This scholarly exploration delves into the realm of epidemiological statistical methods, juxtaposing their application within the distinct public health landscapes of the United States and Africa. The study's core objective was to dissect and compare the evolution, effectiveness, and adaptability of these methods across these diverse regions, thereby enriching the understanding of global health dynamics. Embracing a qualitative methodology, the study employed advanced analytical tools and AI technologies, ensuring a thorough examination of data, and facilitating a nuanced comparative analysis. The findings reveal a marked evolution in the United States, characterized by a shift from traditional epidemiological approaches to more sophisticated, data-driven techniques. In contrast, African epidemiological practices emphasized community engagement and education in disease prevention, gradually pivoting towards non-communicable diseases and mental health. The study also illuminated the critical role of technology in modern epidemiological research, enhancing efficiency and broadening the scope of investigations. Furthermore, it highlighted the significant impact of international policies on epidemiological methods and underscored the dynamic interplay between technology and policy in shaping public health strategies. Conclusively, this study not only achieved its objectives but also offered a comprehensive view of the current state and potential future directions of epidemiological research. Recommendations emphasize the need for continued innovation in methodologies, adoption of inclusive approaches considering socioeconomic contexts, and alignment of technological advancements with policy decisions. As epidemiology continues to evolve, this study serves as a guiding light, steering future research and interventions towards more effective and equitable public health outcomes.

https://wjarr.com/sites/default/files/WJARR-2024-0178.pdf

Epidemiological statistical methods: A comparative review of their implementation in public health studies in the USA and Africa

We evaluated the effect of macrolide-resistant mutations in the Mycoplasma pneumoniae 23S rRNA gene on the severity of lower respiratory tract infections in immunocompetent young adults treated at the Smolensk Military Hospital between 25 October 2017, and 17 November 2021. All analyzed cases represented a non-severe infection of the lower respiratory tract: 44 case histories with community-acquired pneumonia and 20 cases with acute bronchitis. The presence of mutations in the gene 23S rRNA of M. pneumoniae was determined with standard Sanger sequencing. The macrolide-resistant genotype was found in 4/44 (9.1%) of the samples of the patients with pneumonia and in 3/20 (15%) of the samples of the patients with acute bronchitis. The analyzed cases with identified M. pneumoniae carrying a mutation in the 23S rRNA gene did not show any differences in the clinical presentation in terms of disease severity caused by M. pneumoniae with the wild-type (WT) phenotype.

/pdf/course-of-lower-respiratory-tract-infection-in-young-people-13chjcsw.pdf

Course of Lower Respiratory Tract Infection in Young People Treated at the Military Hospital of Smolensk Garrison with Detected Mycoplasma pneumoniae Carrying a Macrolide-Resistant Mutation in 23S rRNA Gene

Objective.

To evaluate effect of 23S rRNA gene mutations in Mycoplasma pneumoniae on severity of community-acquired pneumonia (CAP) in young adult patients.
Materials and Methods.

A total of 42 case histories of young adult patients with CAP treated at the Smolensk military hospital over the period of 25 October 2017 to 25 December 2019 were reviewed. «AmpliSens® Mycoplasma pneumoniae/Chlamydophila pneumoniae-FL» real-time PCR kit was used to detect M. pneumoniae from nasopharyngeal swabs collected prior to antimicrobial therapy. Testing for 23S rRNA gene mutations conferring macrolide resistance was performed by real-time PCR melt curve analysis (patent no. 2646123) and confirmed by DNA sequencing.
Results.

All patients had a clinical picture of non-severe CAP on hospital admission. All patients were treated with standard doses of azithromycin or clarithromycin. No respiratory failure or any other complications were observed. Macrolide-resistant genotype of M. pneumoniae was detected in 4 (9.5%) patients. Clinical, laboratory and radiological resolution of pneumonia in all cases occurred on day 10– 16, regardless of the presence of macrolide-resistant genotype.
Conclusions.

There were no differences in clinical course of severity between CAP caused by M. pneumoniae with 23S rRNA gene mutation and CAP caused by wild-type M. pneumoniae The presence of mutations in the 23S rRNA gene of M. pneumoniae did not worsen the clinical course of CAP.

