Molecular Diagnosis as an Alternative for Public Health Surveillance of Leptospirosis in Colombia
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ABSTRACT:
SUBMITTER: Arboleda M
PROVIDER: S-EPMC10673046 | biostudies-literature | 2023 Nov
REPOSITORIES: biostudies-literature
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Project description:While genomic approaches to precision medicine hold great promise, they remain prohibitively expensive for developing countries. The precision public health paradigm, whereby healthcare decisions are made at the level of populations as opposed to individuals, provides one way for the genomics revolution to directly impact health outcomes in the developing world. Genomic approaches to precision public health require a deep understanding of local population genomics, which is still missing for many developing countries. We are investigating the population genomics of genetic variants that mediate drug response in an effort to inform healthcare decisions in Colombia. Our work focuses on two neighboring populations with distinct ancestry profiles: Antioquia and Chocó. Antioquia has primarily European genetic ancestry followed by Native American and African components, whereas Chocó shows mainly African ancestry with lower levels of Native American and European admixture. We performed a survey of the global distribution of pharmacogenomic variants followed by a more focused study of pharmacogenomic allele frequency differences between the two Colombian populations. Worldwide, we found pharmacogenomic variants to have both unusually high minor allele frequencies and high levels of population differentiation. A number of these pharmacogenomic variants also show anomalous effect allele frequencies within and between the two Colombian populations, and these differences were found to be associated with their distinct genetic ancestry profiles. For example, the C allele of the single nucleotide polymorphism (SNP) rs4149056 [Solute Carrier Organic Anion Transporter Family Member 1B1 (SLCO1B1)∗5], which is associated with an increased risk of toxicity to a commonly prescribed statin, is found at relatively high frequency in Antioquia and is associated with European ancestry. In addition to pharmacogenomic alleles related to increased toxicity risk, we also have evidence that alleles related to dosage and metabolism have large frequency differences between the two populations, which are associated with their specific ancestries. Using these findings, we have developed and validated an inexpensive allele-specific PCR assay to test for the presence of such population-enriched pharmacogenomic SNPs in Colombia. These results serve as an example of how population-centered approaches to pharmacogenomics can help to realize the promise of precision medicine in resource-limited settings.
| S-EPMC6439339 | biostudies-literature
Project description:WEWASH
| PRJEB74231 | ENA
Project description:OBJECTIVES:In response to an expressed need for more focused measurement of preconception health (PCH), we identify a condensed set of PCH indicators for state and national surveillance. METHODS:We used a systematic process to evaluate, prioritize, and select 10 PCH indicators that maternal and child health programs can use for surveillance. For each indicator, we assessed prevalence, whether it was addressed by professional recommendations, Healthy People 2020 objectives, or Centers for Disease Control and Prevention winnable battles, measurement simplicity, data completeness, and stakeholders' input. RESULTS:Fifty PCH indicators were evaluated and prioritized. The condensed set includes indicators that rely on data from the Pregnancy Risk Assessment Monitoring System (n = 4) and the Behavioral Risk Factor Surveillance System (n = 6). The content encompasses heavy alcohol consumption, depression, diabetes, folic acid intake, hypertension, normal weight, recommended physical activity, current smoking, unwanted pregnancy, and use of contraception. CONCLUSIONS:Having a condensed set of PCH indicators can facilitate surveillance of reproductive-aged women's health status that supports monitoring, comparisons, and benchmarking at the state and national levels.
| S-EPMC5903944 | biostudies-literature
Project description:Objectives:To assess the performance of a Bayesian case detector (BCD) for influenza surveillance and clinical diagnosis. Methods:BCD uses a Bayesian network classifier to compute the posterior probability of a patient having influenza based on 31 findings from narrative clinical notes. To assess the potential for disease surveillance, we calculated area under the receiver operating characteristic curve (AUC) to indicate BCD's ability to differentiate between influenza and non-influenza encounters in emergency department settings. To assess the potential for clinical diagnosis, we measured AUC for diagnosing influenza cases among encounters having influenza-like illnesses. We also evaluated the performance of BCD using dynamically estimated influenza prevalence, and measured sensitivity, specificity and positive predictive value. Results:For influenza surveillance, BCD differentiated between influenza and non-influenza encounters well with an AUC of 0.90 and 0.97 with dynamic influenza prevalence (P < 0.0001). For clinical diagnosis, the addition of dynamic influenza prevalence to BCD significantly improved AUC from 0.63 to 0.85 to distinguish influenza from other causes of influenza-like illness. Conclusions and policy implications:BCD can serve as an influenza surveillance and a differential diagnosis tool via our dynamic prevalence approach. It enhances the communication between public health and clinical practice.
| S-EPMC6676953 | biostudies-literature
Project description:WGS data for the surveillance of Enterobacterales
| PRJEB76821 | ENA
Project description:Leptospirosis is a global zoonotic disease caused by spirochete bacteria of the genus Leptospira. The disease exhibits a notable incidence in tropical and developing countries, and in Colombia, environmental, economic, social, and cultural conditions favor disease transmission, directly impacting both mortality and morbidity rates. Our objective was to establish the pooled lagged effect of runoff on leptospirosis cases in Colombia. For our study, we included the top 20 Colombian municipalities with the highest number of leptospirosis cases. Monthly cases of leptospirosis, confirmed by laboratory tests and spanning from 2007 to 2022, were obtained from the National Public Health Surveillance System. Additionally, we collected monthly runoff and atmospheric and oceanic data from remote sensors. Multidimensional poverty index values for each municipality were sourced from the Terridata repository. We employed causal inference and distributed lag nonlinear models to estimate the lagged effect of runoff on leptospirosis cases. Municipality-specific estimates were combined through meta-analysis to derive a single estimate for all municipalities under study. The pooled results for the 20 municipalities suggest a lagged effect for the 0 to 2, and 0-3 months of runoff on leptospirosis when the runoff is < 120 g/m2. No effect was identified for longer lagged periods (0-1, 0 to 4, 0 to 5, and 0-6 months) or higher runoff values. Incorporation of the multidimensional poverty index into the meta-analysis of runoff contributed to the models for the lagged periods of 0-3, and 0-4 months.
