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PubMed2003

Support among persons infected with HIV for routine health department contact for HIV partner notification.

Public health partner notification (PN) services are provided inconsistently to persons diagnosed with HIV/AIDS in the United States, and some community groups representing persons with HIV/AIDS have opposed widespread application of PN. We surveyed persons with HIV recently reported to our health department and a random sample of HIV-infected persons attending an HIV/AIDS clinic. A total of 95 persons, of whom 76 (80%) were men who have sex with men, completed an anonymous self-administered questionnaire. Eighty-four percent of participants believed the health department should routinely offer everyone diagnosed with HIV help in notifying their partners; 79% indicated they would be somewhat or very likely to provide information to a doctor, case worker, or health department employee for purposes of PN; and 20% indicated they wanted help in notifying a recent sex partner. Seventy-eight percent of participants believed the health department should contact all HIV-infected persons after diagnosis to help them access medical care and social services, and 68% wanted the health department to contact them about the availability of medical or social services. In contrast to common public perceptions, these results suggest that most persons with HIV support health departments routinely contacting people after HIV diagnosis and that many want assistance with PN.

Adult↗
PubMed1998

Notification of infectious diseases by junior doctors in accident and emergency departments.

OBJECTIVE: To assess the knowledge about notifiable infectious diseases by accident and emergency (A&E) senior house officers. METHODS: A telephone questionnaire of senior house officers was carried out over a one week period at the end of their six month attachment in A&E departments in Northern Ireland. RESULTS: 81 (91%) of the senior house officers participated in the study; 23 (29%) realised that the doctor diagnosing the notifiable disease had a statutory duty to notify that disease; nine (11%) were aware there were three statutory lists in the United Kingdom. Knowledge about which infectious diseases require notification varied from 79/81 (98%) for meningococcal disease to 15/91 (19%) for methicillin resistant S aureus. Seventy nine (98%) of the doctors thought that a poster displayed in the A&E department would be helpful. There was no significant difference between duration of qualification and performance on the questionnaire (p = 0.2). CONCLUSIONS: Despite varying experience, junior doctors in A&E do not know which infectious diseases are notifiable by statute. They felt that it would be helpful to have a poster in the A&E department listing the notifiable diseases of that region. To encourage accurate reporting, interregional variation between the statutory lists should be abolished and replaced by one nationally agreed list.

Communicable Diseases↗
PubMed1998

[Neurocysticercosis: contribution of autopsies in the consolidation of mandatory notification in Ribeiräo Preto-SP,Brazil].

Neurocysticercosis is a serious public health problem in several countries of Asia, Africa and Latin America. The objective of the present study is to present autopsy findings of neurocysticercosis in the Pathology Division of the University Hospital, Medical School of Ribeirão Preto, University of São Paulo, from 1992 to 1997. Neurocysticercosis was detected in 38 (1.5%) of 2522 autopsies. In twenty two (57.9%) of these, the diagnosis was made post-mortem, while 16 (42.1%) had a previous diagnosis of cysticercosis based on laboratory and imaging studies. Reviewing the medical records, we found that 21 patients (55.2%) were neurologically asymptomatic, while the various clinical manifestations in the others were in accordance with the literature. The high frequency of asymptomatic individuals detected only post-mortem indicates the importance of autopsies as an additional source of data to consolidate the compulsory notification of cysticercosis. Considering the results of this study, the new coefficient of prevalence of cysticercosis in Ribeirão Preto is 67 cases/100,000 inhabitants.

Aged↗
PubMed1997

Tuberculosis notifications in Australia, 1995.

This is the fifth annual report of the National Mycobacterial Surveillance System (NMSS), for new and relapsed cases of tuberculosis notified to State and Territory health authorities in 1995. Cases of atypical mycobacterial infection notified to the scheme are also briefly summarised. The notification rate for new cases of tuberculosis was 5.47 per 100,000 population, and for relapsed cases 0.28 per 100,000. These rates have remained stable for a number of years in Australia, and are low compared with rates in other countries. Some identifiable groups in the Australian community continue to experience higher rates of tuberculosis, including members of indigenous communities and some groups born overseas. Surveillance through the NMSS has a major role to play in the control of tuberculosis.

Adolescent↗
PubMed1999

Lessons from patient notification exercises following the identification of hepatitis B e antigen positive surgeons in an English health region.

