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Biomedical subjects

M Vall Mayans

Publications and source records attributed to M Vall Mayans.

17 recordsLinked to original sources

High rates of tuberculosis infection among children from Ciutat Vella District, Barcelona, 1996-1997.

With tuberculosis (TB) rates of over 160/100,000 in 1997, Ciutat Vella District, Barcelona, is the main community focus of TB in the city. For the purpose of TB screening, 415 children >2 years old from that district received a tuberculin skin test (TST); 27 (6.6%) (95%CI 4.5-9.3) were found to be infected but disease-free. The frequency of a positive TST increased significantly with age, from 0% in the 2-4 year age group to 14.6% in 10-14 year olds. Three culture-positive source adults, two of them sputum smear-positive, who were not previously known were traced from six TST-positive children. Previous BCG vaccination was not associated with a positive TST. These data support the use of universal TST screening in children living in Ciutat Vella District, Barcelona, as a means of identifying and treating TB cases.

Adolescent↗

[HIV infection in the alternative centers for voluntary detection of anti-HIV antibodies in Cataluna, Spain (1995-1996). VIHDEVO collaborative group].

OBJECTIVE: The knowledge of HIV serostatus may help the treatment and follow up of those infected people, and change the risky behaviours in those not infected. Epidemiological information from people tested can better address the activities of control and prevention of HIV infection. DESIGN: Collection of demographic and epidemiological information. PARTICIPANTS: People voluntary tested in four alternative test settings in Catalonia. MEASUREMENTS AND MAIN RESULTS: Of 1,733 petitions of voluntary testing, 63 (3.7%) were HIV positive. Overall prevalence in men were two fold than in women (4.6% vs 2.3%). In both years of study, the mean age for women HIV positive were higher than the mean age for women with aids. CONCLUSIONS: The results of this study confirm the age and sex pattern found for the HIV infection in other sentinel populations in Catalonia. Some measures should be taken in order to increase the accessibility of young women to the test.

AIDS Serodiagnosis↗

[Prevalence of maternal HIV infection in Catalonia (1994): results of non-related anonymous neonatal screening. VIHNADO Group].

BACKGROUND: Spain has the highest incidence rate of AIDS in Europe. Catalonia contributes with around 30% of the AIDS cases detected in Spain. From 1990 to 1994 the AIDS heterosexual transmission category increased from 9.6% to 14.6% in Catalonia. The objective of the study was to determine the HIV prevalence in a heterosexual population of pregnant women. SUBJECTS AND METHODS: Unlinked anonymous HIV screening by means of an agglutination assay and an enzyme immunoassay of eluates of dried blood spots from nearly half of the neonates born in Catalonia during 1994. RESULTS: HIV testing was done on 21,074 neonates. Overall HIV prevalence was 0.32% (95% CI: 0.25-0.40). It varied from 0.45% in Barcelona, 0.38-0.29% in the health regions around Barcelona, to 0.20-0.09% in the rest. The mean age of HIV infected women was younger (27) than that of the seronegative ones (29) (p < 0.001). The highest prevalence was 0.61% in women aged 20-24 years. CONCLUSIONS: The HIV prevalence in the heterosexual population of pregnant women in Catalonia is among the highest in Europe. Preventive efforts must begin with schoolchildren and be directed to adolescents and young women. It is convenient that women who want to become pregnant and mothers receiving antenatal care have access to voluntary confidential HIV testing.

Adult↗

The spread of AIDS and the re-emergence of tuberculosis in Catalonia, Spain.

OBJECTIVE: To assess the impact of HIV/AIDS on the incidence of tuberculosis (TB) and to analyse the determinants of TB presenting as the first indicative disease of AIDS. DESIGN: Analysis of TB and AIDS surveillance data. SETTING: Catalonia, north-east Spain. PATIENTS: Two separate sources were used: (i) TB cases reported to the Catalan TB registry diagnosed between January 1982 and December 1993; (ii) AIDS cases reported to the AIDS Catalan registry diagnosed between January 1982 and December 1994. MAIN OUTCOME MEASURES: Expected and observed TB cases, and number and characteristics of AIDS cases presenting with TB. RESULTS: From 1987 to 1993 the annual TB crude incidence rate increased by 50% to a rate of 49.7 per 100,000, with a least 60% of the increase directly due to AIDS. During that period specific rates among children aged 0-4 years remained high at around 40 per 100,000. A total of 7,010 AIDS cases were diagnosed between 1988 and 1994, of whom 24.3% had TB. Multivariate analysis from those AIDS cases showed that besides male sex, young age, and urban residence, the strongest predictors of TB among AIDS cases were history of imprisonment (odds ratio, 2.16; P < 0.001) and intravenous drug use (odds ratio, 1.65; P < 0.001). CONCLUSIONS: The high rates of TB among children and young adults suggest that TB transmission has increased during this period, especially among people at high risk of AIDS. The determinants of individual risk of TB among AIDS patients act together, especially in prisons. The HIV/TB coepidemic is an emerging threat potentially for all and requires expanding targeted measures to prevent and control both disease in our setting.

