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PubMed2005

Intranasal immunisation with defective adenovirus serotype 5 expressing the Venezuelan equine encephalitis virus E2 glycoprotein protects against airborne challenge with virulent virus.

There is no vaccine licensed for human use to protect laboratory or field workers against infection with Venezuelan equine encephalitis virus (VEEV). Infection of these groups is most likely to occur via the airborne route and there is evidence to suggest that protection against airborne infection may require high antibody levels and the presence of antibody on the mucosal surface of the respiratory tract. Recombinant defective type 5 adenoviruses, expressing the E3E26K structural genes of VEEV were examined for their ability to protect mice against airborne challenge with virulent virus. After intranasal administration, good protection was achieved against the homologous serogroup 1A/B challenge virus (strain Trinidad donkey). There was less protection against enzootic serogroup II and III viruses, indicating that inclusion of more than one E3E26K sequence in a putative vaccine may be necessary. These studies confirm the potential of recombinant adenoviruses as vaccine vectors for VEEV and will inform the development of a live replicating adenovirus-based VEEV vaccine, deliverable by a mucosal route and suitable for use in humans.

Adenoviruses, Human↗
PubMed2006

Control of the taeniosis/cysticercosis complex: future developments.

Cysticercosis is due to the establishment of the larval stage of the zoonotic cestode parasite Taenia solium. The infection causes substantial human morbidity and mortality, particularly in several Latin American countries and parts of Africa and Asia, as well as economic losses in pig husban dry due to condemnation of infected pork meat. The life cycle of T. solium includes human beings as definitive hosts and pigs as intermediate hosts. Cysticercosis is acquired by the ingestion of eggs released by human tapeworm carriers, who become infected after ingesting pork meat contaminated with cysticerci. Taenia solium transmission has been associated with poverty, lack of sanitary services and practices of rearing backyard pigs with free access to the areas that villagers use as toilets, as well as cultural behaviour. Nonetheless, due to the recent increase of migration and tourism, industrial countries are also reporting cases of human cysticercosis. There are many epidemiological studies that have been conducted mainly in Latin American countries that have evaluated intervention measures for control of cysticercosis including the development and testing of vaccines. Furthermore, the involvement of international agencies and institutions, such as the World Health Organization, the Food and Agriculture Organization and the International Livestock Research Institute, as well as the commitment of policymakers, scientists and field workers, are key means for the sustainable control and, hopefully, eradication of T. solium infections.

Animal Husbandry↗
PubMed2003

Domestic poultry-raising practices in a Peruvian shantytown: implications for control of Campylobacter jejuni-associated diarrhea.

Raising poultry at home is common in many periurban communities in low-income countries. Studies demonstrate that free-range domestic poultry increase children's risk of infection with diarrhea-causing organisms such as Campylobacter jejuni. Corralling might reduce risk, but research on the socioeconomic acceptability of corralling is lacking. To explore this issue, we studied local knowledge and practices related to poultry-raising in a Peruvian shantytown. Our objectives were to understand: (1). motives for raising domestic poultry; (2). economic and cultural factors that affect the feasibility of corralling; and (3). local perceptions about the relationship between domestic poultry and disease. During 1999-2000, we met with community health volunteers and conducted ethnographic and structured interviews with residents about poultry-raising practices. We then enrolled 12 families in a 2-month trial of corral use during which field workers made biweekly surveillance visits to each family. Most participants reported that they raise birds because home-grown poultry and eggs taste better and are more nutritious and because they enjoy living around animals. Some want to teach their children about raising animals. To prevent theft, many residents shut their birds in provisional enclosures at night, but most stated that birds are healthier, happier, and produce better meat and eggs when let loose by day. Many view bird feces in the house and yard as dirty, but few see a connection to illness. Residents consider chicks and ducklings more innocuous than adult birds and are more likely to allow them inside the house and permit children to play with them. After extensive orientation and technical assistance, participants were willing to corral birds more often. But due to perceived disadvantages, many kept birds penned only intermittently. Additional food and water costs were a significant obstacle for some. Adequate space, bird care and corral hygiene would also need to be addressed to make this intervention viable. Developing a secure, acceptable and affordable corral remains a challenge in this population.

