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F Dabis

Publications and source records attributed to F Dabis.

At least 181 records · Page 10Linked to original sources
PubMed1992

Women and HIV infection: a cohort study of 483 HIV-infected women in Bordeaux, France, 1985-1991. The Groupe d'Epidémiologie Clinique du SIDA en Aquitaine.

OBJECTIVES: To study the epidemiological trends, clinical patterns, evolution and prognosis of HIV infection in women. DESIGN: Cohort study of 1816 HIV-infected patients. RESULTS: Up to 1 January 1991, 483 (26.6%) of the patients reported to the Groupe d'Epidemiologie Clinique du SIDA en Aquitaine surveillance system were women. The male-to-female ratio has decreased progressively (3.4:1 in 1985; 2.7:1 in 1990) over time. Fifty per cent of HIV-infected women are or have been intravenous drug users (IVDU). The proportion of heterosexually acquired HIV infection increased from 11.6 to 34.6% over the last 5 years; 46.9% of the women infected through heterosexual intercourse reported sexual contacts with male IVDU. Excluding Kaposi's sarcoma, no significant difference was observed between men and women in the overall distribution of AIDS-defining events. The observed trend of a slower progression to AIDS in women, compared with men, disappeared when controlling for prognostic variables. However, female sex significantly enhanced survival after AIDS diagnosis in multivariate analysis (relative risk, 2.7; 95% confidence interval, 1.1-6.2). CONCLUSION: Early diagnosis of HIV infection in female patients and prevention of HIV infection among women is now a priority for public health interventions, both in industrialized and in developing countries.

AIDS-Related Opportunistic Infections↗
PubMed1991

Perinatal transmission of HIV-1: lack of impact of maternal HIV infection on characteristics of livebirths and on neonatal mortality in Kigali, Rwanda.

We present the baseline results of a prospective cohort study on the perinatal transmission of HIV-1 in Kigali, Rwanda. HIV-1-antibody testing was offered to all women of urban origin delivering a live newborn at the maternity ward of the Centre Hospitalier de Kigali from November 1988 to June 1989; 218 newborns of 215 HIV-positive mothers were matched to 218 newborns of 216 HIV-negative mothers. The matching criteria were maternal age and parity. No differences in socioeconomic characteristics were observed between HIV-positive and HIV-negative women. HIV-positive mothers more frequently reported a history of at least one death of a previously born child (P less than 0.01) and a history of abortion (P less than 0.001). Most of the HIV-positive women were asymptomatic, but 72.4% of them had a CD4; CD8 ratio less than 1 versus 10.1% in the HIV-negative group (P less than 0.001). The frequency of signs and symptoms was not statistically different in the two groups, except for a history of herpes zoster or chronic cough, which was more frequent among HIV-positive women. The rates of prematurity, low birth weight, congenital malformations and neonatal mortality were comparable in the two groups. However, infants of HIV-positive mothers had a mean birth weight 130 g lower than the infants of HIV-negative mothers (P less than 0.01). The impact of maternal HIV-1 infection on the infant seems limited during the neonatal period.

Abortion, Spontaneous↗
PubMed1990

Telematics: a new tool for epidemiological surveillance of diarrhoeal diseases in the Aquitaine sentinel network.

A sentinel health information system using telematics and a network of general practitioners was set up in Aquitaine in south western France in 1986. Among the health problems under surveillance was acute diarrhoea. Data for each patient who fulfilled the usual case definition for acute diarrhoea were reported by general practitioners using home terminals (Minitels) connected to a central computer by telephone. Over one year 2234 cases of diarrhoea were reported, the incidence varying from 0.8 to 1.5 cases per doctor per week. Seasonal variations in incidence were observed, with peaks in the winter and in the summer. Only 379 (17%) episodes of diarrhoea were classified as severe, and these patients consulted their general practitioners earlier than patients whose diarrhoea was less severe. Foreign travel was rarely found in the patients' histories, but clusters of cases were found in communities (4.6%) and in families (22.3%). The advantages of this system were easy reporting and immediate feedback, but it was difficult to extrapolate the data, and the system was inadequate for intervening in outbreaks of diarrhoeal disease. Our knowledge of diarrhoeal diseases in south west France improved.