AIDS-Related Opportunistic Infections↗

[The impact of AIDS in the global mortality in Catalonia, 1981-1993].

OBJECTIVES: To compare the evolution of the principal causes of death in Catalonia, Spain and to assess the impact of AIDS as a contributing factor to the increase of mortality in young people in Catalonia. METHODS: Data from the mortality register of Department of Health in Catalonia has been used. We have compared the principal causes of death in Catalonia for the global population and for the group of 20 to 39 year olds. We have calculated the potential years of life lost (PYLL) between the ages of 13 to 65. RESULTS: Since the first case of AIDS in 1981, AIDS has been the cause of death with the most important increase for the global population in Catalonia. AIDS is the sixth cause of death and the first cause of PYLL. For the young population in Catalonia (aged 20-39) AIDS became, in 1993, the first cause of death. From 1992 to 1993 the PYLL due to AIDS increased 5% in men and 51% in women. CONCLUSIONS: The present situation has led AIDS being the first cause of death among young population. The collaboration between mortality registers and AIDS registers is absolutely essential to assess more accurately the impact of AIDS on the mortality of population.

Acquired Immunodeficiency Syndrome↗

Testing of saliva and serum for HIV in high-risk populations. Ad Hoc Group for the Comparative Saliva and Serum Study.

Paired samples of saliva and serum from 286 high-risk subjects were tested for HIV using two commercial enzyme immunoassays following the same WHO testing strategy supplemented with a Western blot technique. Agreement between HIV testing in both sample types was 98.9% (95% confidence interval: 97.7-100). The sensitivity of an EIA (Wellcozyme GACELISA) alone for saliva was 100% (133/133) and the specificity 98.7% (151/153). These results support previous data showing that in some situations saliva might be an effective alternative to serum for HIV testing.

AIDS Serodiagnosis↗

Do bedbugs transmit hepatitis B?

An intervention study was done over two years in seven Gambian villages to determine the contribution of bedbugs to hepatitis B transmission. In addition, fortnightly questionnaires were completed for each child to assess other possible routes of transmission. The intervention, insecticide spraying of the child's dwelling, was highly effective in reducing exposure to bedbugs but there was no effect on hepatitis B infection. No other risk factor for transmission was identified despite a consistent village-to-village variation in the rate of childhood infection. The major mode of transmission of hepatitis B in childhood remains unknown.

Animals↗

[The evolution of the prevalence of breast feeding in the Manlleu Basic Health Area (1988-1991)].

OBJECTIVE: To discover the prevalence of maternal lactation in the Manlleu Health Area and the variations in latency since the area was set up to the present day. DESIGN: Crossover study, based on the record-sheet of the health controls in the clinical notes, of maternal lactation for those recently-born babies monitored in the area between January 1988 and December 1991 (n = 686). SITE. The geographical boundaries of Manlleu Basic Health area (Barcelona). MAIN MEASUREMENTS AND RESULTS: The prevalence of maternal lactation progressively increased from the base of 1988 (lineal tendency chi 2 = 34.3 p < 0.0001). The number of mothers beginning maternal lactation went up from 62% in 1988 to 72% in 1991. Right from the first month duration also increased, but the differences were especially marked between the second and the fifth months (p < 0.05). The average time of lactation also increased, from 92 days in 1988 to over 114 days in 1991 (p = 0.02). CONCLUSIONS: Prevalence and duration of maternal lactation has improved substantially since the setting-up of the Basic Health Area. This improvement could be attributed to the publicity material that we made available at general health check-ups during the first 6 months.

Breast Feeding↗

Premature mortality related to AIDS among men and women in Catalonia.

OBJECTIVES: To evaluate the mortality pattern observed in relation to the AIDS epidemic, and to estimate the current and future demographic impact of AIDS among the population aged between 20 and 39 years in Catalonia, Spain. DESIGN: Spain has the highest cumulative incidence rate of AIDS in Europe. One-third of Spanish AIDS cases have been consistently reported from Catalonia, an autonomous region in northeastern Spain with a population of 6 million, and with Pattern I HIV transmission. In this study data from the population-based AIDS registry and death certificates in Catalonia were used. METHODS: Since 1981 AIDS data have been collected routinely from all hospitals using an active surveillance system. All causes of death are coded from death certificates (ICD-9). Mortality rates since 1981 were analysed by age and sex. To assess the relative importance of premature mortality due to AIDS, years of potential life lost (YPLL) before age 65 were used. RESULTS: Since 1982 there has been a continuous increase in crude mortality rates, particularly significant for men aged 20-39 years after 1986 (F < 0.001). While AIDS was the fourth most likely cause of death among people aged 20-39 years in 1988, by 1991 it was the second most likely. In 1990 AIDS contributed to 13,213 YPLL (8.7%) for men and 2579 YPLL (4%) for women. During the last few years AIDS-related deaths have had the highest mortality rate progression among young adults. CONCLUSION: According to the current available data, AIDS might become the leading cause of death for the population aged 20-39 years in the near future. AIDS is having an important impact on the demography of European countries with Pattern I transmission and high HIV prevalence rates.

