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[Asphyxiation by suffocation and strangulation in children younger than 15 years of age].

OBJECTIVE: Our aim was to describe non-intentional strangulation or suffocation suffered by children under 15 years of age. METHODS: Records from the Medical Examiner's Office showed child death by non-intentional strangulation or suffocation from January 1, 1991 to December 31, 2001. RESULTS: A total of 44 suffocations or non-intentional strangulations were registered. Overall mortality was 3.62/1,000,000 persons-year (27.57/1,000,000 in children < 1 year of age, 1.94/1,000,000 in older children); 63.6% were males. Most frequent mechanisms included neck entrapment between bars 18.2%, facial obstruction by bed clothes 15.9%, being covered by rubble, sand, or garbage 15.9%, strangulation by cord, chain, or strip 11.4%, and strangulation by dress or bed clothes 9.1%. CONCLUSIONS: Nearly all registered deaths could be prevented by education, supervision, or structural modifications. Strategies should also include obligatory standards for manufacturing and for warnings on labels.

Accidents↗

Vector-borne disease problems in rapid urbanization: new approaches to vector control.

Owing to population growth, poor levels of hygiene, and increasing urban poverty, the urban environment in many developing countries is rapidly deteriorating. Densely packed housing in shanty towns or slums and inadequate drinking-water supplies, garbage collection services, and surface-water drainage systems combine to create favourable habitats for the proliferation of vectors and reservoirs of communicable diseases. As a consequence, vector-borne diseases such as malaria, lymphatic filariasis and dengue are becoming major public health problems associated with rapid urbanization in many tropical countries. The problems in controlling these diseases and eliminating vectors and pests can be resolved by decision-makers and urban planners by moving away from the concept of "blanket" applications of pesticides towards integrated approaches. Sound environmental management practices and community education and participation form the mainstay of some of the most outstanding successes in this area. On the basis of these examples, it is argued that the municipal authorities need to apply a flexible methodology, which must be based on the possibilities of mobilizing community resources, with minimal reliance on routine pesticidal spraying. In this way, vector control becomes a by-product of human development in the city environment. This is now a true challenge.

Animals↗

Disposal of injection material used for the treatment of hepatitis C: comparison with insulin-dependent diabetes and thromboembolism.

AIM: The survey conducted in the Provence-Alpes-Cote d'Azur region in France in 1999 showed that 38% of patients infected with the hepatitis C virus (HCV) receiving interferon injections in their home were aware of the recommendations concerning the disposal of injection material and that 41% of the needles were discarded with household waste after use. The purpose of our study conducted in the Centre region of France was to ascertain how injection material used by HCV-positive patients for interferon treatment are disposed of in comparison with material used by patients injecting insulin for insulin-dependent diabetes mellitus (IDDM) or low-molecular-weight heparin (LMWH) for thromboembolism. MATERIAL AND METHODS: A questionnaire to be completed by patients was proposed to HCV-positive patients attending hepatogastroenterology clinics in the Centre region hepatitis C network for therapeutic follow-up (N=113 patients) between October 2001-January 2002. The same questionnaire was proposed to patients attending follow-up consultations for insulin-dependent diabetes mellitus (N=85 patients) or thromboembolism (N=23 patients) between March-June 2002. RESULTS: Significantly more patients stated they were aware of recommendations for disposal of injection material in the HCV group (89%) than in the IDDM (67%) or LMWH (26%) groups (P<0.01). Injection material was discarded with household waste less often by patients in the HCV group (6%) than in the IDDM (32%) or LMWH (29%) groups (P<0.001) and more often collected in a safety box prior to incineration (73% in the HCV group versus 63% and 14% in the IDDM and LMWH groups respectively). The safety box was discarded with household garbage more often by patients in the IDDM (54%) or LMWH (50%) groups than in the HCV group (0%) (P<0.001). Equivalent proportions of the patients said they recapped the needle after use (HCV 83%; IDDM 93%; LMWH 84%). DISCUSSION: Information concerning use of safety boxes for disposal of injection material should be provided to patients in order to comply with regulatory recommendations on proper disposal of used injection material. Moreover, the habit of recapping needles (89% of all patients in this study) is still widespread.

Adolescent↗

Bacterial contamination of the housefly Musca domestica, collected from 4 hospitals at Cairo.

