Diarrhoea (“scouring”) in sheep increases the risk of faecal soiling of the breech (“dag”) that in turn causes significant production losses for sheep producers and increases susceptibility of sheep to breech blowfly strike. The common causes of scouring in sheep of post-weaning age in Western Australia have not been well described. In a written questionnaire sent to sheep producers in the south west of Western Australia, about half of the respondents reported lamb, hogget and ewe flocks with moderate or severe dag. Flocks with moderate or severe dag were reported more commonly in the winter and spring months in all age groups. Young sheep and mated ewes were most susceptible to moderate or severe dag. The utilisation of professional worm control advice and parasite management tools did not reduce the risk of moderate/severe dag. A study conducted at an abattoir showed that large strongyle worm egg counts (WEC) were frequently identified in lamb lines but were much less common in adult lines. The relationship between WEC and scouring was not clear, suggesting that factors other than large strongyle infections were important, particularly in adult sheep. The low WEC and seasonal scouring pattern observed in adult sheep was consistent with the larval hypersensitivity scouring syndrome and/or factors related to green pasture as potential common causes of scouring in adult sheep. This observation was consistent with detailed investigations of flocks with “low WEC scouring” that found larval hypersensitivity scouring syndrome or factors associated with green pasture were the most likely causes of scouring in eight of the nine flocks examined. Large immature worm burdens were common and the scouring sheep had more fourth stage larvae than normal sheep. Treatment with a fully effective drench and an ivermectin controlled-release rumen capsule did not result in a reduction of faecal moisture content between three and seven weeks after treatment. The effects of dietary soluble non-starch polysaccharides were studied using carboxymethylcellulose (CMC) as a model. The CMC model was used to demonstrate that significant interactions between diet and strongyle larvae determined both faecal consistency and strongyle establishment. Sheep fed CMC had softer, looser and wetter faeces, but the factors that determined faecal consistency were complex. Establishment of T. colubriformis was significantly greater in sheep fed CMC suggesting that the environment within the gut may affect establishment of T. colubriformis in the small intestine. The findings suggested that dietary factors may interact with strongyle larvae to determine both worm establishment and severity of scouring. The results of the studies described in this thesis suggested that factors related to immature strongyle larvae, diet and the immune response interact to determine the severity of the scouring observed in sheep of post-weaning age in the south west of Western Australia.

Magister Philosophiae - MPhil / Child mortality in Sierra Leone is the highest ranked in the world. Government officials and researchers have tried to understand how and why this has become such a big phenomenon in Sierra Leone. Researchers have come up with three main causes for child mortality in Sierra Leone: maternal factors, environmental factors and health factors. The majority of research has been carried out on maternal, as well as environmental factors. However, minimal research has been carried out on health factors in Sierra Leone. Therefore, the objective of this study is to see how maternal and environmental factors have an effect on health factors, which in turn causes child mortality. The data used was from the 2008 Sierra Leone Demographic and Household Survey (SLDHS). The child dataset was used as it contained the information required from both the mother and the child. Of the three categories that were used, the first was maternal factors, which included the mother’s age, the mother's occupation, the mother's education, the sex of the child, the birth number and religion. The second category was environmental factors, which included the source of water, type of toilet, place of residence, source of energy and the dwelling material used for the household. The final category was health factors, which included whether the child had a fever in the last 2 weeks, short rapid breaths, a cough or fever, a problem in the chest or runny nose and whether the child had Diarrhoea recently and still has Diarrhoea. The study showed that child mortality had four statistically significant factors associated with it: place of residence, birth number, religion and type of toilet facility. Furthermore, when it came to diseases affecting children, the SLDHS had not given much information, so we looked only at the effects it had on children. From our results, we concluded that ARI, Diarrhoea and Measles each had one variable that was statistically significant to it. As for Pneumonia, there were no variables associated with children contracting the disease.