/pdf/effect-of-23s-rrna-gene-mutations-in-mycoplasma-pneumoniae-1letrjfdsp.pdf

Effect of 23S rRNA gene mutations in Mycoplasma pneumoniae on severity of community-­acquired pneumonia in young adult patients treated at the Smolensk military hospital

The development of new methods for diagnosing infectious diseases, such as polymerase chain reaction, sequencing, and mass spectrometry, has made it possible to expand our understanding of the microflora of the human body in general and of the respiratory tract in particular. The most common microorganisms in lungs include Proteobacteria (Pseudomonas spp., Haemophilus spp.), Bacteriodetes (Prevotella spp., Porphyromonas spp.) and Firmicutes (Veillonella spp., Streptococcus spp.). Pathological processes in the lower respiratory tract change the microbiome. Consequently, Moraxella, Haemophilus, and Acinetobacter microorganisms are found in patients with chronic obstructive pulmonary disease. The main causative agents of community-acquired pneumonia include Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, Klebsiella pneumoniae and other enterobacteria. Atypical causative agents of pneumonia include Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. The wide prevalence of S. pneumoniae in the population confirms the need for vaccines to prevent the development of invasive and noninvasive forms of infection. The aim of the study was to analyze literature data on the structure of the normal microflora of the lung and to investigate its role in the development of pathological conditions. Conclusion. A growing body of research confirms the important role of the normal microflora of the respiratory tract. Vaccination against diseases of the bronchopulmonary system may reduce the incidence and mortality of pneumonia. However, the problem of community-acquired pneumonia is still relevant. In particular, the changes in the structure of the pathogens of this disease is of great interest. Vaccination against respiratory pathogens in combination with uncontrolled use of antibiotics during the pandemic of the new coronavirus infection could contribute to a change in the structure of both the lower respiratory microflora in general and the pathogens of bacterial community-acquired pneumonia in particular. The detection of a change in the predominant pathogen calls for revising etiotropic treatment and organizing planned prophylaxis if the appropriate vaccines are available.

Microflora of the lungs in health and disease, the impact of vaccination

ПОЛИМОРФИЗМ ГЕНА ИНТЕРЛЕЙКИНА-10-1082G>А И ЭКСПРЕССИЯ ИНТЕРЛЕЙКИНА-10 У ПАЦИЕНТОВ ПРИЗЫВНОГО ВОЗРАСТА С ВНЕБОЛЬНИЧНЫМИ ПНЕВМОНИЯМИ Загалаев Б.Т. 1 , Мироманова Н 

Polymorphism of the interleukin-10-1082g>a gene and expression of interleukin-10 in contraction-age patients with community-acquired pneumonia

The purpose of the study is to analyze morbidity and to determine etiology of community-acquired pneumonia of conscripts, to examine the epidemiological effectiveness of pneumococcal conjugate and non-conjugate polysaccharide vaccines for the prevention of community-acquired pneumonia in soldiers. Materials and methods . The incidence of communityacquired pneumonia of conscripts in the period from 2008 to 2017 was examined. PCR diagnosis of samples sputum and smears from the pharynx of 694 patients with pneumonia of conscripts was carried out to detect fragments of DNA/RNA of 14 different pathogens. Epidemiologic efficacy of conjugated and non-conjugated pneumococcal vaccine was studied in groups from a total population of 1727 soldiers. Results . It is established that over the past 8 years, the incidence of community-acquired pneumonia of military conscripts decreased by 2.7 times. However, the level of morbidity achieved in 2017 (25.7 ‰) is still very high compared to the incidence of contract soldiers (5.3 ‰) and the population (4.2 ‰). When determining the etiology of pneumonias in military conscripts by means of PCR diagnosis, the prevalence of S. pneumoniae and adenoviruses was established, the genetic material of which was detected in 56.3% and 35.9% of the examined samples, respectively. 56.1% of pneumonia had mixed, mainly viral-bacterial etiology. Among those who were vaccinated with pneumococcal conjugate vaccine, the incidence of community-acquired pneumonia was 4.5 times lower in the 5 – month follow – up period than in the comparison group (p < 0.001) (effectiveness was 77.7%), and among those who were vaccinated with non-conjugate polysaccharide vaccines it was 2.8 times lower (p < 0.001) (effectiveness was 64.3%). It was found that the use of pneumococcal conjugate vaccine in military teams formed a collective immunity that prevents the circulation of pneumococci and the development of diseases not only in vaccinated persons, but also in unvaccinated persons. Conclusion . Both types of pneumococcal vaccines – conjugate, first used in the military, and usually used non-conjugate polysaccharide vaccine, have shown high epidemiological effectiveness in the prevention of community-acquired pneumonia and can equally be recommended for vaccination of recruits a month before the call to military service and of young soldiers, not vaccinated before the call.

/pdf/epidemiologicheskaia-i-etiologicheskaia-kharakteristika-79j071w0uu.pdf

Эпидемиологическая и этиологическая характеристика внебольничной пневмонии у военнослужащихпо призыву в современный период. Сравнительная оценка эффективности пневмококковых вакцин.

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