Four general hospitals were surveyed for bacterial contamination of the house fly, M. domestica which were caught inside the hospital sites and outside surroundings, especially, general garbages. Fly collections were made using the hanging sticky ribbon traps (spiralette). Bacterial isolation was made from each sample both externally and internally during two successive years representing the different seasons of the year. Twenty one bacterial isolates were identified from the 4 surveyed hospitals belonging to six families; Enterobacteriaceae (9 species each), Brucellaceae (2 species), Acromobacteriaceae and Pseudomonodaceae (one species each).

Animals↗

[The ecological and epidemiological principles of prevention of ascariasis under the conditions of large-scale solid waste storage].

The paper presents the results of a study of the impact of large-scale solid waste storage on ascariasis morbidity in the population. The use of sewage sediments as an organic soil fertilizer to grow strawberries and table greens is shown to substantially increase the risk of Ascaris infection in the population. Storage of solid domestic garbage on specialized dumping grounds does not lead to mass environmental pollution with geohelminthic eggs.

Adolescent↗

Socio-demographic and environmental factors associated with Aedes breeding places in Phuket, Thailand.

This study aimed to determine the socio-demographic and environmental factors influencing potential breeding sites of the dengue vector in Phuket Province. Three hundred houses were recruited by cluster random sampling for larval inspection. Of all the types of water containers, a high proportion of tires and discarded items were infested by Aedes larva (42% and 32%, respectively). Due to the abundance of water tanks, jars for using water and discarded containers (1.7, 2.1, 0.8 per house), these were the main breeding sites (0.29, 0.35, and 0.28 infested containers per house, respectively). Buddhists' houses were significantly more likely to have a larvae-infested flower vase than Muslims' houses. Townhouses had relatively few infested containers, while those on rubber plantations had 18.3 times higher odds of having at least one container with larva. No window screens increased the odds of larva infestation in the discarded containers by 4.2 times. With this information and given a reliable piped water supply, the number of water containers can be reduced to minimize the breeding places. Garbage should be properly disposed of. Screens should be installed, if possible. Buddhists should be advised on the proper protection of flower vases.

Adolescent↗

[Intestinal parasitoses in a village of Côte d'Ivoire. I: Control and prevention plan].

The goal was to develop a complex medical, hygienic, sanitary and educational plan for control and prevention of intestinal parasitic infections in the rural areas in Ivory Coast. In a village situated at the border of the Ebrié lagoon, 416 persons were examined: 371 children, of which 343 were school and preschool children, aged 4 to 15 years (195 boys and 148 girls), 28 young children aged 6 months to 3 years, and a group of 45 adults. The parasitologic exams included perianal swabs (Graham's method), stool examination using saline solution, iodized solution (Lugol) and preparation Kato-Miura's method in thick layer. Parasitic intensity was done for helminths and worm burden have been carried after specific treatment of roundworms. Hygienic conditions as environment, school, dwelling and personal hygiene, eating habits, drinking water sanitation, garbage disposal, toilets, reproduction areas of hematophagous and mechanical vectors etc. have recorded. The prevalence of intestinal parasites was 84.8% in children (with 76.7 % polyparasites) and 29.0 % in adults. The results pointed out a hyperendemic zone. Parasitic infectious transmitted from person to person was frequent among children: 37.3% pinworms in school children, 30.3% amoeba cysts and 30.3% flagellate. Infections transmitted by soil were predominant, with 62.1 % roundworms (78.6 % in children aged 7 to 10 years) presenting an important parasitic intensity and worm burden. The parasitoses transmitted as larvae were frequent, only Strongyloides stercoralis being most frequent parasite in adults compared to children. A feasible plan of control the intestinal parasites has been established in collaboration with the local hospital, village leaders and health workers. Short-term measures have been carefully chosen, targeting especially the schools, teachers and health workers. The first health education measure concerns the hand cleanliness at home and at schools. It was suggested that a bucket of water be used per class, that the water be changed more often during the day, and soap be made available at all time. Lessons on the ways of transmission of parasites will be introduced in schools. A door-to-door education plan was discussed with village health workers and hospital nurses and laboratory technicians during the maternal-infantile prophylactic visits. The health education problems have been discussed extensively with village health workers. As a preliminary example, the prevention and campaign against the pinworm, a common parasite in children was chosen, whose transmission mechanism from person to person can be easily understood by children and mothers. Simultaneously the prevention of parasitic infections contributes extensively to the prevention of other serious diseases, as the typhoid fever etc. which are endemic in the region. Long-term preventive measures have been discussed with village leaders. The first measure is to fix the deep-well drinking water pump station of the village, financed by outside parties, with labour provided by the village. Measures for proper maintenance of the water pump station have also been discussed with representatives of the village. The program of the World Health Organization and National Institute of Hygiene of Ivory Coast concerning the periodic treatment of intestinal helminths, especially A. lumbricoides, given to all school aged children was discussed.