The results of hepatitis B virus (HBV) serology from notification exercises conducted in cohorts of patients exposed to three surgeons positive for hepatitis B e antigen (HBeAg) identified in one English health region in 1994 and 1995 were reviewed. Of 777 patients notified, serology results at six months or more after exposure were available for 514 individuals who had not received post exposure prophylaxis. In one case DNA analysis confirmed transmission of HBV from surgeon to patient. Pre-existing natural immunity to HBV was found in a further 19 patients, none of whom had evidence of recent infection, and in 13 patients (classified as cases of undetermined origin) transmission during surgery could not be excluded. The overall estimated transmission rate was 0.2% for confirmed cases (95% confidence interval (CI) 0.004-1.1) and 2.7% (95% CI 1.5-4.5) if cases of undetermined origin were included. The management of recall exercises should consider the risks of the operative procedures performed and the time that has elapsed since exposure.

Adolescent↗
PubMed2002

PCR and the notification of meningococcal disease.

The polymerase chain reaction (PCR) can be used to investigate suspected meningococcal infection, with rapid results. We became aware that Birmingham Health Authority was not being informed about certain patients on whom meningococcal PCR had been performed. To establish whether notification was overlooked in some patients with suspected meningococcal disease, or whether PCR was performed on patients in whom it was thought meningococcal disease was unlikely, we compared numbers of patients notified to us over six months who had PCR with numbers of patients not notified who had PCR. Between 1st August 1999 and 31st January 2000, 54 PCR requests were made on seventy-seven notified patients; 51 PCR requests were made on non-notified patients and none were positive. Median age and length of stay were shorter in the non-notified patients. We conclude: (i) PCR may be being used inappropriately on younger patients who have shorter admissions and are unlikely to have meningococcal disease; (ii) in a number of patients initially admitted and notified with meningococcal disease the diagnosis is subsequently reconsidered. A 'denotification' procedure for such patients could make information on meningococcal disease more reliable.

Adolescent↗
PubMed1996

Attitudes to prenatal testing and notification for HIV infection in Nairobi, Kenya.

Four hundred antenatal clinic attendants were surveyed for their attitude to testing and notification for HIV infection test results. The participants were systematically sampled from the antenatal clinic at the Kenyatta National Hospital, Nairobi, and interviewed using a closed-ended structured questionnaire. All the attendants had heard of HIV, and only 5(1.3%) did not know how Acquired Immunodeficiency Syndrome (AIDS) presents. Fifty one percent of them had no objection to their blood being tested for HIV. In fact, 52.5% thought, wrongly, that blood was routinely tested for HIV at the hospital's antenatal clinic. More than one third (35.8%) of respondents wished their permission to be obtained before the testing and 95% wished to be informed of the test result. Acceptability of testing was 33.8%, for Named Voluntary Testing, 62.0% for Universal Testing and 1.0% for Anonymous Testing. All the women said they would want to use a method of contraception, principally tubal ligation, if found HIV seropositive and 63.7% would seek a termination of pregnancy. In this study population, acceptability and expressed willingness to know HIV test results and willingness to let a spouse/sexual partner know the result was high. This paper makes recommendations that HIV testing be made available at the ANC, together with competent pre and post-test counselling.

Adolescent↗
PubMed1997

Epilepsy and driving in South Australia--an assessment of compulsory notification.

We examined the licensing of drivers with conditions likely to endanger the public in a State in which doctors are obliged to notify the licensing authority. During 1991, 1460 medically endorsed licenses were cancelled. A sample of 245, including all 49 with epilepsy were mostly voluntary, the twenty exceptions with retained files being drivers with epilepsy. In the same period, 115 traffic accidents were attributed to illness, with the only four (4) investigated by the licensing authority being those with licenses endorsed "epilepsy" where a seizure was responsible. Compulsory notification appeared to result in the identification of epilepsy as the important medical reason for controlling licenses, but failed to recognise sleep disorders or alcoholism, both more significant causes of traffic accidents. In those accidents attributed to illness, almost no action was taken to review the medical fitness of drivers, suggesting a reliance on doctors rather than police or road safety authorities.

Accidents, Traffic↗
PubMed1997

[A handling program for resistant pneumococci. Physicians sometimes neglect mandatory notification].

Streptococcus pneumoniae infections belong to the leading worldwide causes of illness and death among young children, people with underlying debilitating medical conditions, and the elderly. Following early documentation of infections due to pneumococcal strains with reduced penicillin susceptibility in Australia in 1967, and of infections due to penicillin-resistant strains in South Africa in 1978, pneumococcal resistance to penicillin and other antibiotics has progressed rapidly and is now a global problem. In Sweden, notification of the occurrence of pneumococci with a minimum inhibitory concentration (MIC) > or = 0.5 mg/L for penicillin G (PcG) has been mandatory for general practitioners (GPs) and clinical microbiological laboratories since 1 January 1996. In 1996, 1,057 cases of infection by such pneumococci were reported by microbiological laboratories, but only 262 cases by GPs. With a view to minimising the impact of pneumococci with reduced penicillin susceptibility in Sweden, the National Board of Health and Welfare set up a working group of experts in November 1994. To reduce the transmission of such bacteria in the community, the working group introduced a control programme which includes the isolation of day-care children under six years of age carrying pneumococci with PcG-MICs > or = 0.5 mg/L. An enquiry among the 25 regional centres for infectious disease control in the country to ascertain compliance in the different counties of Sweden showed the programme to have been adhered to in a majority of counties, although many had chosen alternative measures to deal with the problem.