Adult↗
PubMed2001

Side effects and oral contraceptive discontinuation in rural Bangladesh.

Using data from a survey on oral contraceptive (OC) compliance in rural Bangladesh, this study examines the role of side effects on OC discontinuation along with other potential predictors. A total of 1403 currently married women aged 15-49 years were interviewed; of these 43% discontinued OCs. Of the women who discontinued, 53% did so because of side effects, which was the main self-reported reason for OC discontinuation. Multivariate analysis revealed that after adjusting for duration of OC use, women who experienced side effects were 1.4 times more likely to discontinue OC use than their counterparts without such experience. Discontinued OC use was also associated with being Muslim, not being visited by field-workers, OC use as first method of contraception, lack of husband's support, and was inversely associated with duration of OC use. Adequate counseling about OC use, emphasizing the possibility of side effects, and better management of them, coupled with improved client-provider interaction and husband's supportive role could help in reducing OC discontinuation in rural Bangladesh.

Adolescent↗
PubMed1988

Environmental factors in the etiology of neural tube defects: a negative study.

A case-control study was made on women who had an infant with a neural tube defect and twice as many controls. Cases and controls were selected from a national medical birth registry from which prospectively collected data on previous pregnancy, contraceptive use, and smoking were also retrieved. Women's occupation was either retrieved from that registry or from census information which was partially checked with direct interview. Information on environmental characteristics of the place of living of the women in early pregnancy was given by field workers who were unaware of the status of case or control. Cases and controls showed no statistically significant difference with regard to previous pregnancies and use of contraceptives at or the month before the time of conception. Case women smoked 10 cigarettes or more a day slightly more often than control women did but the difference was not statistically significant. No statistically significant difference in occupation distribution was seen between cases and controls (but cases had slightly more occupations where chemical exposure is likely), and no differences in home environment could be found. It is concluded that the factors studied play no major etiological role for the origin of neural tube defects in Sweden.

Abnormalities, Drug-Induced↗
PubMed2002

A matter of time: evaluating the storage of fecal samples for steroid analysis.

The extraction and immunoassay of fecal steroids is an increasingly common technique, used in both captive and field studies to provide an approximation of an animal's circulating concentration of hormones through non-invasive methods. Storage of fecal samples is of critical concern because fecal bacteria metabolize fecal steroids within hours after deposit. Ethanol is often used as a preservative for fecal samples stored for several hours at room temperature. We examined the stability of fecal estrogen (fE) and glucocorticoid (fGC) metabolites from baboon (Papio cynocephalus) samples in a 95% ethanol solution at ambient temperature and at -20 degrees C over the course of six months, to determine the effect of storage on steroid concentrations. As measured by radioimmunoassay, fE metabolite concentrations increased by 122% at 90 days and fGC metabolite concentrations increased by 92% at 120 days. After peaking, both hormones declined to near initial concentrations by 180 days in ambient temperature samples. In samples stored at sub-zero temperatures, fGC metabolite concentrations showed a similar but dampened pattern, while fE metabolite concentrations exhibited small and variable changes with no consistent trend. We discuss explanations for the dynamic pattern of changing fecal metabolite concentrations and offer practical and analytical guidance to field workers for situations in which ideal conditions for stabilizing hormones are not available.

Animals↗
PubMed1994

Who are the homeless?