| S-EPMC11234012 | biostudies-literature
Project description:BackgroundLeptospirosis is responsible for various clinical syndromes, classically linked with fever and acute kidney injury.Methodology/principal findingsA prospective multicenter observational study was conducted in six health institutions in the region of Urabá, Colombia. Enrollment was based on leptospirosis-compatible clinical syndrome and a positive preliminary serological test, with PCR used to confirm the disease. Clinical data were collected using a standard questionnaire at enrollment, complemented with a review of clinical records. A total of 100 patients were enrolled, 37% (95% CI 27.0-46.9%) had a positive PCR result confirming acute leptospirosis. The most frequent symptoms in patients with a positive PCR test were headache (91.9%; 34/37), chills and sweating (80.6%; 29/37), nausea (75%; 27/37), dizziness (74.3%; 26/37), vomiting (61.1%; 22/37), congestion (56.8%; 21/37), and conjunctival suffusion (51.4%; 19/37). The frequency of clinical signs classically described in leptospirosis was low: jaundice (8.3%; 3/36) and anuria/oliguria (21.6%; 8/37). An increased neutrophile percentage was reported in 60.6% (20/33) of patients. The presence of complications was 21.6% (8/37), with pulmonary complications being the most frequent (75.0% 6/8). One confirmed case died resulting in a fatality of 2.7% (95% CI 0.5-13.8).Conclusions/significanceLeptospirosis should be considered within the differential diagnoses of an undifferentiated acute febrile syndrome. Leptospirosis presents diagnostic challenges due to limitations in both clinical and laboratory diagnosis thus it is important to improve understanding of disease presentation and identify signs and symptoms that might help differentiate it from other causes of febrile illness.
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Project description:The ubiquitous and openly accessible information produced by the public on the Internet has sparked an increasing interest in developing digital public health surveillance (DPHS) systems. We conducted a systematic scoping review in accordance with the PRISMA extension for scoping reviews to consolidate and characterize the existing research on DPHS and identify areas for further research. We used Natural Language Processing and content analysis to define the search strings and searched Global Health, Web of Science, PubMed, and Google Scholar from 2005 to January 2020 for peer-reviewed articles on DPHS, with extensive hand searching. Seven hundred fifty-five articles were included in this review. The studies were from 54 countries and utilized 26 digital platforms to study 208 sub-categories of 49 categories associated with 16 public health surveillance (PHS) themes. Most studies were conducted by researchers from the United States (56%, 426) and dominated by communicable diseases-related topics (25%, 187), followed by behavioural risk factors (17%, 131). While this review discusses the potentials of using Internet-based data as an affordable and instantaneous resource for DPHS, it highlights the paucity of longitudinal studies and the methodological and inherent practical limitations underpinning the successful implementation of a DPHS system. Little work studied Internet users' demographics when developing DPHS systems, and 39% (291) of studies did not stratify their results by geographic region. A clear methodology by which the results of DPHS can be linked to public health action has yet to be established, as only six (0.8%) studies deployed their system into a PHS context.
| S-EPMC7930261 | biostudies-literature
Project description:On Twitter, people answer the question, "What are you doing right now?" in no more than 140 characters. We investigated the content of Twitter posts meeting search criteria relating to dental pain. A set of 1000 tweets was randomly selected from 4859 tweets over 7 non-consecutive days. The content was coded using pre-established, non-mutually-exclusive categories, including the experience of dental pain, actions taken or contemplated in response to a toothache, impact on daily life, and advice sought from the Twitter community. After excluding ambiguous tweets, spam, and repeat users, we analyzed 772 tweets and calculated frequencies. Of the sample of 772 tweets, 83% (n = 640) were primarily categorized as a general statement of dental pain, 22% (n = 170) as an action taken or contemplated, and 15% (n = 112) as describing an impact on daily activities. Among the actions taken or contemplated, 44% (n = 74) reported seeing a dentist, 43% (n = 73) took an analgesic or antibiotic medication, and 14% (n = 24) actively sought advice from the Twitter community. Twitter users extensively share health information relating to dental pain, including actions taken to relieve pain and the impact of pain. This new medium may provide an opportunity for dental professionals to disseminate health information.
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Project description:Wastewater surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has garnered extensive public attention during the coronavirus disease pandemic as a proposed complement to existing disease surveillance systems. Over the past year, methods for detection and quantification of SARS-CoV-2 viral RNA in untreated sewage have advanced, and concentrations in wastewater have been shown to correlate with trends in reported cases. Despite the promise of wastewater surveillance, for these measurements to translate into useful public health tools, bridging the communication and knowledge gaps between researchers and public health responders is needed. We describe the key uses, barriers, and applicability of SARS-CoV-2 wastewater surveillance for supporting public health decisions and actions, including establishing ethics consideration for monitoring. Although wastewater surveillance to assess community infections is not a new idea, the coronavirus disease pandemic might be the initiating event to make this emerging public health tool a sustainable nationwide surveillance system, provided that these barriers are addressed.
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