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PubMed2001

Epidemiology of bancroftian filariasis in three suburban areas of Matara, Sri Lanka.

The epidemiological parameters of bancroftian filariasis were investigated in three suburbs of Matara, within the south-western coastal belt of Sri Lanka where the disease is endemic. The overall prevalence of microfilaraemia and the geometric mean density of the microfilaraemias observed were 4.4% and 20.6 microfilariae/60 microl fingerprick blood, respectively. Prevalence was significantly lower in the female subjects than in the male, and in males aged < 20 years than in older males. Overall, 9.5% of the subjects had the clinical manifestations of bancroftian filariasis (6.4% had filarial fever, 3.0% had elephantiasis and/or oedema, and 6.2% had hydrocele). The prevalence of elephantiasis/oedema was generally higher among the female subjects (4.2%) than among the male (1.4%), and an age-prevalence plot for this manifestation showed a linear increase in prevalence after the age of 40 years. Hydrocele also became commoner with increasing age, but this increase in prevalence began at the lower age of 20 years. More than 60% of the cases of elephantiasis/oedema but only 26.3% of the subjects found to have hydroceles experienced filarial fever attacks. The cases of fever and elephantiasis/oedema (but not those of microfilaraemia or hydrocele) were aggregated within households. However, the children whose mothers were microfilaraemic were much more likely to be microfilaraemic themselves (8.7%) than the children who had amicrofilaraemic mothers (2.8%), microfilaraemic fathers (0.0%) or amicrofilaraemic fathers (2.7%). The results of entomological surveys indicated that transmission of Wuchereria bancrofti occurred throughout the year in the study community.

Adolescent↗
PubMed2003

Pregnancy outcomes among nulliparous teenagers in suburban Nigeria.

Our objective was to study the pregnancy outcomes among teenagers in a rural Nigerian setting. Single births to 1394 nulliparous mothers aged <or=19 during 1996-2001 at three district general hospitals were studied retrospectively. The outcome of pregnancy was compared with that of 1488 older nulliparae aged 20-24 years who delivered during the study period. Compared with women aged 20-24 years, patients of 15 years or less were at higher risk for anaemia, premature labour, low birth weight, and operative deliveries. However, the older teenagers (16-19 years) were less at risk. When women with inadequate prenatal care were removed from analysis, the risks in younger teenagers were not significantly different from those of older mothers. This calls for action to make prenatal care more available to teens, particularly those less than 15.

Adolescent↗
PubMed2000

Out-of-hours primary care and the patients who die. A survey of deaths after contact with a suburban primary care out-of-hours service.

OBJECTIVE: To assess how and to what extent out-of-hours primary care facilities care for patients who die shortly afterwards, and whether information about deaths and causes of deaths are fed back to doctors who treated the deceased persons. DESIGN: An observational prospective study of patients who die. SETTING: An out-of-hours primary care facility providing services to a population of 78,000. SUBJECTS: 531 patients who died in the 1-year study period. MAIN OUTCOME MEASURES: Extent of reporting back about deaths to the out-of-hours primary care facility and description of contacts with out-of-hours primary care prior to death. RESULTS: 134 of 531 deceased patients had been treated by an out-of-hours primary care physician within the last 4 weeks of life. The physicians had received information about the cause of death in only 9 of the cases (6%). Six dead patients (5%) had their condition misinterpreted by the out-of-hours primary care physicians, with a possible delay in appropriate care. CONCLUSION: Prompt feedback of causes of death to primary care physicians represents an important, but mostly unexploited, potential for quality improvement.

Aged↗
PubMed2001

Suburban transmission of Q fever in French Guiana: evidence of a wild reservoir.

The annual incidence of Q fever in French Guiana was found to have increased in 1996 and was 37/100,000 population over the last 4 years. Subsequent investigations in Cayenne and its suburbs indicated that a wild reservoir of the bacteria was responsible for the epidemiologic pattern. A case-control study showed that residence near a forest and occupations and activities that result in exposure to aerosols of dusts from the soil are risk factors for Q fever. By means of time-series analysis, a strong positive correlation between rainfall and the incidence of Q fever with a time lag of 1-3 months was found. The spatial distribution of the cases showed that transmission occurs widely throughout greater Cayenne, which is incompatible with a pinpoint source of contamination. Transmission from livestock and dissemination of the bacteria by the wind appeared to be unlikely, which strengthens the hypothesis that a wild reservoir is responsible for transmission.

Adolescent↗
PubMed1993

Quality comparisons between privately and publicly managed health care centres in a suburban area of Stockholm, Sweden.

