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Biomedical subjects

B Olowokure

Publications and source records attributed to B Olowokure.

At least 19 recordsLinked to original sources

Global surveillance for chemical incidents of international public health concern.

OBJECTIVE: In December 2001, an expert consultation convened by WHO identified strengthening national and global chemical incident preparedness and response as a priority. WHO is working towards this objective by developing a surveillance and response system for chemical incidents. This report describes the frequency, nature and geographical location of acute chemical incidents of potential international concern from August 2002 to December 2003. METHODS: Acute chemical incidents were actively identified through several informal (e.g. Internet-based resources) and formal (e.g. various networks of organizations) sources and assessed against criteria for public health emergencies of international concern using the then proposed revised International Health Regulations (IHR). WHO regional and country offices were contacted to obtain additional information regarding identified incidents. FINDINGS: Altogether, 35 chemical incidents from 26 countries met one or more of the IHR criteria. The WHO European Region accounted for 43% (15/35) of reports. The WHO Regions for Africa, Eastern Mediterranean and Western Pacific each accounted for 14% (5/35); South-East Asia and the Americas accounted for 9% (3/35) and 6% (2/35), respectively. Twenty-three (66%) events were identified within 24 hours of their occurrence. CONCLUSION: To our knowledge this is the first global surveillance system for chemical incidents of potential international concern. Limitations such as geographical and language bias associated with the current system are being addressed. Nevertheless, the system has shown that it can provide early detection of important events, as well as information on the magnitude and geographical distribution of such incidents. It can therefore contribute to improving global public health preparedness.

Bioterrorism↗

Severe acute respiratory syndrome (SARS): knowledge, attitudes, practices and sources of information among physicians answering a SARS fever hotline service.

In June 2003, Taiwan introduced a severe acute respiratory syndrome (SARS) telephone hotline service to provide concerned callers with rapid access to information, advice and appropriate referral where necessary. This paper reports an evaluation of the knowledge, attitude, practices and sources of information relating to SARS among physicians who staffed the SARS fever hotline service. A retrospective survey was conducted using a self-administered postal questionnaire. Participants were physicians who staffed a SARS hotline during the SARS epidemic in Taipei, Taiwan from June 1 to 10, 2003. A response rate of 83% was obtained. All respondents knew the causative agent of SARS, and knowledge regarding SARS features and preventive practices was good. However, only 54% of respondents knew the incubation period of SARS. Hospital guidelines and news media were the major information sources. In responding to two case scenarios most physicians were likely to triage callers at high risk of SARS appropriately, but not callers at low risk. Less than half of all respondents answered both scenarios correctly. The results obtained suggest that knowledge of SARS was generally good although obtained from both medical and non-medical sources. Specific knowledge was however lacking in certain areas and this affected the ability to appropriately triage callers. Standardized education and assessment of prior knowledge of SARS could improve the ability of physicians to triage callers in future outbreaks.

Clinical Competence↗

An enquiry into the respiratory health effects on a rural community of a soil mound erected close to residential property.

The health concerns of a rural community were investigated following the erection of a soil mound in close proximity to residential property. Retrospective comparisons were made of respiratory and non-respiratory consultations with general practitioners between the exposed population and a sociodemographically similar comparison population. A 2-year period was examined, 1 year before and 1 year after the mound was erected. In the 1-year period prior to erection of the mound, similar consultation rates for both respiratory and non-respiratory conditions were observed in both populations. In the 1-year period following erection of the mound, the exposed population was more likely to consult for respiratory conditions than the comparison population (OR=4.10, 95% CI 2.26-7.44). No differences were observed for non-respiratory conditions. We identified a significant increase in respiratory consultations in the exposed population following erection of the soil mound. Limitations associated with this type of study should be considered when interpreting the results.

Adult↗

Influence of material deprivation on hospital admissions for gynaecologic infections.

This study was conducted to examine the relationship between age, material deprivation, and hospital admissions for selected gynaecologic infections in an English health region. Data from hospital episode statistics relating to hospital admissions for pelvic inflammatory disease (PID), infections of the uterus, and infections of the cervix, vagina, and vulva were obtained. Townsend deprivation scores (based on 1991 census data) were allocated by linking postcodes of cases to enumeration districts (EDs) and then assigning the EDs to appropriate quintiles of material deprivation. Both single variable and multivariable (Poisson regression) analyses were performed. For women with PID, the risk of hospitalisation increased with increasing deprivation (P<0.0001), and women in the most deprived quintile were at increased risk (relative risk [RR] 1.31; 95% confidence interval [95%CI] 1.24-1.39) for hospitalisation. Multivariable analysis identified an elevated risk of hospital admission in women aged 25-44 years for PID (RR 2.03; 95%CI 0.84-4.87) and infections of the cervix, vagina, and vulva (RR 1.47; 95%CI 1.16-1.87), and the incidence of both conditions increased significantly with age. In summary, the results obtained suggest that women from the most deprived areas are at greatest risk of hospitalisation for gynaecologic infections, particularly PID. Preventive measures together with earlier diagnostic, treatment, and referral procedures are required to reduce morbidity.