Adolescent↗

Behavior of cellulose-degrading bacteria in thermophilic anaerobic digestion process.

Previously, we found that the newly isolated Clostridium sp. strain JC3 became the dominant cellulose-degrading bacterium in thermophilic methanogenic sludge. In the present study, the behavior of strain JC3 in the thermophilic anaerobic digestion process was investigated quantitatively by molecular biological techniques. A cellulose-degrading experiment was conducted at 55 degrees C with a 9.5 L of anaerobic baffled reactor having three compartments (Nos. 1, 2, 3). Over 80% of the COD input was converted into methane when 2.5 kgCOD m(-3) d(-1) was loaded for an HRT of 27 days. A FISH probe specific for strain JC3 was applied to sludge samples harvested from the baffled reactor. Consequently, the ratio of JC3 cells to DAPI-stained cells increased from below 0.5% (undetectable) to 9.4% (compartment 1), 13.1% (compartment 2) and 21.6% (compartment 3) at day 84 (2.5 kgCOD m(-3)d(-1)). The strain JC3 cell numbers determined by FISH correlated closely with the cellulose-degrading methanogenic activities of retained sludge. A specific primer set targeting the cellulase gene (cellobiohydrolaseA: cbhA) of strain JC3 was designed and applied to digested sludge for treating solid waste such as coffee grounds, wastepaper, garbage, cellulose and so on. The strain JC3 cell numbers determined by quantitative PCR correlated closely with the cellulose-sludge loading of the thermophilic digester. Strain JC3 is thus important in the anaerobic hydrolysis of cellulose in thermophilic anaerobic digestion processes.

Bacteria, Anaerobic↗

Rapid assessment procedures in environmental sanitation research: a case study from the northern border of Mexico.

BACKGROUND: There is a need to enhance the quality and sustainability of environmental health programs in Mexico. What socio-cultural factors influenced the adoption or rejection of Clean Water in Homes programs in this population? We applied rapid appraisal procedures (RAP) to evaluate these community-based programs. METHOD: Qualitative study conducted in communities along Mexico's northern border. We conducted informal dialogues, semi-structured interviews, field notes and observations. Home visits used a checklist to observe: sources of water, handwashing, as well as human waste and garbage disposal patterns. Data analysis was conducted using ATLAS.ti, which facilitated comparison and illustration of discrepancies, the elaboration of emerging issues and relationships between them. RESULTS: Community members perceived that the Clean Water program was a top-down intervention. Water is perceived as a political issue and a matter of corruption. Inequity also limits solidarity activities involved in environmental sanitation. Migration to the United States of America (US) contributes to community fragmentation, which in turn dilutes communal efforts to improve water and sanitation infrastructure. While targeting women as program "recipients", the Clean Water program did not take gendered spheres of decision-making into account. Community members and authorities discussed the main results in "assemblies", particularly addressing the needs of excluded groups. CONCLUSION: The oversight of not exploring community members' needs and priorities prior to program implementation resulted in interventions that did not address the structural (economic, infrastructure) and socio-cultural barriers faced by community members to undertake the health-promoting behaviour change, and provoked resentment.

Adolescent↗

[Humors and odors: body order and social order in nineteenth-century Rio de Janeiro].

Archeological diggings in household garbage deposits from nineteenth-century Rio have uncovered an abundance of equipment used in the elimination of fecal material and phlegm. These findings formed the basis for an analysis and interpretation of the era's attitudes regarding body fluids, as adopted when the mentalities of the new 'bourgeois' segments - then undergoing a process of rise and consolidation - were impregnated by Hippocratic humoralism. The text shows how the introduction of a 'body order' was fundamental in building and keeping the social order in the nineteenth century. It likewise shows how the ideology of hygienization was one of the most important and efficacious strategies for underpinning the bourgeoisie's (victorious) project to achieve hegemony.

Archaeology↗

[Agricultural environment quality of China and its improving countermeasures].