As in many other countries, the health care system in Sweden is currently undergoing rapid changes. Within a framework of public financing, the delivery of health care is to an increasing extent being transferred to various entrepreneurs; private, public or cooperatives. A privately run, but publicly financed, health care centre was evaluated with regard to quality and costs. Quality was defined in terms of the central guidelines for Swedish primary health care: first level responsibility, accessibility, a holistic view of the patient, and continuity of care and safety. The services offered by the private health care centre were evaluated by different methods--questionnaires, health care utilization data and economic analyses--and found to be of similar quality but produced at a lower cost than by three publicly managed health care centres.

Community Health Centers↗
PubMed1992

Prevalence of olfactory dysfunction, hearing deficit, and cognitive dysfunction among elderly patients in a suburban family practice.

Olfactory and hearing senses diminish with age, and cognitive dysfunction increases. The association between sensory deficits and cognitive dysfunction has not been well studied. This paper presents the results of testing a group of 50 community-dwelling patients of a family physician who developed a computer-assisted comprehensive geriatric assessment program. Olfactory dysfunction was present in 39% of subjects, with 18% being unable to detect smoke. There was no correlation between olfactory dysfunction and cognitive dysfunction. Hearing deficit, however, was found in 10% of subjects, all of whom also had either an associated olfactory or cognitive dysfunction. This study demonstrates the high prevalence of olfactory and auditory dysfunction in an ambulatory geriatric population, with a possible association between hearing deficit and cognitive dysfunction. The problem of multiple sensory deficits should be addressed in any long-term management decisions regarding elderly patients.

Aged↗
PubMed2005

Predictors of indoor exposure to mouse allergen in urban and suburban homes in Boston.

BACKGROUND: Mouse allergen exposure is prevalent among urban children with asthma. Little is known about mouse allergen exposure in children at risk for the development of allergic diseases. AIMS OF THE STUDY: To assess indoor mouse allergen exposure in early life among children with parental history of asthma or allergies. METHODS: Prospective birth cohort study of 498 children with a history of allergy or asthma in at least one parent living in metropolitan Boston. RESULTS: Of the 498 participating children, 357 (71.7%) resided outside the city of Boston and 439 (90.7%) lived in households with incomes > 30,000 dollars. Mouse allergen was detected in 42% of the homes of study participants. In a multivariate analysis adjusting for sex, income, and endotoxin, black race [odds ratio (OR) = 3.0; 95% confidence interval (CI) = 1.3-6.6, P = 0.009], signs of mice in the home at age 2-3 months (OR = 3.0; 95% CI = 1.6-5.6, P = 0.0006), and kitchen cockroach allergen levels > or = 0.05 to < 2 U/g (OR = 1.8; 95% CI = 1.1-3.2, P = 0.02) were associated with detectable mouse allergen in the kitchen. In this model, living in a single detached house was inversely associated with detectable kitchen mouse allergen levels (OR = 0.4; 95% CI = 0.2-0.6, P = 0.0001). CONCLUSION: Infants with a parental history of asthma or allergies are commonly exposed to mouse allergen in their homes. Among infants at high risk for atopy, predictors of increased mouse allergen levels included black race, reported mice exposure, and moderate levels of cockroach allergen.

Air Pollution, Indoor↗
PubMed1989

School adjustment, school performance and peer relations among first-graders in a Swedish suburban area.

A study of 95 first-graders in one school management area used teacher ratings of problems and sociometric ratings to assess school adjustment and peer relations; 14% of the children had difficulties in reading/writing, motor skill, concentration and psychosocial function. Behavioural problems did not generally coincide with poor scholastic performance, but a small group (6.3%) exhibited problems in both reading/writing, concentration, gross and fine motor skill and psychosocial functions. Sociometric results showed only moderate agreement with teacher ratings. Extremely popular boys had no teacher-rated problems, but children with teacher-rated problems did not to any high degree tend to be isolated. Poor gross motor skill did distinguish isolated boys from others, a relationship that was not evident among the girls. The need to study the validity of teacher ratings as well as the prognostic value of school adjustment in first grade was stressed.

Achievement↗
PubMed1989

A longitudinal study of mental health problems in a suburban population in Sudan.

A psychiatric study of 197 children living in villages outside Khartoum was made in 1964-1965. In 1983, 104 randomly chosen subjects were investigated again. All were interviewed by a psychiatrist and somatically examined. The overall psychiatric impairment was 14% (males, 18%; females, 8%) according to the psychiatric interview; the Self-rating Questionnaire gave a higher figure (28%). The rate of somatic illness was similar: 14% according to the medical doctor, 22% according to the self-rating of the subjects. Childhood data predicted 17% of the variance in adult mental health. Somatic state of health in childhood and traditional type of work by the father were the most important variables. Data from the life situation of the individual explained 67% of the variance in adult mental health.