Lesotho is experiencing a problem of seasonal bloody diarrhoea outbreaks that occur in the southern districts of the country. Usually large proportions of the meagre resources are used to combat such outbreaks. Measures have been taken to provide water and improve sanitation for the commonly affected communities. However, the problem has continued unabated. There was therefore, a need to isolate factors that are associated with the transmission of bloody diarrhoea among the communities in the Moriti, Holy Cross, Liphiring and Mohalinyane health centres where bloody diarrhoea is prevalent. In this study, 145 cases of bloody diarrhoea and 269 controls were selected from the four health centres. Cases and controls were selected from subjects who were seen in the health centres during the period of December 2002 to February 2003. All available cases were selected whereas controls were selected by systematic sampling. The study examined environmental factors such as water source, waste and refuse disposal and hygiene practices. Binary logistic regression was used to estimate the effects of several exposures on bloody diarrhoea. The model showed maintenance of the boreholes to be the most important variable. The Odds ratio among people who experienced unavailability of water was 3.88 greater, among children who do not wash hands the odds ratio was 4.66 higher. Among subjects who ate bread in January the Odds ratio was 1.45 more and among subjects who had someone with bloody diarrhoea in the household the Odds ratio was 2.60 greater. / Dissertation (MSc)--University of Pretoria, 2005. / School of Health Systems and Public Health (SHSPH) / MSc / Unrestricted

Research aimed at optimizing diagnostic laboratory procedures is central to the development of effective bovine viral diarrhoea virus (BVDV) control programmes. BVDV is a single-stranded RNA virus that crosses the placenta to infect foetuses resulting in reproductive losses due to foetal death or persistently infected (PI) calves that usually die early in life. Persistently infected animals are widely accepted to be the primary reservoir of BVDV and the largest source of BVDV infection. Persistently infected animals that survive calfhood are at risk of developing mucosal disease in later life which is a severe and usually fatal condition. In addition, persistently infected calves that become replacement heifers in the herd may experience significant morphological changes that occur in the ovaries which can result in impaired reproductive performance. This poses important challenges to overall animal/herd health and causes losses to the cattle industry. Long-term storage of bovine ear notch samples from calves persistently infected (PI) with BVDV may affect the ability of diagnostic assays to efficiently detect the virus. This study assessed the effects of 1) long-term storage of formalin-fixed samples at room temperature to detect BVD viral antigen with the aid of immunohistochemistry (IHC), 2a) long-term storage of fresh ear notch samples kept at -20°C, and 2b) long term storage of phosphate-buffered saline (PBS) ear notch supernatant kept at -20°C on the ability of an antigen-capture ELISA (AC-ELISA) to detect viral antigen. Previous studies have verified 100% sensitivity for both AC-ELISA on ear notch supernatant and immunohistochemical testing of ear notches to detect BVDV provided that samples are properly collected and stored. In this study, ear notch samples from seven animals were subjected to prompt formalin fixation and fresh samples to prolonged storage at -20°C. Frozen ear notches and ear notch supernatant yielded positive results on AC-ELISA for the duration of the study, i.e. 6 months, and OD values remained significantly within range. There was no significant difference between storing fresh ear notch samples and PBS ear-notch supernatant at -20°C. However, positive IHC staining on formalin-fixed ear notches started to fade away between day 17 and day 29 when stored at room temperature. We conclude that fresh ear notches could safely be stored at -20°C for a period of 6 months for detecting BVD viral antigen at a later stage. Copyright / Dissertation (MSc)--University of Pretoria, 2009. / Veterinary Tropical Diseases / unrestricted

