Biomedical subjects

D R Prevots

Publications and source records attributed to D R Prevots.

21 records · Page 2Linked to original sources

PubMed1992

First reported outbreak of classical dengue fever at 1,700 meters above sea level in Guerrero State, Mexico, June 1988.

An outbreak of classical dengue fever occurred from March to August 1988 in the city of Taxco, Guerrero State, Mexico. Taxco is at an elevation of 1,700 meters above sea level, and this study represents the highest altitude at which an outbreak of dengue has been documented. An investigation was conducted to obtain serologic confirmation of dengue infection, determine the extent of the outbreak, and identify risk factors for dengue illness. Toxorhynchites cell lines were used for viral isolation, and hemagglutination inhibition was used to measure anti-dengue antibody titers. The case definition used in the investigation was any person with fever, headache, myalgias, and arthralgias, or rash or retroocular pain. Dengue virus type 1 was isolated from five acute cases. Of 1,686 persons living in the affected area, 42% (715) met the case definition. Large (200-liter) water containers were significantly associated with infection (relative risk = 1.7, 95% confidence interval 1.5-1.9). The effect of altitude on epidemic transmission is most likely modulated by seasonal temperatures. The epidemiologic and serologic confirmation of a dengue outbreak at 1,700 meters above sea level represents the capability of Aedes aegypti to adapt to new environments, and the potential for epidemic spread in cities at comparable altitudes or higher.

Adolescent↗

PubMed1991

Determinants and predictors of dengue infection in Mexico.

A national serosurvey was conducted in Mexico from March to October 1986 to identify predictors of dengue transmission and target areas at high risk of severe annual epidemics. A total of 3,408 households in 70 localities with populations less than 50,000 were randomly sampled, and serology was obtained from one subject under age 25 years in each household. When comparing exposure and infection frequencies across the 70 communities, the authors found that median temperature during the rainy season was the strongest predictor of dengue infection, with an adjusted fourfold risk in the comparison of 30 degrees C with 17 degrees C. High temperatures increase vector efficiency by reducing the period of viral replication in mosquitoes. The proportion of houses in a community with larva on the premises was significantly associated with the community proportion infected (odds ratio (OR)adj = 1.9; 95% confidence interval (CI) 1.4-2.5), as was the proportion of households with uncovered water containers present (ORadj = 1.9; 95% CI 1.4-2.7). Because these factors have effects beyond the individual household and subjects infected from them create a risk for other subjects, both analyses of effects and organization of control efforts must be at the community level. A predictive model was constructed using the community level risk factors to classify communities as being at high, medium, or low risk of experiencing an epidemic; 57% of these communities were correctly classified using this model.

Adult↗

PubMedDate not supplied

Parental attitudes toward multiple poliovirus injections following a provider recommendation.

OBJECTIVES: Changes to the polio vaccination schedule, first to a sequential inactivated poliovirus/oral poliovirus (IPV/OPV) schedule in 1996 and most recently to an all-IPV schedule, require infants to receive additional injections. Some surveys show parental hesitation concerning extra injections, whereas others show that parents prefer multiple simultaneous injections over extra immunization visits. This study describes parental behavior and attitudes about the poliovirus vaccine recommendations and additional injections at the 2- and 4-month immunization visits. METHODS: Beginning July 1, 1996, providers in eight public health clinics in Cobb and Douglas Counties, Georgia, informed parents of polio vaccination options and recommended the IPV/OPV sequential schedule. A cross-sectional clinic exit survey was conducted from July 15, 1996, to January 31, 1997, with parents whose infants (younger than 6 months) were eligible for a first poliovirus vaccination. RESULTS: Of approximately 405 eligible infants, parents of 293 infants were approached for an interview, and 227 agreed to participate. Of those 227 participants, 210 (92%) parents chose IPV for their infant and 17 (8%) chose OPV. Of greatest concern to most parents was vaccine-associated paralytic polio (VAPP) (155, or 68.3%); the next greatest concern was an extra injection (22, or 9.7%). These parental concerns were unrelated to the number of injections the infant actually received. CONCLUSIONS: After receiving information on polio vaccination options and a provider recommendation, parents overwhelmingly chose IPV over OPV. Concern about VAPP was more common than objection to an extra injection. The additional injection that results from using IPV for an infant's first poliovirus vaccination appears to be acceptable to most parents.

Administration, Oral↗