Disease Notification↗
PubMed1998

Tuberculosis notifications in England: the relative effects of deprivation and immigration.

SETTING: Metropolitan areas of England, including London boroughs, in 1991. OBJECTIVE: To investigate the relative importance of deprivation, immigration and the elderly in explaining variations in tuberculosis rate. DESIGN: A retrospective study using multiple Poisson regression models to assess the interrelationship between various population parameters. RESULT: Significant differences ere observed between London and other metropolitan districts in the measures of tuberculosis, immigration and the elderly. In addition, all population parameters were significantly intercorrelated in London: areas with a high proportion of immigrants had high levels of deprivation and low proportions of elderly. In other metropolitan districts, only immigration and the Jarman index were significantly associated, and removing the immigration component from the index removed this statistical significance. Multiple Poisson regression models revealed that the immigrant index had the strongest explanatory power in explaining tuberculosis rates, but there were significant interactions between this and measures of urban deprivation indices. That is, there was a greater effect of increasing deprivation at lower levels of immigration than at higher levels. This phenomenon was more pronounced in London boroughs than other metropolitan districts. The elderly index had no significant influence on tuberculosis rates. CONCLUSION: Although the association between tuberculosis and deprivation previously reported for the city of Liverpool is confirmed across all urban areas of England, the immigrant proportion of the population has a greater statistical power in explaining variations in rates of urban tuberculosis. However, tuberculosis notifications can be most accurately predicted by combining both measures than by either one alone.

Aged↗
PubMed1986

Decreasing the incidence of surgical wound infections. Validation of a surveillance-notification program.

In an attempt to validate the observations of a previously published ten-year study of surgical wounds, we studied 8,474 wounds over an 18-month period using a protocol nearly identical to that of the previous study. Our study corroborated the following predictors of clean-wound infection: increasing duration of surgery, age less than 1 or greater than 50 years, increasing duration of preoperative hospitalization, use of drains, and shaving and emergency surgery. We failed to corroborate use of wound irrigation as a protective measure or time of preoperative shaving as a significant variable. Most importantly, we found a 42% reduction in the clean-wound infection rate during the study period (1.9% to 1.1%), adding support to the concept that a wound surveillance program with surgeon notification is both efficacious and cost-effective.

Adolescent↗
PubMed1991

Drake Chemical Workers' Health Registry Study: I. Notification and medical surveillance of a group of workers at high risk of developing bladder cancer.

A medical surveillance program and epidemiologic study of 408 former workers of the Drake Chemical Company (now a Superfund waste site) was established in 1986. The Drake Health Registry Study was initiated because these workers had probable past exposures to beta-naphthylamine (BNA), a potent bladder carcinogen. The registry is widely viewed as a model for notification of workers at high risk of disease due to past occupational exposures. By the 40th month, 90% of the 366 living workers had been notified of the existence of the registry; 262 had been enrolled in the annual or semi-annual screening for bladder cancer. Among these, 27 persons have had abnormal screening results indicating moderate to high risk of bladder cancer and have been made eligible for further diagnostic tests. While no invasive bladder tumors were found among 18 persons completing the extended diagnostic evaluation, two diagnoses of moderate to severe dysplasia have been made. The registry has also identified three living and three deceased cases of bladder cancer in the cohort; a mortality analysis showed a 20- to 30-fold excess of bladder cancer. An incidence projection, based on the six identified cases, reveals that between six and ten new bladder cancer cases are likely to occur among the Drake cohort over the next 20 year period.

2-Naphthylamine↗
PubMed1993

Worker notification: viewpoint of the employer.

Prior to notifying workers of risk exposure, employers should first consider and weigh the psychological, physiological, and social costs as well as the potential negative impact on labor-management relations, community resources, and the costs of false negatives and false positives. Only if the contributions of notification override and outweigh the composite costs should employers feel compelled to notify workers.

Communication↗
PubMed1993

Content of worker notification.

This article summarizes discussions held during the workshop on the issue of the content of worker notification messages and related topics. The workshop itself involved a number of sessions where participants formed small groups. This article represents a distillation of the summary reports by the rapporteurs from each group. It is not intended as a complete review of this issue. Rather, it presents some of the concerns that arose during freewheeling discussions, with the idea that the points raised may help others to think about some of the issues involved.