Water, a fundamental human right, impacts human health through its quantity (i.e., physical amount and ability to access it) and quality. Consumption of poor-quality water can lead to a variety of waterborne illnesses, often manifested as diarrhoea. Millions of individuals worldwide lack access to drinking water that is free from contaminants and is available and accessible when needed. In areas where water is not piped to homes, several physical, demographic, socio-economic and health factors affect access to potable water. These factors may also influence which water point an individual fetches water (i.e. their waterpoint choice) from in the presence of multiple alternative waterpoints. Through this study, effects of various physical, health, demographic and socio-economic factors on waterpoint choice were explored. This study, based on datasets from a rural Maasai community in Kenya, implements a multinomial logit model to explore effects of various physical (travel time and water quality), health (aggregate frequency of self-reported diarrhoea stratified by age groups), demographic (average household age, household population, number of children under 5, number of women between 8-45 years of age and ratio of household population to number of women between 8-45) and socio-economic factors (education and income) on waterpoint choice. Travel time to the most probable waterpoint as predicted by the model was compared with the travel time to a household’s chosen waterpoint. Both travel times were calculated using the least-resistance path function incorporating slope and landcover. Results from model optimization showed that combinations of travel time, average household age, diarrhoea among adult women, income, education and number of women between 8-45 years were significant contributors to the three waterpoint choice models. The expected travel time to the most probable waterpoint predicted by these models and actual travel time to chosen waterpoint fit well, showing that the models explain waterpoint choice well. / Thesis / Master of Public Health (MPH)

Yes / Enteropathogenic Escherichia coli (EPEC) is usually associated with outbreaks and sporadic cases of severe infantile diarrhoea in the developing world, and less commonly with sporadic cases in developed countries. Very little evidence indicates that EPEC is a food-borne pathogen for adults. In a previous study, two groups of adult travellers became ill, and eae+ E. coli of serogroup O111 was isolated from affected individuals and epidemiologically linked to food consumption. Here the strain responsible was further investigated and characterized as an unusual atypical EPEC. PCR analysis of the designated type isolate showed the presence of the rorf1 and espB genes of the LEE pathogenicity island, which was inserted at the chromosomal selC locus. The isolate was negative for the enteroaggregative E. coli EAST-1 toxin present in other strains of EPEC associated with food-borne outbreaks. The strain adhered sparsely to HEp-2 cell monolayers in a diffuse manner, but fluorescent actin staining demonstrated that it was capable of inducing polymerization of actin at the sites of bacterial attachment. Strain P2583 is the first EAST-negative EPEC to be confirmed as a cause of outbreaks of infection in adults following the consumption of contaminated food or water.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2016-08-24T00:22:08Z No. of bitstreams: 1 DISSERTA??O UEFS-1.pdf: 4397842 bytes, checksum: 5bbf7864e46035d01b3cd15d9b25b50d (MD5) / Made available in DSpace on 2016-08-24T00:22:08Z (GMT). No. of bitstreams: 1 DISSERTA??O UEFS-1.pdf: 4397842 bytes, checksum: 5bbf7864e46035d01b3cd15d9b25b50d (MD5) Previous issue date: 2016-04-01 / It is important to emphasize that both the quality of the water as the quantity and regularity of supply are determining factors for the emergence of diseases in humans. Therefore, we used the epidemiological ecological study, quantitative, in order to assess the consumption of rainwater and the incidence of diarrhea in children under 5 years of age: the exposed, which use capture systems roof rain water which is stored in tanks for potable purposes, composed of 111 children of the city of Lowland Ro?a-Ba; and not exposed, which use public water supply, composed also by 111 children of the city of Baixa Grande-Ba. Health indicators were adopted that diarrhea and measured over a period of 90 days. They were applied form, spreadsheet and field observation form with the families and children participating in the survey. The analysis of data obtained from said diarrhea and measured showed a significant association between episodes of diarrhea in the total sample of children