Acute Disease↗
PubMed1990

Dietary vitamin A, beta carotene and risk of epidermoid lung cancer in south-western France.

This hospital-based case-control study was designed to investigate the association of low dietary vitamin A and beta carotene consumption with epidermoid lung cancer. Cases were patients with histologically confirmed epidermoid lung cancer diagnosed in six selected hospitals of southwestern France in 1983-84. Controls were selected from patients admitted to the same hospitals during the same period with diagnoses other than cancer. Cases and controls were matched for sex, age, place of residence, occupation, professional exposure to carcinogens, tobacco and alcohol consumption. A total of 106 cases of epidermoid lung cancer and 212 controls were interviewed on their typical weekly intake of 80 food items rich in preformed vitamin A and beta carotene. Index measures of the vitamin A and beta carotene daily intakes were computed for each individual patient and expressed in retinol equivalent (RE). A statistically significant odds ratio (OR) was found for preformed vitamin A (OR = 4.3; 95% CI: 2.5-7.3) with the threshold of 1,000 RE. A similar result was found for beta carotene with the same threshold (OR = 4.1; 95% CI: 2.3-7.4). Using the conditional logistic regression, consumption of preformed vitamin A and consumption of beta carotene were significantly and independently associated with epidermoid lung cancer. While confirming the protective role of beta carotene against epidermoid lung cancer, this study also shows that preformed vitamin A might have a distinct and important protective effect.

Carcinoma, Squamous Cell↗
PubMed1990

Incidence of Campylobacter infection in infants in western Algeria and the possible protective role of breast feeding.

A case-control study aimed at comparing the incidence of campylobacter infection with that of other enteropathogens in infants was performed in Oran, Western Algeria. During a one-year period, infants consulting in a health centre were included if they had acute diarrhoea. The controls comprised infants going to the same centre for vaccination. Butzler medium Virion was used to look for thermophilic campylobacters. Campylobacters were isolated in 17.7% of the 411 patients and in 14.9% of the 247 controls. No statistically significant difference was found after stratification by age. In contrast, other enteropathogenic bacteria were rarely present. Among the potential factors of clinical expression of infection, breast feeding appeared to have a protective effect which was higher for campylobacter diarrhoea than that observed for other causes of diarrhoea. These data contrast with those previously published in Bangladesh and could be an incentive for promoting breast feeding in this country, where the tradition is decreasing far below the standard which is generally accepted.

Age Factors↗
PubMed1990

A cohort study of 89 HIV-1-infected adult patients contaminated by blood products: Bordeaux 1981-1989. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA)

A hospital-based surveillance of HIV infection was implemented in the Bordeaux Regional University Hospital (France). This reporting system, initiated by the Groupe d'Epidemiologie Clinique du SIDA en Aquitaine, identified and followed-up 89 adult patients with transfusion-associated HIV-1 infection (7.2% of all reported cases). Contamination occurred between August 1981 and June 1985 and diagnosis was made between 1985 and 1989. By 30 June 1990, 43 patients (48.3%) had full-blown AIDS, and 28 of them had died. The mean follow-up period was 66 months (s.d. 16 months). The mean incubation period, i.e. The time interval between the contaminating transfusion and the development of full-blown AIDS, was 62 months [median 73 months; 95% confidence interval (CI) 66-82 months]. Five years after contamination, the cumulative probability of reaching the AIDS stage was 34.2% (95% CI 20.3-49.3%), and the probability of survival was 81.7% (95% CI 72.5-90.0%). From this surveillance system we estimate that in south-western France at the end of 1989 the cumulative incidence of transfusion-associated HIV-1 infection was at least 126 cases (45.6 per million inhabitants). Although we anticipate an increase in transfusion-associated AIDS cases over the next 5 years, there have been no reports of contamination after 1 August 1985, when systematic screening of HIV antibodies was implemented in French blood banks. This confirms the efficacy of screening in countries like France where the risk of contamination through blood products is now minimal.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Cysticercosis and neurocysticercosis: epidemiological survey in North Togo].

