Temporal and geographical distributions of reported cases of Escherichia coli O157:H7 infection in Ontario.
(49/6923)
The distribution of 3001 cases of verocytotoxigenic Escherichia coli (VTEC) reported in the Province of Ontario, Canada, were examined to describe the magnitude of this condition geographically and to evaluate the spatial relationship between livestock density and human VTEC incidence using a Geographical Information System. Incidence of VTEC cases had a marked seasonal pattern with peaks in July. Areas with a relatively high incidence of VTEC cases were situated predominantly in areas of mixed agriculture. Spatial models indicated that cattle density had a positive and significant association with VTEC incidence of reported cases (P = 0.000). An elevated risk of VTEC infection in a rural population could be associated with living in areas with high cattle density. Results of this study suggested that the importance of contact with cattle and the consumption of contaminated well water or locally produced food products may have been previously underestimated as risk factors for this condition. (+info)
Kala-azar epidemic in Varanasi district, India.
(50/6923)
Reports at the Sir Sunder Lal Hospital, Banaras Hindu University, of a large number of kala-azar cases from one particular village in Varanasi district, Uttar Pradesh, led us to carry out an epidemiological study of the situation using standard techniques. The overall prevalence and case fatality of the disease were 12.9% and 10.5%, respectively. A history of fever and hepatosplenomegaly was noted for all the cases. The case definition was the presence of parasites in bone marrow or splenic aspirate smears. The disease was more prevalent among adults, but occurred also among children. However, there was no clear linear relationship between the prevalence of the disease and age group. Kala-azar occurred among males and females, and its prevalence did not correlate significantly with income. Since the disease vector continues to be present in the study area, the health authorities should take strong steps to control the disease. (+info)
Seroepidemiologic study on the occurrence of antibodies against Yersinia enterocolitica and Yersinia pseudotuberculosis in urban and rural population of the Lublin region (eastern Poland).
(51/6923)
The aim of this study was to assess the seroprevalence of antibodies against Yersinia in the rural and urban population and to determine the frequency of particular serotypes of Yersinia enterocolitica and Yersinia pseudotuberculosis. 472 sera were examined, 257 of rural inhabitants and 215 of urban inhabitants. The survey was carried out by passive hemagglutination test with the antigens of Yersinia serotypes considered pathogenic for humans: Y. enterocolitica 03, 05, 06, 08, 09 and Y. pseudotuberculosis I and III. In the examined rural population positive reactions to Yersinia antigens were significantly more frequent than in the examined urban population (42% versus 20%, p<0.0001). The most frequent reactions were against Y. enterocolitica serotypes 05 and 08. (+info)
Occupational dermatoses in farmers - a proposal for diagnostic procedure.
(52/6923)
The article presents a proposal for diagnostic procedures in cases of suspected occupational dermatosis in farmers. The process of certifying a disease as occupational is difficult because of lack of the monitoring of occupational risks in private farms; moreover, there is no compulsory medical assessment before one starts work as a farmer. Many patients meet an occupational health professional for the first time when the disease is already advanced and legal action towards obtaining an occupational rent has already been issued. In these circumstances, confirming or rejecting the possible occupational etiology of a given dermatosis is very difficult. This article presents a diagnostic procedure which has been devised by the author and used with some success for two years at the Institute of Agricultural Medicine, Lublin, Poland. (+info)
The epidemiology of viral hepatitis in children in South Texas: increased prevalence of hepatitis A along the Texas-Mexico border.
(53/6923)
An initial retrospective study of 194 children demonstrated a high prevalence of hepatitis A but not hepatitis B or C infection among children living along the Texas-Mexico border. A larger prospective study of hepatitis A was conducted with 285 children (aged 6 months to 13 years) living in 3 sociodemographically dissimilar areas of South Texas. Children living in colonias along the border had a significantly higher prevalence of hepatitis A virus infection (37%) than children living in urban border communities (17%) or in a large metropolitan area (San Antonio [6%]). Independent risk factors for hepatitis A infection included increased age, colonia residence, and history of residence in a developing country. Use of bottled water (vs. municipal or spring/well water) and years of maternal secondary education were protective. Improved sanitation or routine hepatitis A vaccination in early childhood may reduce the prevalence of hepatitis A in these areas. (+info)
Poverty, time, and place: variation in excess mortality across selected US populations, 1980-1990.