Adolescent↗

Response patterns to a postal survey using a cervical screening register as the sampling frame.

This study compared different types of respondent to a postal survey. A random sample of women aged 20-64 years (n = 4057) was selected from a population-based cervical screening register to examine their information experience during the screening programme. The initial response rate was 57%, and this increased to 81% after one reminder. Respondents were older (P < 0.0001) than non-respondents, but both groups were comparable with regard to attendance history for cervical screening (respondents 89.3%; non-respondents 89.1%) and normal smear test results (respondents 84.0%; non-respondents 81.4%). Early and late respondents were similar in age. Compared with late respondents, early respondents were more likely to live in highly affluent (P < 0.0001) and rural areas (P = 0.026). They were also more likely to be non-attenders (P < 0.0001), but they were less likely to have had inadequate smear results (P = 0.030) than late respondents. These results suggest that consideration should be given to factors other than sociodemographic differences when examining response patterns to postal surveys.

Adult↗

SARS.

Explore the source record for details and available documents.

Humans↗

Temporal and seasonal variation in the occurrence of chemical incidents.

AIMS: To determine whether there were temporal or seasonal patterns in the occurrence of chemical incidents reported to the West Midlands Chemical Incident Surveillance System, UK. METHODS: A retrospective analysis of reports maintained on a computerised database was carried out for information received from January 1997 to December 2001. RESULTS: Annual numbers of events increased significantly from 77 (7.5%) in 1997 to 282 (27.4%) in 2001. Compared to the average of other seasons, proportionately more incidents occurred in the summer (29.3%). Compared with the average of other days, incidents were more likely to occur on Thursdays (17.1%) and least likely on Saturdays (8.9%). When grouped together on a six hourly basis incidents were most frequent between 12 00 and 17 59 (31.1%) and least frequent between 00 00 and 05 59 (21.2%). CONCLUSIONS: The surveillance system shows that chemical incidents do not occur randomly but have marked temporal and seasonal variation. These results have implications for service provision, training, and the development of preventive strategies.

Accidents, Occupational↗

Immunization with Haemophilus influenzae (Hib) conjugate vaccine following discharge from hospital.

BACKGROUND: This study was undertaken to ascertain Haemophilus influenzae type b (Hib) conjugate vaccination status following discharge from hospital and to determine the time taken to vaccinate with Hib conjugate vaccine following hospital discharge of unvaccinated children. MATERIALS AND METHODS: Population-based cross-sectional survey involving children aged 3-59 months admitted to a hospital with laboratory confirmed invasive H. influenzae disease. RESULTS: Of 51 eligible children, 42 (82%) had not received Hib conjugate vaccine prior to admission. No children were immunized prior to discharge. Vaccination following discharge took an average of 110 days (range 3-441 days). More than one quarter (28%) remained unvaccinated following discharge. If these children had been immunized, immunization coverage among this group of children would have increased significantly from 73% to 98% (p = 0.0017). CONCLUSION: In the immediate post-Hib conjugate vaccine period, delayed immunization after discharge was identified. This reduces the individual and community benefits of immunization.

Bacterial Capsules↗

Changing socioeconomic risk factors for invasive H. influenzae disease after the introduction of conjugate vaccine.

OBJECTIVES: To determine socioeconomic risk factors for invasive Haemophilus influenzae (HI) disease before and after the introduction of HI type b (Hib) conjugate vaccine in the West Midlands, UK. METHODS: Study population consisted of children aged <5 years with laboratory confirmed invasive disease. Linear associations between disease rates and socioeconomic variables were examined 2-years before and 2-years after the introduction of conjugate vaccine. RESULTS: Pre-vaccine there were no trends in disease incidence. Post-vaccine there was an absolute reduction in disease incidence and significant disease differentials between affluent and deprived populations were identified for non-owner-occupancy (P=0.032) and car access (P=0.049). CONCLUSIONS: Our results suggest that changes in socioeconomic risk factor for invasive HI occurred after the introduction of conjugate vaccine. This may have implications for future immunisation strategies.

Child, Preschool↗

The knowledge of healthcare professionals with regard to the treatment and prevention of head lice.