An epidemiologic survey was carried out by a team of medical doctors working in the Kozah district of North Togo during April 1987. It was designed to evaluate the incidence of epilepsy and cysticercosis, taking a sample population of 5,264 subjects aged over 15 years old. 81.7% of the population feed on pigs which are allowed to roam freely in the vicinity of people's habitations. Cysticercosis (123 cases; incidence 23.3 cases per thousand) was diagnosed when one of the following three tests gave a positive result:--serum sample greater than or equal to 0.400 OD with ELISA test (101 cas),--identification of a cysticercosis cyst on anatomopathological examination of subcutaneous cysts (12 cases),--presence of typical calcification patterns revealed by cranial or muscle X-rays (21 cases in 18 patients). General epilepsy or partial motor fits were entirely clinically diagnosed (88 cases; 16 per thousand of population). Cysticercosis proved to be the cause of 29.5% epileptic sufferers, onset occurring after the age of 50 in 66% of these patients.

Adolescent↗
PubMed1989

Loss of maternal measles antibody during infancy in an African city.

Measles epidemics with 20% of the cases under nine months of age continue to occur in Brazzaville, Congo, even though measles vaccination coverage was 77% in the 12- to 23-month age group in 1986. In order to estimate the duration of passive immunity against measles, we conducted a serologic survey of infants aged 2 to 9 months. Measles antibody was measured from capillary blood with the plaque inhibition test. An antibody titre of 40 milli-International Reference Units per ml of serum (mIRU/ml) or less was defined as seronegative. Among the 252 infants studied, the proportion with detectable antibody dropped from 95.8% at 2 months of age to 48.5% at 4 months of age, and to 8.2% in the 7-8 month age group. A simple logistic model with age as the only variable provided an excellent fit to the observed values. Between the ages of 8 and 28 weeks, there was an almost steady decline of approximately 4.7% per week in the proportion of infants who were seropositive. These findings suggest that loss of maternal measles antibody during infancy might be faster than reported in other African populations. Giving measles vaccine to infants before the age of nine months currently recommended by the Expanded Programme on Immunization may be useful in some populations. Further studies of seroconversion and impact on measles are needed.

Age Factors↗
PubMed1989

Evaluation and simplification of the World Health Organization clinical case definition for paediatric AIDS.

The World Health Organization (WHO) clinical case definition for paediatric AIDS was tested during a 1-month period on 221 consecutive hospitalized children in Kigali, Rwanda. Relevant clinical features not included in the WHO case definition were also evaluated. Thirty-four out of the 221 children (15.4%) were HIV seropositive. Although the specificity of the WHO case definition was high (92%), the sensitivity and the positive predictive value (PPV) were low (41 and 48%, respectively). The following individual signs had a PPV at least equal to the complete WHO case definition: chronic diarrhoea (47%), respiratory distress secondary to lower respiratory tract infection (50%), oral candidiasis (53%), parotitis (67%), generalized lymphadenopathy (88%), and herpes zoster infection (100%). When logistic regression analysis was done on the nine variables included in the WHO case definition, confirmed maternal infection was the best predictive variable for HIV seropositivity in children (P less than 10(-5). We further excluded the serological status of the mother from the analysis and performed a stepwise logistic regression analysis on the 18 clinical signs and symptoms for which information had been collected. Those signs and symptoms contributing the most to the regression were: respiratory distress, chronic diarrhoea and generalized lymphadenopathy. Based on these findings, we propose a simplified clinical case definition for paediatric AIDS in Africa with better sensitivity, specificity and PPV than the WHO case definition. Further work is needed using this approach to develop case definitions useful for epidemiological surveillance and for case management.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Epidemiological surveillance of suicides and attempted suicides in Aquitaine, south-west France, using an original computer network of sentinel general practitioners.