studied and the spatial distribution where the highest concentrations occurred. Children who drank rain water had higher risk in percentage and time of occurrence, to have episodes of diarrhea than children who drink tap water, but with a difference not very acentuda. The incidence in children who consume rainwater stored in cisterns was 11.1%, and 5.8% in families who drink tap water. / ? importante ressaltar que tanto a qualidade da ?gua quanto a sua quantidade e regularidade de fornecimento s?o fatores determinantes para o surgimento de doen?as no ser humano. Portanto, utilizou-se o estudo epidemiol?gico do tipo ecol?gico, de natureza quantitativa, a fim de avaliar o consumo de ?gua da chuva e a incid?ncia de diarreia em crian?as menores de 5 anos de idade: as expostas, as quais utilizam sistemas de capta??o de ?gua de chuva do telhado e que ? armazenada em cisternas para fins pot?veis, compostas por 111 crian?as da cidade de V?rzea da Ro?a?Ba; e as n?o expostas, as quais utilizam ?gua da rede p?blica de abastecimento, compostas, tamb?m, por 111 crian?as da cidade de Baixa Grande-Ba. Os indicadores de sa?de adotados foram diarreia referida e mensurada, durante um per?odo de 90 dias. Foram aplicados formul?rio, planilha e ficha de observa??o de campo junto ?s fam?lias e crian?as participantes da pesquisa. A an?lise dos dados obtidos da diarreia referida e da mensurada apresentou uma associa??o significante entre os epis?dios de diarreia na amostra total de crian?as estudadas e na distribui??o espacial onde ocorreram as maiores concentra??es. As crian?as que beberam ?gua de chuva apresentaram maior risco, em percentual e tempo de ocorr?ncia, de ter epis?dios de diarreia do que as crian?as que bebem ?gua da rede p?blica, por?m com uma diferen?a n?o muito acentuda. A incid?ncia nas crian?as que consomem ?gua da chuva armazenada em cisternas foi de 11,1%, e de 5,8% nas fam?lias que bebem ?gua da rede p?blica.

No description available.

Clostridium difficile infection (CDI) has proven to be a constantly evolving disease periodically posing new diagnostic and clinical dilemmas. Different regions of the world have reported specific local genomic characteristics of the infecting strains, which may be related to variation in disease presentation and outcome. This study was performed to determine the clinical and molecular features of severe, recurrent and community-associated disease in the Lothian region of Scotland, UK among patients diagnosed from August 2010-July 2011. Three hundred and thirty-five patients with laboratory confirmed CDI were studied for epidemiological features, clinical presentation, and laboratory markers. They were followed up for one year to determine recurrence and mortality. Four hundred and thirty-two episodes were recorded. Ribotypes, presence of toxin genes and MLVA subtypes of isolates from these episodes were determined. During the course of the study, PCR ribotype 078 was identified as an important emerging type and concerns of “hypervirulence” were raised when an outbreak was recorded in 2012. This ribotype was studied to compare its clinical and molecular characteristics with other endemic ribotypes and between its own outbreak-related and endemic subtypes. Asymptomatic children were also sampled to determine their role as pools of potential pathogens. Severe episodes accounted for 40.4% of total and 29.3% patients had multiple episodes on record. One-year mortality was 32.8% of which CDI was listed on 25.5% death certificates. Ribotype 078 was confirmed in 6.8% episodes. Community-associated disease was identified in 25.3% patients, which differed significantly from hospital-associated disease in the number of antibiotics and gastrointestinal manipulation prior to CDI. Endemic PCR ribotype 078 caused significantly less recurrent disease and more community- associated disease when compared to the most prevalent ribotype 001. Patients who died from ribotype 078 within 30d had a lower Charlson comorbidity index than ribotype 001 counterparts suggesting that the former may infect healthier patients. MLVA subtyping of ribotype 078 proved useful in identifying epidemiological relationships during the outbreak. CDI had contributed to the death of 50% of all patients infected with the outbreak related ribotype 078 strain compared to 14.3% of those infected with the endemic strains. This study documents the changing epidemiology of CDI in the region and demonstrates differences in epidemic and endemic disease.

