Norovirus infections in the Czech Republic in 2008-2020

INTRODUCTION

Noroviruses, together with rotaviruses, are the most common cause of viral gastroenteritis in the Czech Republic (CR). The aim of this study was to analyse data on the incidence of norovirus gastroenteritis in the CR and thus to add to the body of knowledge about its significance.

MATERIAL AND METHODS

A descriptive analysis was performed of the basic characteristics of norovirus gastroenteritis reported under ICD-10 code A08.1 to the Epidat or ISIN electronic infectious diseases information system between 2008 and 2020. On the basis of reports from five microbiological laboratories, weekly data on confirmed cases of norovirus infection from 2010-2020 were analysed. Databases of microbiology laboratories from across the Czech Republic were searched to determine the number of the laboratories where norovirus infections were diagnosed and the methods used for this purpose in 2008-2020.

RESULTS

From 2008 to 2020, 33,575 cases of norovirus gastroenteritis were reported to the infectious diseases information systems, which equates to an annual incidence of 24.5/100,000 population, varying between years from 8.2 to 77.1/100,000. Men accounted for 40.2% of cases with an incidence of 20.1/100,000 compared to 28.8/100,000 recorded in women. Of the total of reported cases, 14,282 patients (42.5%) required hospital admission. Over the whole study period, 7,431 cases of norovirus gastroenteritis were recorded in children under 5 years of age. This age category accounted for 13.7-38.9% of the annual totals of reported cases. The incidences were 101.8/100,000 in children under 5 years of age, 40.1/100,000 in 5-14-year-olds, 12.7/100,000 in 15-64-year-olds, and 38.2/100,000 in the age group 65 years and over. Twenty-four deaths (case fatality rate of 0.07%) were reported as associated with norovirus gastroenteritis at the ages 42-94. In the age categories 15-64 years and 65 years and over, the case fatality rates were 0.02% and 0.24%, respectively. Over the study period, 274 epidemics occurred, during which 16,893 (50.3%) of the total of 33,575 cases were reported. In the epidemic outbreaks, 1,694 (10.0%) patients required hospital admission. The largest outbreak with 5,248 reported cases in 2015 was associated with contamination of the Prague water supply system. Norovirus infections were laboratory diagnosed year-round, peaking in the autumn and winter months. They are currently diagnosed by 81 laboratories in the Czech Republic, 90.1% of which use immunochromatographic tests.

CONCLUSION

The study confirmed the highest incidence of norovirus gastroenteritis among children under 5 years of age and the highest case fatality rate in the age group 65 years and over. Over half of the reported cases were outbreak associated. Most laboratories use immunochromatographic tests. The use of more sensitive laboratory methods would improve diagnosis.

Changes of perceived risk and mental well-being during two waves of COVID-19 pandemic in Czechia

Background

The COVID-19 pandemic has been negatively affecting many people's daily life. The strict preventive measures might have contributed to psychological distress, fear and fatigue. Therefore, it is crucial to build trust and ensure effective communication from the government to maintain public awareness. This study focuses on the comparative analysis of public health risk perception of COVID-19 during the pandemic.

Methods

The questionnaire surveys were conducted online during the first (April 2020) and second (November-December 2020) waves of the pandemics. The health risk concerns, perceived mental well-being and compliance with the adopted measures of the population were evaluate for potential development in time. The impact of age, gender and socio-demographic factors were tested. The average values of the 5-point Likert scale were tested for differences by Mann-Whitney and Kruskal-Wallis tests on the significance level 5% and analyzed using the SW STATA v.15.

Results

From a sample of 9,168 (1st survey) and 1,042 (2nd survey) Czech respondents aged 40 years, respectively 45 years in average, the present results showed that individual health concerns increased with age, while descending trend toward younger age was observed in terms of mental health. The perceived risk of COVID-19 substantially elevated over the observed period (p < 0.001) as well as compliance with the measures (p < 0.001). Further, 27% of the respondents self-evaluated their mental health as bad or very bad that was analysed as a significantly worsening (p < 0.001). Moreover, 66% of respondents evaluated communication of the government as unsatisfactory that was in relation with a low compliance with measures.

Conclusions

This study contributes to understanding the development of the risk perception as a public response to COVID-19 pandemic. A divergence among the generation was observed. More focused communication of government might be required to enhance public trust.

