ABSTRACT
During the spring of 2009, a novel influenza A (H1N1) virus of swine origin caused human infection and acute respiratory illness in Mexico. After initially spreading in North America, the virus spread globally resulting in the first influenza pandemic since 1968. While the majority of illnesses caused by pandemic (H1N1) 2009 were mild and self-limiting, severe complications, including fatalities, were also reported. In view of the increasing number of laboratory-confirmed cases and deaths from pandemic (H1N1) 2009 in the Eastern Mediterranean Region of the World Health Organization, the Regional Office convened a consultation meeting of experts involved in the clinical management of patients infected with pandemic (H1N1) 2009 virus. The consultation resulted in developing an interim guidance and algorithm for clinical management of pandemic (H1N1) 2009 virus infection in health-care settings. This paper describes the process, the technical basis and the components of this interim guidance.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human/prevention & control , Influenza, Human/virology , Algorithms , Humans , Influenza, Human/epidemiology , Mediterranean Region/epidemiology , Pandemics/prevention & control , World Health OrganizationABSTRACT
PURPOSE: Surveillance for patients with meningitis is a high priority in order to determine the etiology of disease and design prevention strategies. This study presents data on the causes of bacterial meningitis among children <6 years of age treated in a network of hospitals throughout Egypt. METHODS: Training was provided to standardize the collection of clinical information and optimize recovery of bacterial pathogens. Bacterial isolates were tested for antimicrobial resistance patterns using Kirby Bauer disk diffusion, E-test and/or Beta-lactamase (BL) testing methods. RESULTS: Patients with culture-confirmed bacterial meningitis (228 children<6 years) were identified including 89 (39%) patients with H. influenzae (HI), 68 (30%) with Streptococcus pneumoniae (SP), 30 (13%) with N. meningitidis (NM), 18 (8%) with Mycobacterium tuberculosis (MTB) and 23 (10%) with other bacteria. The overall case fatality ratio was high (24%) and increased among children with TB meningitis (56%). The susceptibility for HI to ampicillin (AMP), chloramphenicol (C) and ceftriaxone (CRO) was 21%, 13%, and 100% respectively. The susceptibility for SP to C and CRO was 79% and 100%, respectively. CONCLUSIONS: HI and SP are the leading causes of bacterial meningitis among children in Egypt. The majority of HI strains tested were resistant to AMP or C suggesting the need for routine use of CRO as first line therapy. Among older children TB emerges as a significant cause of bacterial meningitis in Egypt.
Subject(s)
Drug Resistance, Bacterial , Meningitis, Bacterial/drug therapy , Meningitis, Bacterial/epidemiology , Age Factors , Child, Preschool , Developing Countries , Egypt/epidemiology , Female , Haemophilus influenzae/drug effects , Haemophilus influenzae/isolation & purification , Haemophilus influenzae/pathogenicity , Hospitalization , Humans , Infant , Male , Meningitis, Bacterial/microbiology , Mycobacterium tuberculosis/drug effects , Mycobacterium tuberculosis/isolation & purification , Mycobacterium tuberculosis/pathogenicity , Neisseria meningitidis/drug effects , Neisseria meningitidis/isolation & purification , Neisseria meningitidis/pathogenicity , Population Surveillance , Seasons , Streptococcus pneumoniae/drug effects , Streptococcus pneumoniae/isolation & purification , Streptococcus pneumoniae/pathogenicityABSTRACT
The National Blood Pressure Survey aimed to determine blood pressure levels among Omanis > or = 18 years, study the epidemiological factors most related to blood pressure and suggest a programme for the management and control of hypertension in Oman. Of the 4732 people screened, 1278 (27.01%) had high blood pressure. Multiple regression analysis showed that blood pressure depended on age, body mass index and income per capita simultaneously. In a logistic regression model, adjusted risks associated with obesity and those aged > or = 45 years were significantly increased compared with the relevant different categories. A national plan of action for hypertension control and management is recommended and discussed.
Subject(s)
Blood Pressure , Hypertension/epidemiology , Adult , Age Distribution , Aged , Cross-Sectional Studies , Female , Humans , Hypertension/etiology , Hypertension/prevention & control , Income , Logistic Models , Male , Middle Aged , Needs Assessment , Obesity/complications , Oman/epidemiology , Population Surveillance , Risk Factors , Sex Distribution , Surveys and QuestionnairesABSTRACT
The National Blood Pressure Survey aimed to determine blood pressure levels among Omanis > or = 18 years, study the epidemiological factors most related to blood pressure and suggest a programme for the management and control of hypertension in Oman. Of the 4732 people screened, 1278 [27.01%] had high blood pressure. Multiple regression analysis showed that blood pressure depended on age, body mass index and income per capita simultaneously. In a logistic regression model, adjusted risks associated with obesity and those aged >/= 45 years were significantly increased compared with the relevant different categories. A national plan of action for hypertension control and management is recommended and discussed