This paper analyzed the present status of China agricultural water and soil environment. It was indicated that the agricultural water environment in this country was more serious, with the affected area being approximately 20% of the total farmland, and 5% of it being severely affected. More attention should be paid to the pollution of agricultural chemicals in soil environment. The impacts of industrial wastes, urban sewage and garbage, agricultural chemicals, and soil erosion on agro-environment were discussed, with the impact degree of these factors analyzed. The major problems in China agricultural environment melioration were presented, related researches and major countermeasures in this country and developed countries were reviewed, and relevant measures and suggestions on improving the agricultural environment quality of China were put forward.

Crops, Agricultural↗

[The eradication of African swine fever in Brazil, 1978-1984].

The African swine fever episode in Brazil was due to trade and tourism between Spain, Portugal and Brazil, at a time when outbreaks were on the rise in Europe. The eradication of the disease, the slaughter of pigs, the elimination of the carcasses and the isolation of affected farms were given wide media coverage, and had a major socio-economic impact. It was forbidden to raise pigs in garbage dumps or to give them feed considered hazardous. Analyses performed in Brazil as well as national and international investigations by researchers from reference laboratories concluded that the disease had spread from Rio de Janeiro to other states, as is stated in official reports. Following emergency measures, a control programme was implemented, leading to enhanced quality in the pig farming sector. The authors describe epidemiological surveillance of African swine fever, classical swine fever and related diseases, biosafety in swine farming, and the emergency action plan comprising animal health training for veterinarians and social workers. The results of the eradication programme were excellent, despite the controversy over compulsory sacrifice in a country with serious social problems. In 2004, Brazil was the fourth largest pork producer and exporter, with an output of 2.679 million tons and exports of 508,000 tons to international markets with very high standards.

African Swine Fever↗

Infanticide in Eastern Croatia.

For the layperson no crime is more difficult to comprehend than the killing of a child by his or her own parents. This is a retrospective study of neonaticide and infanticide in Eastern Croatia from 1980 to 2004. Judicial records of infanticide cases stored in Regional and County Courts were analyzed for the circumstances surrounding the offense. Twenty-four babies were discovered in various places during investigating period of time. The victims were almost equally divided between boys (12) and girls (11). The gender of one baby was unknown. The mean weight of babies was 2.7 SD = 0.66 kg. The perpetrators preferred rubbish-heaps (33.4%), burying in soil (16.7%), various premises in or around the house (16.7%) and garbage cans (12.5%) as places for hiding the dead babies. The most dominant cause of death in sixteen cases of live birth was asphyxia (37%) with equal distribution of smothering, stuffing the mouth with rags and strangulation. Other frequent causes of death were placing the child in a plastic bag and abandonment (25%), brain injury (25%) and wounding using a sharp weapon (12.5%). The cause of death for six babies remained unknown due to advanced decomposition. Two babies were stillborn. The age of accused mothers varied from 16 to 33, mean 24 SD=5.2 years. Most of them were unmarried (60%) and had limited formal education. They usually kept the pregnancy a secret (73%) and gave birth (93%) without public welfare assistance. The mother lived in the terror of shame and with the guilt that accompany conception without marriage. Fear seemed to be a pronounced motivating factor for committing infanticide. The data on court proceedings were available in fifteen cases. The mothers were officially indicted in all cases for infanticide under the Croatian Criminal Code. The perpetrator remained unidentified in nine suspicious crimes. The court convicted ten mothers of the crime of infanticide. Often juries were unwilling to punish the mother, citing the mother's lifelong guilt of having killed her child as enough punishment.

Adolescent↗

Bacteria fauna from the house fly, Musca domestica (L.).

The house fly, Musca domestica has long been considered a potential agent for disease transmission ever since its existence. The general truth of this assertion remains undisputed till the present day in spite of increasing awareness toward an improved sanitation and better hygiene. The habitual movement of house fly from filthy substrata such as human faeces, animal excreta, carcasses, garbage, etc. makes them ideal candidates for disease transmission such as cholera, shigellosis, salmonellosis and others when settling on food. Fly as a potential mechanical vector of pathogenic bacteria was elucidated in this study by examining flies from various breeding sites such as food courts, dumping ground, food processing areas and poultry farm in Peninsular Malaysia. The flies were baited with 10% sugar solution on a glass slide in the field. All materials used for collection of samples were sterile. Bacteria from fly sample were isolated using the normal isolation technique. Bacillus sp., Coccobacillus sp., Staphylococcus sp., Microccus sp., Streptococcus sp., Acinetobacter sp., Enterobacter sp., Proteus sp., Escherichia sp., Klebsiella sp. and yeast cells were isolated from feaces, vomitus, external surfaces and internal organs of house fly. Newly emerged house fly did not harbour any bacteria.