Key messages

Compliance with the measures substantially elevated over the pandemics that is in relation with low government trust. Mental well-being has been significantly worsened over the COVID-19 pandemics.

[Combined Symptomatic Treatment of Groin Pain Syndrome in Professional Football Players - Prospective Study Results]

PURPOSE OF THE STUDY The results of the prospective study evaluating the outcomes of a combined therapeutic approach of non-operative therapy of Groin Pain Syndrome (GPS) in professional football players are presented. MATERIAL AND METHODS The evaluated cohort consisted of a total of 31 football players of a professional football club divided into two groups. The Group 1 included 10 symptomatic patients suffering from GPS for at least 4 weeks, the Control Group 2 included 21 healthy football players not suffering from GPS. The symptomatic patients with GPS who had undergone any surgery or had sustained any major injury to their low back, groins, hip or knee joints were excluded from the study. It was a prospective non-randomized study. The results were evaluated using the HAGOS (Copenhagen Hip and Groin Outcome Score) questionnaire, which in Group 1 compared the results before the initiation of the new combined therapeutic approach of non-operative therapy developed by us and the results after the end of this treatment, i.e. after 6 weeks. Moreover, the HAGOS was used to compare the results of the Group 1 after the treatment and the Control Group 2, i.e. the healthy football players. The HAGOS evaluated six separate areas: Pain, Symptoms, Physical function in daily living, Physical function in sport and recreation, Participation in physical activities, and hip and/or groin-related Quality of Life. The resulting score for each domain ranges from 0 to 100 (100 = no problems, 0 = extreme problems). The results were statistically evaluated by an independent statistician. RESULTS In Group 1, after the end of the treatment a statistically significant improvement was observed in all the parameters assessed by HAGOS. Pain (70 before the treatment, 95 after the treatment), Symptoms (58.9 before/85.7 after), Physical function in daily living (70 before/100 after), Physical function in sport (46.9 before/90.6 after), Participation in physical activities (43.8 before/100 after), Quality of Life (66.3 before/95 after). When comparing the two groups, before the treatment a statistically significant difference was found in all the six parameters assessed by HAGOS, while after the treatment no significant difference between Group 1 and Group 2 was detected. DISCUSSION The most important result of our study is that by applying the new combined therapeutic approach of the GPS nonoperative therapy developed by us better HAGOS score were achieved in our cohort than those achieved by other types of non-operative therapy presented in recent literature. The approach proposed by us is more successful in terms of the speed of return to sport (6 weeks) than the multimodal therapy programme (12 weeks) and Training programme (18 weeks). CONCLUSIONS The results of this prospective study confirm that the Group 1 having undergone the 6-weeek long combined symptomatic non-operative therapy of GPS proposed by us showed a statistically significant improvement in all the parameters assessed by HAGOS and these values showed no statistically significant difference from those of the Control Group of healthy individuals. Key words: Groin Pain Syndrome (GPS), professional football player, HAGOS (Copenhagen Hip and Groin Outcome), symptomatic therapy.

[Stereotactic Body Radiotherapy of Prostate Cancer - Effectiveness and Toxicity]

BACKGROUND

Prostate cancer is the most prevalent cancer in males and its incidence is steadily increasing. Most cases of prostate cancer are diagnosed during the early asymptomatic period, in which case the prognosis is very good. Therapies differ widely in their efficacies and toxicities, and this is an important consideration when it comes to deciding which treatment is optimal for a particular patient. One treatment method for early stage prostate cancer is stereotactic body radiotherapy (SBRT). We present the first results obtained using this modality at our institution.

PATIENTS AND METHODS

A total of 261 patients with low or intermediate risk prostate cancer were treated with SBRT between August 2010 and July 2012. Patients received a total dose of 36.25 Gy in five fractions of 7.25 Gy every other day. The toxicity of the treatment was evaluated according to RTOG criteria. For assessment of quality of life, patients filled out a modified EPIC questionnaire (Expanded Prostate Composite index).

RESULTS

Overall survival (OS) in this study was 93.1%. Biochemical relapse free survival (bRFS) was 97.7%. As expected, OS and bRFS were worse in the group of patients with an intermediate risk of recurrence. Acute and chronic urinary and gastrointestinal RTOG toxicity was very low. Quality of life after treatment, as determined using the EPIC questionnaire, was slightly reduced immediately after treatment but returned to baseline or even improved during long term follow-up.