To improve the epidemiological study of suicide and attempted suicides in Aquitaine, France, we developed a comprehensive surveillance system based on the input of Sentinel General Practitioners (SGPs). From October 1986 to May 1988, for each case of suicide or attempted suicide, the SGPs reported epidemiological data to our system through a computer network of personal home terminals (Minitels). Data included age, sex, method and result of attempt and antecedents. In an analysis of the relationship between the suicidal method, antecedents and results of suicidal act, the principal findings were a high rate of antecedents of suicide attempts by drug overdoses, hangings and drownings; and no antecedents for attempts by the use of firearms. This may show that the increasing accessibility of firearms is making it more likely that impulsive suicide attempts will be lethal.

Adult↗
PubMed1989

Epidemiological study of neuro-cysticercosis in northern Togo (West Africa).

In april 1987, an epidemiologic study in Northern Togo was carried out in order to evaluate the prevalence of cysticercosis and epilepsy. The survey also aimed to investigate possible connections between these two illnesses. The study encompassed 5264 subjects over 15 years old, selected using random sampling techniques; 125 cases of cysticercosis were diagnosed (2.4% of sample population); 12 by anatomo-pathological examination of cysts 18 (14.4%) based on skull and muscle x-ray calcifications and 104 patients were identified using ELISA tests on 1527 serum samples (optical density greater than or equal to 0.4). Among 88 epileptic patients (prevalence = 16.7 per thousand), 27 also suffered from cysticercosis (38.7% of all epileptic patients, 21.6% of cysticercosis patients and 0.51% of the total population).

Adolescent↗
PubMed1989

Monitoring selective components of primary health care: methodology and community assessment of vaccination, diarrhoea, and malaria practices in Conakry, Guinea. ACSI-CCCD team.

The Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (ACSI-CCCD) Project is a primary health care activity that focuses on antenatal care, immunization, diarrhoeal disease control, and malaria control in children under 5 years of age. In order to gauge progress made in the project, a community-based health interview survey to measure simultaneously several prevention and treatment indicators was carried out in 1986 in Conakry, Guinea. A sample of 1415 caretakers and their 2048 children aged under 5 years was visited using a cluster sampling technique. The survey documented the levels of literacy and health education awareness of the caretakers, measured the vaccination coverage levels for children and women of childbearing age, and determined treatment practices for diarrhoea and malaria. Of the 637 women who reported having given birth in the previous 12 months, 96% had visited an antenatal clinic, but only 49% had had two or more doses of tetanus toxoid, and 13% took weekly chemoprophylaxis against malaria. The vaccination coverage for measles was 16% for children aged 12-23 months. Oral rehydration therapy (ORT) was given to 16% of children with diarrhoea; however, only 43% of those who were administered ORT at home were treated according to standard guidelines. Of children with diarrhoea, 51% were given antidiarrhoeal or antimicrobial drugs by caretakers. Fever was treated at home for 79% of the febrile children, and 43% of those with fever also visited health units. The use of injectable antimalarials and prolonged treatments with chloroquine were common. Combining findings from a population-based community study with an assessment of practices in health facilities can provide reliable information for the implementation and monitoring of selective components of primary health care.

Africa, Western↗
PubMed1989

[What role do smoking and air conditioning play in the occurrence of otorhinolaryngological and upper respiratory symptoms in the personnel of a hospital center?].

A cross-sectional study of the risk factors of upper respiratory symptoms has been carried out in September 1987 among the 220 employees of the Dax General Hospital. The study was not able to prove that air conditioning contributed to the occurrence of this symptomatology, but showed that smoking was associated with the disease. Prevalence of symptoms was 34% among the employees who were smokers (32% of the personnel) and only 19% among the non-smokers (p less than 0.025). In the context of the national campaign against smoking, reducing the tobacco consumption at work in buildings with air conditioning systems is likely to decrease substantially the frequency of building sickness among the personnel. This recommendation seems particularly relevant to hospital settings.

Adult↗