Animals↗

[Chromatin diminution at the border of the XX and XXI centuries].

The size of genomes in eukaryotic organisms is one of the greatest mysteries of biology. As known from the middle of the XX century, the level of organization of a particular organism, does not depend on its genome size, i. e. on DNA amount in the nucleus. We believe that an actual function of non-coding DNA stands behind the phenomenon of chromatin diminution, known already for 100 years. Diminution of chromatin normally takes place in cells involved in body building and never occurs in developmental precursors of germ cells. Apparently, the former are cells, in which non-coding DNA is functionally significant. We cloned a fraction of DNA eliminated during chromatin diminution of Cyclops kolensis (Cyclopoida, Crustascea) and sequenced 90 clones totally making 32 kb. Taken together, the provided evidence has demonstrated a high organization ordering of DNA sequences restricted to the germ line. Chromatin diminution never takes place in human cells and in cells of the majority of animals. These cells may isolate non-coding DNA in other ways, making it unreactable for most enzymes and thus functionally cut off. Thus, a certain part of genome with a particular size and structure may serve for genetic isolation of species as shellfish or junk DNA are vital components rather than pieces of garbage.

Animals↗

Knowledge, attitude, and practices related to Kala-azar in a rural area of Bihar state, India.

The Indian Government aspires to eliminate Kala-azar by 2010. Success of any disease control program depends on community participation, and there is no published data about the knowledge, attitude, and practices of the community about Kala-azar in endemic regions of India. For this knowledge, attitude, and practices (KAP) study, the heads of 3,968 households in a rural area, consisting of 26,444 populations, were interviewed using a pre-tested, semi-structured schedule. Most of the study subjects (97.4%) were aware of Kala-azar. Fever (71.3%) and weight loss (30.5%) were the most commonly known symptoms. The infectious nature of the disease was known to 39.9%. The majority believed that the disease spreads by mosquito bites (72.8%). For 63.6%, the breeding site of the vector was garbage collection. Only 23.6% preferred the public health sector for treatment, and 55.9% believed that facilities at primary health centers are not adequate. Poor knowledge of the study subjects about the disease and breeding sites of the vector underscores the need for health educational campaigns if the elimination program is to succeed.

Adolescent↗

Occurrence of hydatidosis in slaughter buffaloes (Bos bubalis) and helminths in stray dogs in Kathmandu Valley, Nepal.

The study aimed at identifying the occurrence of hydatidosis in slaughter buffaloes and helminth eggs, particularly Taenia spp. eggs in stray dogs' fecal samples in Kathmandu Valley, Nepal. The study period was from November, 2004 to April, 2005. A total of 500 buffalo carcasses in a slaughterhouse, at the riversides and individual butchers'sites were examined for the presence of hydatid cysts. The cyst fluid was collected and microscopically examined to determine if it was fertile or not. Of the 500 carcasses examined, 10.6% had hydatid cysts. Specifically, the slaughterhouse carcasses had a 6.7% occurrence of hydatid cysts, whereas those examined at riversides and individual butcher places had 10.0% and 12.7%, respectively. Distributions of the hydatid cysts by specific organs showed single occurrence of 6.4% in lungs, 2.4% in livers and 1.8% in both, livers and lungs. In a total of 53 infected buffaloes, 58.5% were fertile and 41.5% sterile cysts. Overall, 366 faecal samples from stray dogs were collected around buffaloes slaughtering areas (slaughterhouse and individual butcher places), riversides, garbage sites and temple sites. These samples were examined by formalin-ether concentration technique to investigate the presence of different helminth eggs. The total prevalence of Taenia, hookworms, Trichuris/Capillaria,Toxocara, Spirometra and Physaloptera eggs were 12.8%, 18.3%, 19.1%, 12.8%, 1.4% and 1.9%, respectively.

Abattoirs↗

[Assessment of medical waste management in a Palestinian hospital].

We studied medical waste management in a Palestinian hospital in the West Bank and the role of municipality in this management. In general, "good management practices" were inadequate; there was insufficient separation between hazardous and non-hazardous wastes, an absence of necessary rules and regulations for the collection of wastes from the hospital wards and the on-site transport to a temporary storage location inside and outside the hospital and inadequate waste treatment and disposal of hospital wastes along with municipal garbage. Moreover, training of personnel was lacking and protective equipment and measures for staff were not available. No special landfills for hazardous wastes were found within the municipality.

Benchmarking↗