Abstract We investigated an outbreak of exanthematous illness in Maceió by using molecular surveillance; 76% of samples tested positive for chikungunya virus. Genetic analysis of 23 newly generated genomes identified the East/Central/South African genotype, suggesting that this lineage has persisted since mid-2014 in Brazil and may spread in the Americas and beyond.
Abstract Background Chikungunya fever is a globally spreading mosquito-borne disease that shows an unexpected neu- rovirulence. Even though the neurological complications have been a major cause of intensive care unit admission and death, to date, there is no systematic analysis of their spectrum available. Objective To review evidence of neurological manifesta- tions in Chikungunya fever and map their epidemiology, clinical spectrum, pathomechanisms, diagnostics, therapies and outcomes. Methods Case report and systematic review of the litera- ture followed established guidelines. All cases found were assessed using a 5-step clinical diagnostic algorithm assigning categories A–C, category A representing the highest level of quality. Only A and B cases were con- sidered for further analysis. After general analysis, cases were clustered according to geospatial criteria for subgroup analysis. Results Thirty-six of 1196 studies were included, yielding 130 cases. Nine were ranked as category A (diagnosis of Neuro-Chikungunya probable), 55 as B (plausible), and 51 as C (disputable). In 15 cases, alternative diagnoses were more likely. Patient age distribution was bimodal with a mean of 49 years and a second peak in infants. Fifty per- cent of the cases occurred in patients <45 years with no reported comorbidity. Frequent diagnoses were encephali- tis, optic neuropathy, neuroretinitis, and Guillain–Barre ́ syndrome. Neurologic conditions showing characteristics of a direct viral pathomechanism showed a peak in infants and a second one in elder patients, and complications and neurologic sequelae were more frequent in these groups. Autoimmune-mediated conditions appeared mainly in patients over 20 years and tended to show longer latencies and better outcomes. Geospatial subgrouping of case reports from either India or Re ́union revealed diverging phenotypic trends (Re ́union: 88% direct viral vs. India: 81% autoimmune). ConclusionsDirect viral forms of Neuro-Chikungunya seem to occur particularly in infants and elderly patients, while autoimmune forms have to be also considered in middle-aged, previously healthy patients, especially after an asymptomatic interval. This knowledge will help to identify future Neuro-Chikungunya cases and to improve outcome especially in autoimmune-mediated conditions. The genetics of Chikungunya virus might play a key role in determining the course of neuropathogenesis. With further research, this could prove diagnostically significant.
The Global Austism Network has launched the Autism Rising intiative, with a mission "to provide a global forum for support of autism... enriching the lives of people with autism, their families and their communities worldwide". They are inviting all those who are involved with ASD* to participate in a survey "to evaluate different approaches to the diagnosis of ASD, treatment options and the resources available in different communities". To learn more and participate, please click HERE. *Autism Spectrum Disorder
In this video, Dr Greg Martin provides a brief overview of what health systems are and how it is that the building blocks of health systems fit together.
Global health and public health practitioners use Health Economics to better understand the decisions that get made that affect health.
There has been steady progress in LMIC health research capacity, but major barriers to research persist and more empirical evidence on development strategies is required.
Cochrane’s 2016 Citation Screening Challenge: Turning a lonely task into the most fun you can have in evidence based healthcareby Anna, Emily, Gordon and the rest of the Cochrane Crowd team
Cochrane Crowd, Cochrane’s new citizen science platform, recently ran a successful 48 hour citation screening challenge to reach the goal of 1 million research citations screened. The Cochrane Crowd team have provided this overview of the event.
The Epidemiological evauation of vaccines course: efficacy, safety and policy
Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million birthsby Hon Kei Yip et al
The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. The authors compared emergency versus planned CS to investigate their potential difference in the risk of ASD using population-based registries of four Nordic countries and Western Australia. Across the five countries, emergency or planned CS is consistently associated with a modest increased risk of ASD from gestational weeks 36 to 42 when compared with vaginal delivery.
Launch of Mesh: a new online platform co-created by its users and aiming to improve Community Engagementby The Editorial Team
Today,The Global Health Network launches Mesh: a new online platform co-created by its users and aiming to improve Community Engagement with health in low and middle income countries.
If you want to find a job in global health, this is for you.
Parental perspectives on the diagnosis of autism spectrum disorders.
Abstract Chikungunya is an emerging arbovirus that is characterized into four lineages. One of these, the Asian genotype, has spread rapidly in the Americas after its introduction in the Saint Martin island in October 2013. Unexpectedly, a new lineage, the East-Central-South African genotype, was introduced from Angola in the end of May 2014 in Feira de Santana (FSA), the second largest city in Bahia state, Brazil, where over 5,500 cases have now been reported. Number weekly cases of clinically confirmed CHIKV in FSA were analysed alongside with urban district of residence of CHIKV cases reported between June 2014 and October collected from the municipality’s surveillance network. The number of cases per week from June 2014 until September 2015 reveals two distinct transmission waves. The first wave ignited in June and transmission ceased by December 2014. However, a second transmission wave started in January and peaked in May 2015, 8 months after the first wave peak, and this time in phase with Dengue virus and Zika virus transmission, which ceased when minimum temperature dropped to approximately 15°C. We find that shorter travelling times from the district where the outbreak first emerged to other urban districts of FSA were strongly associated with incidence in each district in 2014 (R2).
eSeminar: Research papers that make a difference: discussing research waste, reproducibility and impactby Iveta Simera, the EQUATOR Network
Dr Iveta Seimer, Deputy Director of the UK EQUATOR Centre, discusses research waste, reproducibility, and how to use reporting guidelines to make an impact. Poor reporting seriously affects the integrity of health research literature and critically limits the use and impact of published studies.