A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study
Introduction: In 2016–18, the Democratic Republic of São Tomé and Príncipe suffered a necrotic skin infection epidemic. Methods: A surveillance system was established after increased hospitalisations for this infection. Microbiology results were available for samples analysed in December 2016 and Ma...
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2021
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oai:doaj.org-article:4963ec8c4de04bf980c2502066cec0ea2021-11-06T04:22:02ZA large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study1201-971210.1016/j.ijid.2021.06.050https://doaj.org/article/4963ec8c4de04bf980c2502066cec0ea2021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1201971221005415https://doaj.org/toc/1201-9712Introduction: In 2016–18, the Democratic Republic of São Tomé and Príncipe suffered a necrotic skin infection epidemic. Methods: A surveillance system was established after increased hospitalisations for this infection. Microbiology results were available for samples analysed in December 2016 and March 2017 using whole genome sequencing and metagenomics. Negative binomial regression was used to study the association of weather conditions with monthly case counts in a time-series analysis. Results: From October 2016 to October 2018, the epidemic cumulative attack rate was 1.5%. The first peak lasted 5 months, accounting for one-third of total cases. We could not conclusively identify the aetiological agent(s) due to the country's lack of microbiology capacity. Increased relative humidity was associated with increased monthly cases (incidence rate ratio (IRR) 1.05, 95% CI 1.02–1.09), and higher precipitation in the previous month with a higher number of cases in the following month (months with 0–49 mm rainfall compared with months with 50–149 mm and ≥150 mm: IRR 1.44, 95 % CI 1.13–1.78 and 1.50, 95% CI 1.12–1.99, respectively). Discussion: This epidemic was favoured by increased relative humidity and precipitation, potentially contributing to community-based transmission of ubiquitous bacterial strains superinfecting skin wounds. Funding: World Health Organization Regional Office for Africa, Ministry of HealthLorenzo Subissi, PhDAndreza Sousa, MScIbrahima Ba, MDAnne Perrocheau, MDJoshua Quick, PhDLuke Meredith, PhDEdmilson Augustinho, BScBeni Carvalho Sousa, BScVania Lima, MDJose Luiz, BScAmadou Bailo Diallo, MDMamoudou Harouna Djingarey, MDClaudina Augusto Da Cruz, MDFeliciana Sousa Pontes, MDMaria Tomé Palmer, MDMarisa Conceição, MDVilfrido Santana Gil, MDIbrahima Socé Fall, PhDElsevierarticleskin infectionnecrosiscellulitisepidemiologytime-series analysisclimate changeInfectious and parasitic diseasesRC109-216ENInternational Journal of Infectious Diseases, Vol 110, Iss , Pp S69-S76 (2021) |
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DOAJ |
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EN |
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skin infection necrosis cellulitis epidemiology time-series analysis climate change Infectious and parasitic diseases RC109-216 |
| spellingShingle |
skin infection necrosis cellulitis epidemiology time-series analysis climate change Infectious and parasitic diseases RC109-216 Lorenzo Subissi, PhD Andreza Sousa, MSc Ibrahima Ba, MD Anne Perrocheau, MD Joshua Quick, PhD Luke Meredith, PhD Edmilson Augustinho, BSc Beni Carvalho Sousa, BSc Vania Lima, MD Jose Luiz, BSc Amadou Bailo Diallo, MD Mamoudou Harouna Djingarey, MD Claudina Augusto Da Cruz, MD Feliciana Sousa Pontes, MD Maria Tomé Palmer, MD Marisa Conceição, MD Vilfrido Santana Gil, MD Ibrahima Socé Fall, PhD A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study |
| description |
Introduction: In 2016–18, the Democratic Republic of São Tomé and Príncipe suffered a necrotic skin infection epidemic. Methods: A surveillance system was established after increased hospitalisations for this infection. Microbiology results were available for samples analysed in December 2016 and March 2017 using whole genome sequencing and metagenomics. Negative binomial regression was used to study the association of weather conditions with monthly case counts in a time-series analysis. Results: From October 2016 to October 2018, the epidemic cumulative attack rate was 1.5%. The first peak lasted 5 months, accounting for one-third of total cases. We could not conclusively identify the aetiological agent(s) due to the country's lack of microbiology capacity. Increased relative humidity was associated with increased monthly cases (incidence rate ratio (IRR) 1.05, 95% CI 1.02–1.09), and higher precipitation in the previous month with a higher number of cases in the following month (months with 0–49 mm rainfall compared with months with 50–149 mm and ≥150 mm: IRR 1.44, 95 % CI 1.13–1.78 and 1.50, 95% CI 1.12–1.99, respectively). Discussion: This epidemic was favoured by increased relative humidity and precipitation, potentially contributing to community-based transmission of ubiquitous bacterial strains superinfecting skin wounds. Funding: World Health Organization Regional Office for Africa, Ministry of Health |
| format |
article |
| author |
Lorenzo Subissi, PhD Andreza Sousa, MSc Ibrahima Ba, MD Anne Perrocheau, MD Joshua Quick, PhD Luke Meredith, PhD Edmilson Augustinho, BSc Beni Carvalho Sousa, BSc Vania Lima, MD Jose Luiz, BSc Amadou Bailo Diallo, MD Mamoudou Harouna Djingarey, MD Claudina Augusto Da Cruz, MD Feliciana Sousa Pontes, MD Maria Tomé Palmer, MD Marisa Conceição, MD Vilfrido Santana Gil, MD Ibrahima Socé Fall, PhD |
| author_facet |
Lorenzo Subissi, PhD Andreza Sousa, MSc Ibrahima Ba, MD Anne Perrocheau, MD Joshua Quick, PhD Luke Meredith, PhD Edmilson Augustinho, BSc Beni Carvalho Sousa, BSc Vania Lima, MD Jose Luiz, BSc Amadou Bailo Diallo, MD Mamoudou Harouna Djingarey, MD Claudina Augusto Da Cruz, MD Feliciana Sousa Pontes, MD Maria Tomé Palmer, MD Marisa Conceição, MD Vilfrido Santana Gil, MD Ibrahima Socé Fall, PhD |
| author_sort |
Lorenzo Subissi, PhD |
| title |
A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study |
| title_short |
A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study |
| title_full |
A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study |
| title_fullStr |
A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study |
| title_full_unstemmed |
A large epidemic of a necrotic skin infection in the Democratic Republic of São Tomé and Principe: an epidemiological study |
| title_sort |
large epidemic of a necrotic skin infection in the democratic republic of são tomé and principe: an epidemiological study |
| publisher |
Elsevier |
| publishDate |
2021 |
| url |
https://doaj.org/article/4963ec8c4de04bf980c2502066cec0ea |
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