Communication↗
PubMed1993

Beyond notification: a case study from Cloquet, Minnesota.

All members of Local 158 of the United Paperworkers International Union in Cloquet, Minnesota, were invited to attend a meeting to notify them about the outcome of the Union's study concerning exposure to asbestos fiber. Union members and their families were contacted by letter, radio and television announcements, area newspapers, and word of mouth. They were informed about the medical screening that was being planned and about other information on asbestos-related diseases. During the meeting, they were asked to attend one of the educational sessions, to schedule an appointment for the screening, and to fill out a medical history. It was determined that paperworkers with asbestos-related disease might have rights to at least two types of compensation: worker's compensation from their employers and/or court- or jury-awarded compensation from asbestos manufacturers. Other sources of compensation such as social security of disability pensions might also be available to eligible individuals. The Union did not have a complete listing of all the individuals who worked at plants or in operations where asbestos exposure may have occurred. The Union solicited the aid of the Minnesota Department of Health to help identify former asbestos-exposed workers and to develop an ongoing screening and medical program for workers who were exposed but did not develop symptoms of asbestos-related disease; these illnesses usually take 20 years or more to develop. However, the Union was able to follow-up the notification and subsequent screening by sending members and their families the results of the initial screenings and other information concerning the status of any legal actions taken on behalf of the exposed.(ABSTRACT TRUNCATED AT 250 WORDS)

Asbestos↗
PubMed1995

Surveillance and prevention of work-related carpal tunnel syndrome: an application of the Sentinel Events Notification System for Occupational Risks.

In response to limitations in state-based, occupational disease surveillance, the California Department of Health Services developed a model for provider- and case-based surveillance of work-related carpal tunnel syndrome. The objectives were to enhance case reporting, identify risk factors and high-risk work sites, and link preventive interventions to work sites and the broader community. Using elements from surveillance of communicable diseases and sentinel health events, a model was integrated into the pre-existing reporting system in one California county. Between 1989 and 1991, 54 Santa Clara County health care providers reported 382 suspected cases, of which 365 from 195 work sites met reporting guidelines. Risk factors were profiled from interviews of 135 prioritized cases and 38 employers. Of 24 work sites prioritized for a free, voluntary, nonenforcement inspection, 18 refused and 6 completed an on-site visit. Sentinel Event Notification System for Occupational Risks (SENSOR) captured many cases not reported to the pre-existing reporting system. Case interviews indicated a profile of symptoms and signs, treatment, and exposure to uncontrolled occupational risk factors, including a lack of training on ergonomics hazards. Employer health insurance, rather than workers' compensation, was the apparent source of payment for most medical bills. Employers lacked knowledge and motivation to reduce ergonomic risks. Governmentally mandated occupational ergonomics standards are urgently needed.

Adolescent↗
PubMed1999

Tailored risk notification for women with a family history of breast cancer.

BACKGROUND: Evidence indicates that although first-degree relatives of breast cancer cases are at increased risk of developing the disease themselves, they may be underutilizing screening mammography. Therefore, interventions to increase the use of mammography in this group are urgently needed. METHODS: A randomized two-group design was used to evaluate an intervention to increase mammography use among women (N = 901) with at least one first-degree relative with breast cancer. A statewide cancer registry was used to obtain a random sample of breast cancer cases who identified eligible relatives. The mailed intervention consisted of personalized risk notification and other theoretically driven materials tailored for high-risk women. RESULTS: An overall significant intervention effect was observed (8% intervention group advantage) in mammography at post-test. There was an interaction of the intervention with age such that there was no effect among women <50 years of age and a fairly large (20% advantage) effect among women 50+ and 65+. Health insurance, education, and having had a mammogram in the year before baseline assessment were positive predictors of mammography at post-test. Perceived risk, calculated risk, and relationship to index cancer case were not associated with mammography receipt. CONCLUSION: The intervention was successful in increasing mammography rates among high-risk women 50+ years of age. Further work is needed to determine why it was ineffective among younger women.

Adult↗
PubMed1989

An evaluation of the notification of birth form.

Data on 108 Notification of Birth Forms, from a total of 6 hospitals, have been compared with hospital case notes, for both accuracy and completeness. Items related to socio-demographic features of mothers were reliable. However, certain items related to past obstetric history, such as date of last birth and number of previous live births, were less than 90% reliable. Data on index pregnancy were poorest, with three items, first visit to doctor during pregnancy, first visit to hospital during pregnancy and rubella immune status all less than 75% reliable. Data from one hospital were of poorer quality than others, principally because the information on the form is not obtained directly from the mother. Data on forms related to travellers (N = 29) were also of poorer quality.

Birth Certificates↗