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[Sexually transmitted diseases: notification in Chile, in the V region and in the Vinã Del Mar-Quillota health service (1977-1988)].

Reports of sexually transmitted diseases in the Vth Region of Chile from 1977 to 1988 were analyzed and compared to nationwide reports and to figures for the Viña del Mar-Quillota area. Overall rates of syphilis decreased during the period. In contrast both number of cases and risk of disease increased for gonorrhoea. Risk of syphilis and gonorrhoea was highest in the Vth Region. HIV infection is increasing, especially in the area covered by the Health Service in Viña del Mar-Quillota. Sexually transmitted diseases not subject to reports were screened along with routine examinations for cancer of the cervix. Infection rates of 9.9% for trichomona and 1.09% for candida were thus detected.

Acquired Immunodeficiency Syndrome↗

The EPI in Borno State, Nigeria: impact on routine disease notifications and hospital admissions.

An earlier report on the Nigerian expanded programme on immunization (EPI), covering 1974-1988, failed to demonstrate a clear-cut impact of the programme. This report attempts to determine the effectiveness of EPI in Borno State, Nigeria. We analysed trends in routine notifications for diphtheria, pertussis, tetanus, tuberculosis, measles, and pneumonia, from 1985 to 1991; data on poliomyelitis were excluded because of poor documentation, while we included data on pneumonia for comparison. We also performed a before (1983-1987) after (1988-1991) comparison in terms of the intensifications of EPI by age-specific strata amongst paediatric hospitalization for all EPI diseases at the University of Maiduguri Teaching Hospital, the sole referral hospital for childhood infectious diseases. Our results show an apparent reduction in morbidity from diphtheria, pertussis, tetanus, measles and pneumonia, and this was particularly prominent following intense vaccinations between 1988 and 1991. The reduction in these EPI diseases and pneumonia occurred despite the prevailing adverse socioeconomic conditions, and the absence of a specific control strategy for pneumonia in Nigeria. On the other hand, in spite of national BCG coverage of about 90% there has been a recent (1989-1991) increase in the registered cases of tuberculosis in infants and older children in Borno State. There is a need to intensify other intervention measures alongside EPI activities.

Adult↗

Notification of disease. Worthwhile or not?

Disease notification is part of the community surveillance system for control of infectious diseases, but it has fallen into disuse. Understanding the goals and mechanisms of surveillance allows us to respond most appropriately to the needs of both our patients and the community.

Australia↗

[More and faster notification of infectious disease if notification is carried out by the laboratories instead of the diagnosing physician].

OBJECTIVE: To investigate if notification by the laboratories of a number of Group B diseases (meningococcal disease, whooping cough and hepatitis A) which according to the Communicable Disease Law of 999 must be reported to the local public health authority, would increase the number of reports and the speed at which the reports were made. DESIGN: Comparative study. METHOD: In the participating regions (Den Bosch and north-east Brabant) it was decided that the laboratories would notify the authorities of cases ofmeningococcal disease, whooping cough and hepatitis A. The notifications were compared with those from the middle-Brabant region which was used as a control. This took place in 1997/'98, prior to the start of the notification project and in 2000/'02 when it was running. The number of positive cases of infectious disease confirmed by the laboratories that were reported to the local health authorities and to the Inspectorate of Public Health Services was examined - this is known as the degree of notification. The number of days from diagnosis to notification of the local health authorities was also examined - this is known as the speed of notification. RESULTS: The degree of notification for these three diseases improved from 6I-89% to 87-95% if the authorities were notified by the laboratories. In the control region the degree of notification improved from 29-4I% to 54-60%. The speed of notification increased significantly if notification was done by the laboratories. CONCLUSION: Based on these results it is recommended that the Communicable Disease Law be adapted to allow the laboratories to notify the authorities of cases of infectious disease.

Communicable Disease Control↗

Notification of infectious diseases by general practitioners in New South Wales. Survey before and after the introduction of the Public Health Act 1991 (NSW)

OBJECTIVE: To evaluate attitudes and knowledge about infectious disease notification and the self-reported notifying practices of general practitioners in New South Wales before and after the introduction of the Public Health Act 1991 (NSW). DESIGN: A survey of a random sample of general practitioners in NSW before and after the introduction of the Act. RESULTS: The percentage of doctors who considered notification to be very important increased (57% "before" v. 67% "after"; P = 0.02), as did the percentage who believed that notification usually leads to preventive action (41% v. 54%; P = 0.04). There was no increase in self-reported notification (50% v. 54% who reported notifying cases of notifiable diseases "always, or almost always"; P = 0.42). CONCLUSIONS: Notification of infectious disease by doctors remains suboptimal, but may improve over time as the impact of the new Act is felt. Feedback to doctors showing that preventive action is taken as a result of their notifications may be the most effective way to improve notification practices.

Attitude of Health Personnel↗

Notifications of vaccine preventable diseases in Australia. Quarterly report (January-March 2000).

Vaccine preventable disease notifications for Australia with disease onset dates between January and March 2000 are reviewed. During this quarter, numbers of notifications for Haemophilus influenzae type b disease and measles were the lowest ever recorded, while those for rubella were the lowest recorded since before the epidemic of spring 1992. These are promising trends that are likely to represent a true reduction in disease incidence. Numbers of pertussis notifications declined compared with the last quarter of 1999, but remain high, making up 88% of notifications for the vaccine preventable diseases reported here.

Adolescent↗

[The incidence of respiratory tuberculosis in the province of Leon according to the system of notification of disease mandatory declaration, 1992-1999].

BACKGROUND: Tuberculosis continues to be a major public health problem. Knowing the incidence, trend and geographical spread of reported tuberculosis may serve to evaluate the prevention and control measures implemented and point to further needs. METHODS: Retrospective study of the reported cases of tuberculosis in the province of Leon, broken down by years, Health Care Areas and Basic Health Care Districts for the 1992-1999 period. RESULTS: The average annual incidence rates were 40.3, 38.6 and 44.4 per 100,000 inhabitants/year (10(5) inhabitants/year) for the province of Leon, Leon Health Care Area and Bierzo Health Care Area, respectively. Seventy percent (70%) were males and thirty percent (30%) females. The specific rates by sex in the province of Leon were 55.5 for males and 22.9 per 10(5) for females. The specific rates by age and sex were similar for males and females up to age 25, the incidence among males being much greater as of this age. The geographical spread of tuberculosis in the province of Leon was heterogeneous, the highest incidence being in mining areas. In the Leon Health Care Area, cases among the oldest adults prevailed, no differences being found among young adults and adults over age 55 in the Basic Health Care District. CONCLUSIONS: The province of Leon has an incidence of tuberculosis greater than that estimated for Spain as a whole. It would be necessary to step up epidemiological surveillance and control measure systems as directly-monitored cases detected and systematic study of contacts in order to achieve a greater efficiency regarding the control of this disease.

Adult↗