Introdução: Esse estudo foi realizado em área periurbana carente do Município de Guarulhos, SP, que passa por intensa ocupação e necessita de serviços urbanos como saneamento. A localidade é atendida pela Unidade Básica de Saúde Recreio São Jorge que conta com o Programa Saúde da Família. Objetivos: Associar as condições de acesso da população aos serviços de saneamento e a ocorrência de doenças diarréicas em crianças. Método: Trata-se de estudo transversal e ecológico, cujas informações provêm das fichas de acompanhamento das 817 crianças da localidade (Ficha C) e fichas de cadastro (Ficha A) das respectivas famílias (728). A ocorrência de diarréia em crianças de 0 a 2 anos foi associada às variáveis ambientais: existência de tratamento domiciliar de água, tipo de acesso à água, tipo de esgotamento sanitário. As variáveis de condições de saneamento foram correlacionadas à ocorrência de diarréia por micro-área. Resultados: A cobertura de abastecimento de água das famílias é 93,18%, embora a intermitência do serviço seja freqüente. O uso de água de poços simultaneamente à da rede pública é comum na localidade. Das famílias, 63,88% tratam água no domicílio, por meio de cloração, fervura ou filtragem e apenas 42,72% possuem sistema de coleta pública dos esgotos. A variável de interação tipo de moradia construída em outros materiais que não tijolos e destino impróprio de esgoto sanitário apresentou associação no modelo de regressão com a ocorrência de doenças diarréicas (p<0,001). O coeficiente de correlação entre a ocorrência de diarréias e o tratamento de água no domicílio foi - 0,395, confirmando a importância do tratamento de água domiciliar. Foi encontrada relação inversa entre a ocorrência de diarréia e a cobertura de coleta dos esgotos sanitários (-0,337). Os locais não servidos pela rede coletora de esgotos apresentaram maior número de fossas ou de lançamento de esgotos a céu aberto, aumentando a probabilidade de disseminação de agentes patogênicos devido às precárias condições de vida da população. O abastecimento de água não apresentou correlação significativa, pois a maioria das famílias tem sua moradia ligada à rede de abastecimento público de água. Conclusão: Embora seja área periurbana carente, a população tem boa cobertura de abastecimento de água, porém a utilização de água de poço e a intermitência do serviço estão presentes. Sendo assim, o tratamento domiciliar da água se mostrou importante como medida preventiva. Em relação aos esgotos sanitários, recomendam-se medidas como provimento da rede coletora dos esgotos quando possível, ou campanhas para promover o uso correto de fossas sépticas. / Introduction: This study was realized in needed periurban area of the City of Guarulhos, SP, which has intense occupation and lacks of urban services as sanitation. The locality is served by the Unidade Básica de Saúde Recreio de São Jorge who is inserted on the Family Health Program. Objectives: To associate conditions of access of population to the services of sanitation and the children’s health conditions. Materials and methods: That’s a transversal and ecological study, whose information come from the files of accompaniment of the 817 children of the locality (Fiche C) and files of register in cadastre (File A) of the respective families (728). The occurrence of diarrhoea disease in children of 0-2 years was associated with these environmental variables: existence of domiciliary water treatment, type of access to the water and type of sanitation. The variables of sanitation conditions had been correlated to the occurrence of diarrhoea disease for micro-area. Results: The covering of water supply of the families is 93.18%; even so the intermittent of this service is frequent. It is common the use of water of wells simultaneously to the public supplying. The families, 63.88% deal with water in the domicile, by means of chlorine, boil or filtering and only 42.72% possesses system of sewers public collection. The interaction variable type of housing constructed in other materials that bricks and improper destination of sanitary sewer are associated in the model of regression with the occurrence of diarrhoea in young children (p<0.001). The correlation coefficient among the occurrence of diarrhoea disease and the water treatment in the domicile was -0.395, confirming the importance of the domiciliary water treatment. It was found inverse relation between occurrence of diarrhoea disease in young children and the covering of collection of the sanitary sewers (-0.337). The places not served by public sewers collecting, have shown a bigger number of pits or throwing in open air increasing the probability of dissemination of pathogenic agents due the precarious life conditions of the population. The water supply did not present significant correlation; therefore the majority of the families are served by public water supplying. Conclusion: Although been a needed periurban area, the population has good covering of water supply; however the well water used and the intermittent of service are present. The domiciliary treatment of water is showed important as prevention. In relation to sanitary sewers, are recommended measured as provisions of the collecting net of sewers when possible, or campaigns to promote the correct use of septic pits.