This study examined the knowledge and practice of healthcare professionals regarding the prevention and treatment of head lice 18 months after dissemination of local guidelines. A self-administered postal questionnaire was sent to all primary healthcare professionals (general practitioners and practice nurses), community healthcare professionals (community paediatricians, health visitors and school nurses) and pharmacists in South Staffordshire health district, UK. The overall response rate was 48% (range 24-63%). Compared to other groups: community healthcare professionals were more likely to refer to the guidelines and have adequate knowledge of treatment and prevention; pharmacists were least likely to refer to the guidelines; and primary healthcare professionals were most likely to have poor knowledge about prevention and treatment. Overall, healthcare professionals' knowledge regarding prevention methods was significantly better than their knowledge of treatment methods (63% vs. 5%, P <0.00001). In conclusion, the results of this study suggest that healthcare professionals' knowledge of control methods for head lice varies widely and is sub-optimal and may contribute to ineffective head lice control.

Adult↗

Seroepidemiology of varicella-zoster in Pakistan.

The availability of safe and effective vaccines has renewed interest in the epidemiology of varicella worldwide. To date published data on the epidemiology of varicella in Pakistan is very scarce. Therefore, we conducted a study to determine the age-specific seroprevalence rate of varicella-zoster virus (VZV) antibodies in Pakistan. Between December 1997 and March 1998, 1,509 healthy volunteers aged between 1 month and 30 years were recruited from the Islamabad, Karachi, Lahore and Rawalpindi areas. Demographic information, socioeconomic status and past medical history were obtained by questionnaire. Serum samples were assayed for IgG antibodies against VZV by enzyme-linked immunosorbent assay. Overall 41.8% (600/1,435) of those tested were found to be seropositive for VZV antibodies. No difference was found in results obtained from the different cities. A higher seroprevalence was observed among women (45.2%) compared to men (39.6%). Seroprevalence rates increased with age and were 28.4% in those aged 0-5 years, 41.5% in the 6-10 year age group, 42.5% in the 11-15 year age group, 46.7% in the 16-20 year age group and 53.6% in those aged 21-30 years. Socioeconomic status was not a significant risk factor for VZV seropositivity. This is the first report of the seroepidemiology of VZV in Pakistan. The results indicate that seroprevalence of VZV increases with age in the Pakistani population studied. As in other tropical countries, there is greater susceptibility to varicella among the adolescent and young adult population. The results of this study suggest that these at-risk groups should be included in vaccination programs aimed at reducing the public health impact of varicella.

Adolescent↗

Enhanced surveillance of meningococcal disease in the West Midlands: 1996 to 1998.

Surveillance of meningococcal disease is vital if we are to respond to a changing burden of disease, but current sources of routine data suggest different trends. A scheme for enhanced surveillance of meningococcal disease began in the West Midlands in January 1996 using several data sources, including case reporting from consultants in communicable disease control, data from the PHLS Meningococcal Reference Unit, and monitoring of statutory notifications and laboratory reports. One thousand two hundred and twenty-eight cases of probable meningococcal infection were identified in three years (1996-1998), 594 of which were laboratory confirmed. Routine data for the same period yielded smaller totals--920 notifications and 412 laboratory reports--suggesting that these sources underestimate incidence by 25% to 30%. Diagnosis by polymerase chain reaction became increasingly important, and accounted for 38% of confirmed cases in 1998. A significant excess of male cases was observed (p < 0.01), most obvious in children under 5 years of age. There was no increase in N. meningitidis C2a strains, which had been identified as a threat nationally. A national system of enhanced surveillance has now been set up to inform programmes that aim to reduce the burden of meningococcal infection.

Adolescent↗

Information given to women invited for cervical screening: results of two postal surveys seven years apart.

In South Staffordshire, England, we compared women's views on information provided to them at different stages of the cervical screening program in 1994 with that provided in 2001. An age-stratified random sample of women aged 20-64 years who had a cervical smear taken between January and March 1994 (3856) or between January and March 2001 (4057) were sent postal questionnaires in June 1994 and July 2001, respectively. Response rates in 1994 (3124/3856, 81%) and 2001 (3288/4057, 81%) were similar. Compared to 1994, the proportion of women who thought the invitation letter was clear to read in 2001 increased (70% vs 98%, P < 0.0001); however, letters were thought to be less reassuring in 2001 compared to 1994 (P < 0.0001). In both study periods, 66% of women reported that the procedure was explained to them before the smear was taken. A greater proportion of women received their results by letter in 2001 compared to 1994 (57% vs 41%, P < 0.0001); however, 49% of women waited >4 weeks to receive their results in 2001 compared to 26% in 1994 (P < 0.0001). Bivariate analysis suggests that responses were age related, with older women (> or =45 years) experiencing poorer information provision. The issues highlighted by this study deserve further investigation in other areas.

Adult↗