To describe the demographic, social and medical morbidity and usage of health services of the population of single homeless individuals in Sheffield, a census was carried out over a 12-hour period at sites which homeless people frequent, as identified by those who work with the homeless. These sites included Salvation Army hostels, reception centres, probation day centres, voluntary organisation hostels, and cheap bed and breakfast accommodation. Data were collected by means of a self-administered questionnaire. A total of 340 single homeless individuals were studied, constituting 80-90% of the single homeless population of Sheffield, as estimated by field workers. The population was younger than those of earlier studies and contained a higher proportion of females (14%). One-fifth of the population had been homeless for less than six months, and 60% had been at their present lodging for less than six months. The population has a higher proportion of both ex-prisoners (49%) and ex-inmates of psychiatric hospitals (36%). Over a quarter admit to a history of alcoholism, and 9% to a history of drug abuse; 65% of the population are registered locally with a GP, and 53% of the population see their GP. Those who are more likely to use an Accident and Emergency Department are less socially integrated and more likely to be alcoholic. This study of the single homeless highlights a need for social change to reduce poverty, provide cheap available housing and provide support for disadvantaged groups.

Adult↗
PubMedDate not supplied

Scaling up access to antiretroviral treatment in southern Africa: who will do the job?

Malawi, Mozambique, Swaziland, and South Africa have some of the highest HIV/AIDS burdens in the world. All four countries have ambitious plans for scaling-up antiretroviral treatment for the millions of HIV-positive people in the region. In January 2004, we visited these countries with the intention of directly observing the effect of AIDS, especially on health systems, to talk with policy makers and field workers about their concerns and perspectives regarding the epidemic, and to investigate the main issues related to scaling up antiretroviral treatment. We found that financial resources are not regarded as the main immediate constraint anymore, but that the lack of human resources for health is deplored as the single most serious obstacle for implementing the national treatment plans. Yet, none of the countries has developed an urgently required comprehensive human resource strategy. This may also need increased donor attention and resources.

Africa, Southern↗
PubMedDate not supplied

The effects of chronic violence on preschool children living in South African townships.

Violence in South Africa has reached endemic proportions. To date, more than 11,000 people have died in politically related violence. The present study is specifically concerned with researching the psychological sequelae of civil conflict and violence on preschool children. Using a combination of participatory and empirical methods, five creche teachers (also trained as field workers) took a random sample of 148 children in their creches. The Post Traumatic Stress Disorder Questionnaire for Children was completed by the creche teachers for each of the children under their care. Second, the children were asked to draw pictures of things they had experienced in their life. A significant finding of this study was that preschool children exposed to violence suffered from PTSD. Further, children's drawings showed severe emotional indicators. However, an interesting finding was that these drawings were not good predictors of PTSD; the more a child was able to express emotional trauma through drawings, the less likely he/she would suffer from PTSD. This finding has interesting ramifications for trauma intervention programs for preschool children.

Analysis of Variance↗
PubMed1998

Physicians' prescribing behaviour for diarrhoea in children: an ethnoepidemiological study in Southern Brazil.

With the aim of implementing an intervention program on physician's prescribing behaviour for diarrhoea in children under five, an ethnoepidemiological study was conducted in Pelotas (Brazil), from February to April 1993. Information on prescription of drugs was obtained through record review of 381 cases of diarrhoea provided by 33 medical doctors from eight health centres. Trained field workers observed a total of 54 clinical consultations due to diarrhoea. Brief exit interviews with the mothers were performed just after the observations. Twenty-seven open-ended home interviews were made with the mothers the day after they had been observed. After all observations had been completed, open-ended interviews were conducted with 21 physicians. The results showed that there is a misunderstanding of the role of ORS in the treatment of diarrhoea: mothers want something to "cut" diarrhoea and they notice that ORS does not act in this way and doctors do not explain the action of ORS in diarrhoea management. Comparing with record reviews, during observations a child had a lower probability of receiving an antibiotic or antidiarrheal drug prescription. This finding indicates that other variables than technical skills are involved in doctor's prescribing behaviour. A lack of ability or of motivation to deal with "anxious or difficult mothers" led some doctors to enhance antibiotic or other non-recommended drugs to manage diarrhoea. Therefore, efforts to improve the quality of case management of diarrhoea, through intervention programmes in the government health sector, are needed in Pelotas.

Brazil↗
PubMed1999

The emerging international policy agenda for reproductive health services in conflict settings.

