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Sandy Cairncross

Publications and source records attributed to Sandy Cairncross.

21 records · Page 2Linked to original sources

Dracunculiasis (Guinea worm disease) and the eradication initiative.

Dracunculiasis, also known as guinea worm disease, is caused by the large female of the nematode Dracunculus medinensis, which emerges painfully and slowly from the skin, usually on the lower limbs. The disease can infect animals, and sustainable animal cycles occur in North America and Central Asia but do not act as reservoirs of human infection. The disease is endemic across the Sahel belt of Africa from Mauritania to Ethiopia, having been eliminated from Asia and some African countries. It has a significant socioeconomic impact because of the temporary disability that it causes. Dracunculiasis is exclusively caught from drinking water, usually from ponds. A campaign to eradicate the disease was launched in the 1980s and has made significant progress. The strategy of the campaign is discussed, including water supply, health education, case management, and vector control. Current issues including the integration of the campaign into primary health care and the mapping of cases by using geographic information systems are also considered. Finally, some lessons for other disease control and eradication programs are outlined.

Animals↗

The intensity of transmission of hepatitis A and heterogeneities in socio-environmental risk factors in Rio de Janeiro, Brazil.

The objective of this work was to assess the intensity of transmission of hepatitis A in Rio de Janeiro, Brazil. We also used the estimation of the parameters of a deterministic model to study the effects of risk factors. Age-specific seroprevalence of antibodies against hepatitis A virus (HAV) was obtained from a survey screening in a city of the metropolitan area of Rio de Janeiro, in 1997. From the seroprevalence data, we estimated the age-dependent force of infection (lambda) and the average age of first infection (A), using a deterministic model. To evaluate the influence of the environmental risk factors, we estimated the same parameters stratifying the sample for the selected socio-environmental risk factors: the number of years of schooling of the female responsible for the house, crowding within the bedroom, number of water taps and fittings, and the presence of sewage in front of the house. For the whole sample, the maximum force of infection estimated was 0.12/year and the average age of infection was 10.1 years. This last parameter decreased as the number of persons per bedroom increased, and also when the number of water taps and the number of years of schooling of the woman responsible for the house decreased. The proposed environmental interventions may lead to a decrease in the intensity of transmission of HAV and an increase in the average age of first infection in the next few years. This may have public health implications, since hepatitis A is more severe in adults. In this context, specific vaccination programmes may be necessary, as in developed countries.

Adolescent↗

Impact of drainage and sewerage on diarrhoea in poor urban areas in Salvador, Brazil.

A longitudinal prospective study of the effect of drainage and sewerage systems on diarrhoea in children aged < 5 years was conducted in 9 poor urban areas of the city of Salvador (population 2.44 million) in north-east Brazil in 1989-90. Due to complex political and administrative reasons, 3 areas had benefited from drainage improvements, 3 from both drainage and sewerage improvements, and 3 from neither. An extensive questionnaire was applied to collect information on each child and on the conditions of the household, and mothers recorded diarrhoea episodes in their children aged < 5 years daily for 1 year, using calendars. Fortnightly home visits were made to collect the data. The incidence of diarrhoea in children in neighbourhoods with drainage was less than two-thirds, and in neighbourhoods with drainage and sewerage less than one-third, of the incidence in neighbourhoods with neither. After controlling for potential confounders, the proportion of children with 'frequent diarrhoea' showed the same significant trend across the study groups. Though the groups were not exactly comparable, more than one child was monitored per household, and it was not possible to rotate fieldworkers between study groups, the study provides evidence that community sanitation can have an impact on diarrhoeal disease, even without measures to promote hygiene behaviour.

Brazil↗