CONCLUSION

SBRT is an effective therapeutic modality for early prostate cancer and has acceptable rates of acute and low late toxicity.Key words: prostate cancer - stereotactic body radiotherapy - quality of life The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 5. 1. 2017Accepted: 1. 2. 2017.

[Are risk factors in prenatal and perinatal period important for develompent of schizophrenia?]

OBJECTIVE

Schizophrenia is an important psychical disease of multifactorial origin and not yet clear etiology. In prenatal and perinatal period some potential risk factors for schizophrenia are taken into consideration.

DESIGN

Case-control study of 815 subjects, 407 cases and 408 controls was performed in 2013 to 2015.

METHODS

In this study environmental and genetic risk factors were evaluated including potential risk factors of prenatal and perinatal period.

RESULTS

Statistically important difference was found in child-birth done by cesarean section (p = 0.009) and in patients with schizophrenia were 15.7% complications in the course of childbirth (p < 0.001). Hypoxia, passed umbilical cord were the most frequent complications. In prenatal period premature childbirth, injury and psychical complications were the most frequent. On the other hand difference in weight and length of newborns, breast feeding and infection during pregnancy were found not statistically important.

CONCLUSION

In this study statistically important diference were found in way of carrying childbirth and in some complications during pregnancy and delivery. Influence of infection during pregnancy and influence of weight and length of newborn were not demonstrated.

[Pancreatic cancer and lifestyle factors]

BACKGROUND

Pancreatic cancer is a serious cancer with unfavorable prognosis. Due to differences in the incidence of pancreatic cancer in different regions, it is clear that factors associated with lifestyle play an important role in the etiology. The aim of this study was to evaluate the impact of selected lifestyle factors in relation to pancreatic cancer.

MATERIALS AND METHODS

The study included a total of 529 subjects, including 309 cases and 220 control subjects. Cases of newly diagnosed patients with pancreatic cancer who lived in the region were selected in hospitals in three centers (University Hospital Olomouc, University Hospital Ostrava, Hospital Ceske Budejovice). The control group was obtained in cooperation with selected general practitioners for adults, and it is a population control group.

RESULTS

Analyses compared persons who reported consuming alcohol with those who do not consume alcohol. Results showed a statistically significant inverse association, even after adjustment for the other studied factors (OR = 0.57, 95% CI 0.36 to 0.89). When assessing leisure time physical activity, results showed statistically significant inverse association and 35% decrease in the risk (crude OR = 0.65, 95% CI 0.45 to 0.93), and this inverse association was confirmed after adjustment for other studied factors although the result is on the border of statistical significance (adjusted OR = 0.68, 95% CI 0.44 to 1.04). Drinking coffee and tea has only a marginal impact on the occurrence of pancreatic cancer, although the medium and high consumption of black tea was found increased risk by 90 or 44%, respectively. Smoking is considered a causal risk factor for pancreatic cancer, but in this study, a positive association was not found. The study found no statistically significant association between overweight and obesity.

CONCLUSION

Physical activity, dietary measures that will lead to weight loss and education to non-smoking can have a significant impact on the primary prevention of cancer.

[A multifactor epidemiological analysis of risk factors for pancreatic cancer in women]

STUDY OBJECTIVE

A multifactor analysis of risk factors for pancreas cancer in women.

MATERIAL AND METHODS

A case-control study was conducted in three centres in the Czech Republic (Olomouc, Ostrava, and České Budějovice) in 2006-2009. In total, 226 women (129 pancreas cancer cases, 97 controls) were included in the study. Statistical analysis was performed, the crude odds ratio (OR) was calculated, and logistic regression analysis was used at a 5% level of statistical significance.

RESULTS

A statistically significant inverse association was found between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69). Pregnancy and number of pregnancies or gynecological surgical procedures did not show any association with pancreatic cancer. No significant difference in the first menstrual period was found between pancreatic cancer patients and controls.

CONCLUSIONS

The study results showed inverse association between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69), controlled alcohol consumption (OR 0.26; 95% CI: 0.12-0.55), and anti-inflamatory drug use (OR 0.10; 95% CI: 0.02-0.41).