Over the past 20 years, shifts in the nature of conflict and the sheer numbers of civilians affected have given rise to increasing concern about providing appropriate health services in unstable settings. Concurrently, international health policy attention has focused on sexual and reproductive health issues and finding effective methods of addressing them. This article reviews the background to the promotion and development of reproductive health services for conflict-affected populations. It employs qualitative methods to analyse the development of policy at international level. First we examine the extent to which reproductive health is on the policy agendas of organisations active in humanitarian contexts. We then discuss why and how this has come about, and whether the issue has sufficient support to ensure effective implementation. Our findings demonstrate that reproductive health is clearly on the agenda for agencies working in these settings, as measured by a range of established criteria including the amount of new resources being attracted to this area and the number of meetings and publications devoted to this issue. There are, however, barriers to the full and effective implementation of reproductive health services. These barriers include the hesitation of some field-workers to prioritise reproductive health and the number and diversity of the organisations involved in implementation. The reasons for these barriers are discussed in order to highlight areas for action before effective reproductive health service provision to these populations can be ensured.

Conflict of Interest↗
PubMed2000

Urinary excretion of metabolites following a single dermal dose of [14C]methyl parathion in pregnant rats.

The identification and kinetics of urinary excretion of metabolites of uniformly phenyl-labeled O,O-dimethyl O-4-nitrophenyl phosphorothioate ([14C]methyl parathion) were carried out following a single dermal dose of 10.0 mg (10 microCi)/kg in pregnant Sprague-Dawley rats at 14-18 days of gestation. Urine was collected at each time interval of 1, 2, 4, 12, 24, 48, 72, and 96 h after dosing. Total p-nitrophenol in the conjugated and non-conjugated metabolites was measured as a marker of methyl parathion exposure. Elimination of radioactivity in the urine was rapid. Of the total 14C urinary excretion, 30% of the dose was excreted within 4 h, while 50 and 90% of the dose were recovered in the urine by 24 and 96 h, respectively. Excretion rate of total radioactivity was 60 microgram methyl parathion equivalent/h (1.4 mg/day). By the end of the 96-h experiment, conjugated and non-conjugated metabolites accounted for 78.1 and 21.9%, respectively. Of the non-conjugated metabolites, p-nitrophenol and O,O-dimethyl O-4-nitrophenyl phosphate (methyl paraoxon) were identified by high performance liquid chromatography (HPLC) that accounted for 20%, and 1.9% of total urinary excretion, respectively. Appearance and disappearance rate constants of p-nitrophenol in urine were 0.12 and 0.048 microgram/h, respectively. Conjugated metabolites were classified as: glucuronides 12% of urinary excretion, sulfates 3%, hot sulfuric acid hydrolysable residues 47% and 16.1% remained as unidentified water soluble metabolites. Direct hot acid hydrolysis of urine yielded 49% of extractable 14C-radioactivity compared to 62% when hot acid hydrolysis followed the enzymatic hydrolysis. The presence of the conjugated metabolites as the major class of metabolites of the total excretion indicates that determining only unbound p-nitrophenol as a biological marker for methyl parathion exposure underestimates total urinary excretion of p-nitrophenol. Sequential enzymatic and acid hydrolyses of urine prior solvent extraction are necessary for complete recovery of p-nitrophenol. The results indicate that the present method would show that the pregnant field worker or a housewife being at a greater risk than previously thought.

Administration, Cutaneous↗
PubMed2003

Permeation of captan through disposable nitrile glove.

