Participants have demonstrated a significant and positive difference in physical health indicators over three years of participation in the Sports for Health program. Biomedical Journal of Scientific & Technical Research (BJSTR) Open Access Introduction Over the past few decades, a rise in non-communicable diseases globally and especially in the developing nations has occurred. This may be due to socioeconomic disparities[1] and more so the increasing income inequality [2], as well as the westernization of diets, combined with a decrease in physical activity. Based on WHO report, non-communicable diseases (NCD) are responsible for 63% of deaths globally, with nearly 80% of NCD deaths occurring in low and middleincome nations[3].The greatest risk factors for NCD are tobacco use, physical inactivity, alcohol abuse and unhealthy diet. Physical activity is a critical component for decreasing overall mortality and incidence of NCD[3-5].Furthermore, exercise improves cognition in older adults[6-9].Studies show communitybased programs to be effective in managing and improving the outcomes of non-communicable diseases, especially cardiovascular disease, hypertension and obesity[10,11]. Community based programs also show an increase in participation and a decrease in health care costs[12]. The use of community based approaches to health improvement is not new and serves as a mutli-pronged approach to create a positive change. A community approach not only engages in healthy behaviours, but also empowers members of the community to make lasting and effective changes[13].The community exercise program in Grenada provides community based exercise opportunities to help reduce the burden of NCDs. The program is run by the Royal Grenadian Police Force at fivesites around the island of Grenada. The program is focused on engaging adults in a more active lifestyle by delivering different exercise activities to a group five days a week. This study aimed to evaluate the efficacy of the sports for health program for improving health outcomes using a community based intervention. Design and Methods The study population consisted of Grenadian citizens enrolled in five different community exercise programs as part of the Royal Grenada Police Force, Fitness Club in Point Saline and La Sagesse, Grenville, Gouyave and Tanteen. The community exercise programs offered aerobic exercises, ranging from dancing, fast track, jogging, running, and strength training.Initial data collection for this prospective cohort study began during March of 2011 and continued data collection through quarterly assessments was carriedthrough June/July 2016. The Sports for Health program was designed to monitor and analyse program participants’ physical health indicators, such as Body Mass Index (BMI), Waist to Hip ratio over Biomedical Journal of Scientific & Technical Research Volume 6Issue 4: 2018 Cite this article: Satesh B, Calum M. Evaluation of the Grenada Sports for Health Program. Biomed J Sci&Tech Res 6(4)2018. BJSTR. MS.ID.001388. DOI: 10.26717/ BJSTR.2018.06.001388. 2/3 time, to determine if their participation in the community training program was improving health indicators.The measurements for hip and waist were collected using a tape measure. The weight was collected using a standard mechanical scale. Data were recorded on survey forms at the fitness centres. Results During the baseline evaluation period in March, 2011, complete data sets were obtained for 427 participants. During the evaluation period of March 2014, 337 complete data sets were collected from participant’s from2011 and 264 complete data sets in 2016. The BMI, Waist, hip, and waist: hip ratio is presented in Table 1. BMI and Waist: Hip ratio using a Student’s T-test (α=0.05) demonstrated a significant difference for both measures between 2011 and 2014. There was no demonstrated difference between 2014 and 2016. The number of participants available for the study in 2011, 2014 and 2016 decreased over time. In 2014 there was a loss of 90 participants and a further loss of 73 participants in 2016, resulting in an overall loss of 40% of initial participants.Overall changes in participant measures of waist, hip and weight measurements reported a decrease in all measurements in 2014 with maintenance in 2016. The change in BMI measurement between the group in 2011 and 2014 showed a decrease of 4.9, then maintenance in 2016. The waist to hip ratio reduction of 0.04 was observed between 2011 and 2014 and also maintained in 2016 see Figure 1.The comparison measures of BMI and waist to hip ratio between 2011 and 2014 were significant and had a pvalue <0.05, with no observable difference between 2014 and 2016. Table 1: Comparing physical health indicators between 2011, 2014 and 2016. Measured physical health indicators between 2011, 2014 and 2016