Adolescent↗
PubMed1986

Dental caries status of young children in a suburban community of Mexico City.

One hundred and thirty-four children, 6 to 7 yr of age from a public school in Tepepan, Mexico were examined for the prevalence and severity of dental caries. Average deft score was 6.08 and defs was 12.15. Average DMFT and DMFS scores were .57 and .99 respectively. It was observed that 66% of primary teeth with carious lesions required one surface restoration and 11% three or more surface restorations. In the permanent dentition 99% of the affected teeth required one surface restoration. A comparison of the results with those of the Mexico City public school children survey (1980) showed that the Tepepan children had a similar caries level in primary teeth and a lower caries level in permanent teeth. Although the Tepepan group showed fewer carious lesions, their caries index and unmet restorative index are still high, especially for primary dentition, so an intensive educational, preventive and restorative program is required.

Child↗
PubMed1979

Paediatric services within the primary health care system in suburban areas.

Results from a few studies on community paediatrics in suburbs of Stockholm are presented. Pattern of diagnoses, utilization of care and social and psychological team work are discussed. Goals of the paediatric service in the primary care are set up and a distribution of duties between different professionals is suggested.

Child↗
PubMed1992

Giardiasis causing chronic diarrhoea in suburban Copenhagen: incidence, physical growth, clinical symptoms and small intestinal abnormality.

During a six-year period, 29 children (aged 0.7-13.5 years, mean 3.3 years) suffering from chronic diarrhoea due to giardiasis were studied. The incidence of this illness was 81 per 1,000,000 children aged 0- < 7 years per year. According to growth charts, relative height and weight of the patients decreased significantly (approximately 0.5 SD) from before the onset of diarrhoea to the time of diagnosis and subsequently increased up to the end of catch-up growth. Small intestinal mucosal specimens were studied. Two patients had severe villous atrophy, 8 moderate abnormalities, 6 only light changes and 13 biopsies were normal. D-xylose or lactose malabsorption was detected in 25% of the patients. The lactose malabsorption was due to hereditary low lactase levels. None of the patients with a Danish ethnic background showed lactose malabsorption. D-xylose absorption and the relative weight loss of the patients correlated with the degree of mucosal damage. Patients with persistent diarrhoea (n = 19) were younger and had a shorter duration of diarrhoeal illness and a more significant weight reduction than those with intermittent diarrhoea (n = 10). However, the age at onset of symptoms was similar in the two groups (medians 1.3 years). Seven patients contracted the disease abroad. They all developed persistent diarrhoea and had a more severe course of the illness than those who acquired the disease in Denmark.

Adolescent↗
PubMed2006

Comparison of parent and student responses to asthma surveys: students grades 3-12 and their parents from a suburban private school setting.

Schools are being called upon to help address asthma, a common problem in school-aged children. School-based asthma programs need information about asthma diagnoses, asthma symptoms, and asthma's impact on school attendance. Parent or student surveys are the most common method of collecting these data. However, medical literature offers little guidance to help schools determine whether parents or students are the most appropriate and effective source of asthma-related information. This study compares student and parent responses to the same set of asthma-related questions. In general, parents and students have a high level of agreement in reporting the absence of an asthma diagnosis or asthma symptoms. When parents and students disagreed, students reported many more asthmalike symptoms, especially symptoms with exercise and symptoms at night, than did their parents. The disparity in student and parent symptom reporting did not vary by age of the student. Students appear to provide the most sensitive measure of asthma-related problems.

Adolescent↗
PubMed2003

Ehrlichia-like organism gene found in small mammals in the suburban district of Guangzhou of China.

The 16S rRNA gene of Ehrlichia genus was examined from the blood and spleen of 26 wild small mammals that were captured at a canine feed lot where the first case of canine ehrlichiosis was found in south of China in 1998. Samples (3 blood and 1 spleen) from Rattus norvegicus were positive by polymerase chain reaction. The amplimers were then cloned and sequenced. All of the 16S rRNA gene sequence of these samples were found to be same and unique when compared with the other members of genus EHRLICHIA: The most closely related species was Ehrlichia-like sp. Schotti variant (99.03% related), which was detected and identified in Dutch Ixodes ricinus ticks by Schouls in 1999. The organism found on these animals was obviously not the species of E. muris, which was isolated and identified from a wild mouse in Japan in 1995, since the relatedness of this gene between the former and the latter was 93.28%. It is unclear whether this organism can cause disease in other mammals, including human beings.

Animals↗