The purpose of this study was to investigate the permeation of an aqueous emulsion of the pesticide, captan, as a wettable powder (48.9% captan) through a disposable nitrile glove material using an American Society for Testing and Materials (ASTM)-type I-PTC-600 permeation cell. The goal was to investigate the protective capability of the gloves against dermatitis. The analytical method was based on gas chromatography-mass spectrometry (GC-MS) and gas chromatography-electron capture detection (GC-ECD). The least quantifiable limit (LQL) was 6 ng for GC-ECD and 30 ng for GC-MS. Testing was conducted using the ASTM F739 closed-loop permeation method and a worst-case aqueous concentration 217 mg/ml of captan 50-WP. The average permeation rates were low, with 12+/-5 ng/(cm(2)min) after 2h, 50+/-25 ng/(cm(2)min) after 4h, and 77+/-58 ng/(cm(2)min) after 8h. The calculated diffusion coefficient was (1.28+/-0.10) x 10(-5)cm(2)/h. No significant swelling or shrinkage occurred at P</=0.05. Infrared (IR) reflectance analysis of pre- and post-exposure glove surfaces confirmed no outer or inner surface degradation. The disposable nitrile glove showed excellent resistance to a highly concentrated aqueous emulsion of captan. Because the ASTM normalized breakthrough detection time of 250 ng/cm(2) was <2h, these gloves should not be reused once worn, and decontamination is not advised. Protection is also advised for agricultural reentry field workers, because captan has been shown to persist on crops with a half-life greater than the current reentry intervals of 1-4 days.

Captan↗
PubMed1988

Arthroscopic treatment of osteochondritis dissecans of the scaphoid.

Osteochondritis dissecans of the carpal scaphoid has been reported only rarely in the literature. A 29-year-old, right-hand-dominant oil-field worker with symptomatic osteochondritis dissecans of the left carpal scaphoid was treated by arthroscopic debridement and drilling of the lesion. Preliminary follow-up at 9 months revealed a dramatic relief in his symptoms.

Adult↗
PubMed1992

DNA fingerprinting in non-human populations.

DNA fingerprinting of non-human populations is beginning to fulfill its early promise, and in the past year there has been a flush of papers on mammalian breeding systems. However, many people, particularly field workers, believe that progress in this area has been slow. Attention is now focused on two amenable alternatives: microsatellite polymorphisms and randomly amplified polymorphic DNA. Of these, it is probable that microsatellites hold the key to rapid, efficient and highly informative screening of the genetic variability that exists within natural populations.

Animals↗
PubMed1999

Hepatitis E virus infection prevalence among selected populations in Iowa.

BACKGROUND: HEV causes an enteric infectious disease endemic in developing areas with hot climate. A case of endogenous HEV infection has been reported in the US. Recently, HEV-like virus was isolated from swine in Iowa. Swine production is a major industry in Iowa with the potential for human exposure to swine in and around industrial and family farm operations. OBJECTIVE: The study objective was to determine whether individuals in Iowa are exposed to HEV. STUDY DESIGN: Anti-HEV antibody prevalence in four selected Iowa populations was determined. Sera were collected from 204 patients with non-A, non-B, non-C hepatitis (non-A-C); 87 staff members of the Department of Natural Resources (DRN); 332 volunteer blood donors in 1989; and 111 volunteer blood donors in 1998. All sera were tested for anti-human HEV IgM and IgG by ELISA with confirmation of positivity by a peptide neutralization test. RESULTS: Both the patients with non-A, non-B, non-C hepatitis (4.9%) and the healthy field workers from the Iowa DNR (5.7%) showed significantly higher prevalence of anti-HEV IgG antibodies compared to normal blood donor sera collected in 1998 (P < 0.05). CONCLUSIONS: Human HEV or a HEV-like agent circulates in the Iowa geographical area. At-risk human populations with occupational exposure to wild animals and environmental sources of domestic animal wastes or with unexplained hepatitis have increased seroprevalence of HEV antibodies.

Agricultural Workers' Diseases↗
PubMed2003

Engaging the community in research: lessons learned from the malaria vaccine trial.

When staff of the Papua New Guinea Institute of Medical Research first went into Wosera in 1979, to try and interest the community into participating in malaria research, the traditional warning sign of crossed bamboo sticks constantly blocked their path as they tried to enter the villages. In 2003, the site is a thriving research centre, with many projects under its belt, a successfully executed malaria vaccine trial to its credit, and approximately 13000 people from 29 villages currently participating in demographic surveillance and various research projects. It has been a long road from community suspicion to sustainable community participation, and the field workers have learned many important lessons along the way that can be applicable to research programs in other disease-endemic areas.

Clinical Trials as Topic↗