(54/6923)
STUDY OBJECTIVE: To describe variation in levels and causes of excess mortality and temporal mortality change among young and middle aged adults in a regionally diverse set of poor local populations in the USA. DESIGN: Using standard demographic techniques, death certificate and census data were analysed to make sex specific population level estimates of 1980 and 1990 death rates for residents of selected areas of concentrated poverty. For comparison, data for whites and blacks nationwide were analysed. SETTING: African American communities in Harlem, Central City Detroit, Chicago's south side, the Louisiana Delta, the Black Belt region of Alabama, and Eastern North Carolina. Non-Hispanic white communities in Cleveland, Detroit, Appalachian Kentucky, South Central Louisiana, Northeastern Alabama, and Western North Carolina. PARTICIPANTS: All black residents or all white residents of each specific community and in the nation, 1979-1981 and 1989-1991. MAIN RESULTS: Substantial variability exists in levels, trends, and causes of excess mortality in poor populations across localities. African American residents of urban/northern communities suffer extremely high and growing rates of excess mortality. Rural residents exhibit an important mortality advantage that widens over the decade. Homicide deaths contribute little to the rise in excess mortality, nor do AIDS deaths contribute outside of specific localities. Deaths attributable to circulatory disease are the leading cause of excess mortality in most locations. CONCLUSIONS: Important differences exist among persistently impoverished populations in the degree to which their poverty translates into excess mortality. Social epidemiological inquiry and health promotion initiatives should be attentive to local conditions. The severely disadvantageous mortality profiles experienced by urban African Americans relative to the rural poor and to national averages call for understanding. (+info)
Patterns of smoking in the Baltic Republics.
(55/6923)
BACKGROUND: Tobacco is a leading cause of avoidable death in the Baltic Republics but there is, as yet, relatively little information in the public domain on who is smoking and how this is changing. This information is important for those seeking to develop effective policies to tackle this issue. OBJECTIVE: To determine the pattern of smoking in Estonia, Latvia, and Lithuania. METHODS: Analysis of data on patterns of tobacco consumption from representative surveys of approximately 3000 adults aged under 65 in each country undertaken in 1997. RESULTS: The prevalence of smoking among men is 53.9%, 56.0%, and 53.2% respectively in Estonia, Latvia, and Lithuania. The corresponding figures for women are 24.1%, 10.9%, and 7.6%. For both sexes, current smoking rates are consistently lowest in the age group 50 to 64 and highest in the age group 35 to 49. Education and income are determinants of smoking rates among men but much less so among women. Russian men are more likely to smoke than are men from the majority group in each country. Smoking rates among women are much lower in rural than in urban areas of Latvia and Lithuania but this is not so in Estonia. CONCLUSIONS: Smoking rates among men in the Baltic Republics are already very high. Among women, they still vary considerably. Each country has implemented some measures to reduce smoking. These seem to have been especially effective in Lithuania but, overall, much more action is needed. (+info)
Shifting the distribution of risk: results of a community intervention in a Swedish programme for the prevention of cardiovascular disease.
(56/6923)
STUDY OBJECTIVE: To examine the impact of a systematic risk factor screening and counselling carried out by family physicians and family nurses within the larger framework of a community intervention programme for the prevention of cardiovascular disease (CVD). DESIGN: Quasi-experimental study comparing trends in an intervention area with those in a reference area. SETTING: A Northern Sweden municipality (5500 inhabitants) constituted the intervention area while the Northern Sweden region (510,000 inhabitants) served as the reference area. PARTICIPANTS: All 30, 40, 50, and 60 year old inhabitants were invited each year from 1985 to 1992. Among 2046 eligible 1893 participated (92.5%), which formed eight independent cross sections. One cross section, 1986, was re-surveyed forming a panel. MAIN RESULTS: In the cross sections, mean total cholesterol was reduced from 7.09 to 6.27 mmol/l for men (p < 0.001) and from 7.13 to 5.89 mmol/l for women (p < 0.001) and mean systolic blood pressure from 132.2 to 123.7 mm Hg for men (p < 0.05) and from 129.2 to 122.0 mm Hg for women (p < 0.001) during the eight years. Body mass index (BMI) increased from 25.6 to 26.2 for men (p < 0.05) and from 25.0 to 25.5 for women (NS). A corresponding reduction in cholesterol and blood pressure (for women) occurred in the panel, while BMI was unchanged. The risk for CVD, using the Framingham equation, was estimated to be reduced overall by 19% (p = 0.0021) when comparing early cross sections (1985/86) with the later cross sections (1990/91). CONCLUSIONS: It was concluded that a long term community based CVD prevention programme that combines population and individual strategies can substantially promote a health shift in CVD risk in a high risk rural population. The individual attention and evaluation provided by the health provider survey seem to accelerate, but not increase the amount of, risk reduction. (+info)