Acquired Immunodeficiency Syndrome↗

Risk factors for transmission of hepatitis B virus to Gambian children.

Risk factors for hepatitis B virus transmission were examined in 973 Gambian children aged 6 months to 5 years. 33% had evidence of infection with hepatitis B virus and a third of these were carriers. A significant association was found between infection and tropical ulcer scars, and between e antigenaemia and the presence of bedbugs in each child's bed. There was no association between infection and traditional scarring, circumcision, or injections. Skin disease and arthropods are the two most likely modes of transmission of hepatitis B virus between children in West Africa.

Acute Disease↗

[Short-term prediction of cases of AIDS in Catalonia (1991-1994)].

Predicting AIDS incidence is a useful strategy for health service planning and for the design of preventive and control programmes. The different predictive mathematical models of AIDS can be classified in simple and complex, according to the assumptions used. The present study presents the prediction of the minimum AIDS incidence in Catalonia for the period 1991-94 by means of three simple mathematical models. The models that have been compared are the projection method of Chin and Lwanga, the retroprojection method of Brookmeyer and Gail, and the extrapolation method of Cox and Medley. Baseline information about AIDS cases comes from the AIDS Registry of the "Generalitat" of Catalonia. In a comparable manner, the three methods point out an increase of AIDS incidence until 1994, varying from 1160 to 1733 new cases in that year depending on the method used. We conclude that it will be necessary to increase the provision of health, social and preventive resources against AIDS in Catalonia in the coming years.

Acquired Immunodeficiency Syndrome↗

[AIDS patients with an unclassified risk factor for HIV].

OBJECTIVES: In the surveillance of the AIDS epidemic via registries there is a small proportion of cases whose route of HIV transmission is unknown (5% for Catalonia, Spain). For reclassification purposes, the aim of this study is to detect similarities between these cases with "not qualified risk" (NQR) with the other main HIV transmission groups. METHODS: All Aids cases (> 12 years) resident in Catalonia and reported between 1988 and 1996 to the AIDS registry (n = 8,559) were compared according to their distribution of "age at diagnosis" and "first indicative AIDS disease". ANOVA and log-linear regression models were applied separately by sex. RESULTS: Evidence of similarity with the NQR group was only found for men; in terms of age at diagnosis, the NQR group was similar to both groups of sexual transmission whilst in terms of Aids indicative disease it was similar to the heterosexual transmission group. As from 1994, a reduction in the incidence of NQR cases was observed and coincided with an increase in the heterosexual group. CONCLUSIONS: According to the characteristics of the NQR cases, it can be concluded that all cases acquired HIV via one of the classic routes of infection, primarily through heterosexual contacts. For this reason, it is advisable that the criteria that define heterosexual HIV transmission be relaxed.

Acquired Immunodeficiency Syndrome↗

[Extension of reporting AIDS cases in Catalonia: study based on requests for CD4 lymphocyte count and prescription of antiretroviral drugs].

BACKGROUND: To ascertain the degree to which AIDS is officially reported in Catalunya. METHOD: The request for T CD4+ white blood cell counts and the prescribing of antiretroviral drugs in seven university hospitals in Catalunya from January 1, 1994 to June 31, 1994 were used as data-comparison sources. A case was considered to not have been reported when the clinical history showed a diagnosis of AIDS (according to the Europe 93 definition) and the case in question did not show up on the AIDS Registry for Catalunya. RESULTS: Of the 1,370 cases studied, 50 unreported AIDS cases were found. In all, 98.6% of all cases were found to have been reported, for a 95% confidence interval (95% CI): 98.2-99.0. Most of the unreported cases were males (72%) averaging 37.3 years of age (HCA: 11.8), 52% of whom were injected drug users (IDU's), extrapulmonary tuberculosis being the disease most often diagnosed (16%), 81.4% having been found to have a T CD4+ white blood cell count of 200 WBC/mm3 or below. 92% of these cases were detected based on T CD4+ white blood cell counts. CONCLUSIONS: The degree of completeness found is considered to be adequate. It is recommended that the white blood cell count records being used for this type of studies.

Acquired Immunodeficiency Syndrome↗