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PubMed1993

[Variations by canton in the use of medical observation centers of the disability-insurance in Switzerland].

The Medical Observation Centres of the state Disability Insurance (COMAI) are specialized agencies serving the cantonal commissions of the Disability Insurance in Switzerland. Using data collected for each case examined by the COMAI, utilisation rates and rankings were established for each canton. Utilisation rates varied by a factor of 40 from one canton to the next. This observed variation is independent of the number of new cases presenting to the Disability Insurance and of the number of disability pensions granted. Rankings were also independent of denominators used to define utilisation rates. These results suggest possible non-uniform application of state directives concerning the use of the COMAI, and unequal access to these specialized agencies. The reasons for these variations are the object of a study now underway.

Disability Evaluation↗
PubMed1998

[National reference centers for surveillance of infectious diseases in Switzerland: results of a delphi study].

The national reference laboratories are one of the tools used by public health authorities to control infectious diseases. The Swiss Confederation supports 9 national reference centers (NC), each dealing with a limited number of infectious agents. The purpose of this study was to evaluate if this network meets present day needs, whether it has to be redefined, and how it can be improved. Using the Delphi technique, 34 experts in the field of infectious diseases were questioned to establish a concept for NC in Switzerland. The main result of this study is that official reference laboratories are considered necessary. However, depending on the type of infectious agent, the following types of laboratories should be used: national reference centers, specialized laboratories and laboratories abroad. The study also defined criteria for the designation of NC, their field of action (general objectives, tasks, duration of the mandate, infectious agent to be monitored), evaluation criteria, and the type of funding. Furthermore, possible improvements in the present system were identified and the establishment of good collaborations with reference centers abroad was proposed.

Communicable Diseases↗
PubMed1997

[Vaccination against influenza in Switzerland].

Influenza is still an important cause of morbidity and mortality in our country. The yearly vaccination of the population at risk is always the best method of prevention and for the limitation of health care costs. Today the protection of elderly people and health care professionals by vaccination is not sufficient. Development of information programs, sensibilisation and motivation of the community on a national basis and in line with the health care insurers are necessary. The vaccine's reimbursement since 1996 following the respective legal change will certainly help to promote vaccination against influenza. On the other hand, the competition of different vaccines introduced in Switzerland in the last years will additionally support the penetration of information and vaccination.

Adult↗
PubMed1991

Cancer mortality in young adults in Switzerland, 1951-1989.

Trends in mortality from all neoplasms and major cancer sites in Switzerland among populations aged between 20 and 44 years are presented. In men total cancer mortality was approximately constant around 270/10(6) between 1951 and 1965, but declined appreciably thereafter to 217 per million in 1980-1989. The overall fall was 20%. The pattern of trends was similar for women, although a modest decline was already apparent in the earlier calendar period, and the overall fall was 29% (from 303 to 215/10(6)). These favourable trends reflect therapeutic advancements for Hodgkin's disease, leukaemias, testis and (chiefly non-epithelial) ovarian cancer, better control of cervical cancer, the long-term decline in gastric cancer, but also the downward trends in cancer of the intestines and a few less common sites, such as gallbladder and thyroid neoplasms for reasons that are not yet clear. Appreciable rises were observed for lung and other tobacco-related sites in women, for the oral cavity in men and (in earlier calendar periods) cutaneous melanoma in both sexes. Although restricted to a selected number of sites, these rises are discouraging, since the causes of these neoplasms have long been recognized. Somewhat discouraging also is the absence of decline in male lung cancer. These problems notwithstanding, the overall pattern of trends in cancer mortality in young Swiss adults over the last few decades is still reassuring, particularly in comparison with those observed in other European countries, and in the more general framework of the debate on the perspectives of progress in cancer control. Although restricted to a small proportion of all cancer deaths, in fact, trends in young adults offer useful indications on the likely future trends in the same generations in the near future, since they reflect more recent changes in the pattern of exposure. The size of the changes, however, will probably differ, since the prevalent cancers in middle age are different from those in the young.

Adult↗
PubMed1993

A multivariate example of case-cohort analysis: neonatal mortality in Switzerland, 1979-81.

A study of all births in Switzerland during the years 1979-81 is used to illustrate the advantages of the case-cohort design for this epidemiologic analysis of neonatal mortality. The example shows that familiar associations between infant mortality and explanatory variables such as sex and weight at birth can be precisely estimated using only a sample from the full cohort.

Birth Rate↗
PubMed2000

[Prevalence of tobacco use in Switzerland in the 1990's--estimation of consumption trends based on 2 methods].

Smoking prevalence rates in Switzerland in the 1990s++ have been estimated from Perma data, which have been available quarterly since 1991, as well as from the data of the first and second Swiss Health Surveys, conducted in 1992/93 and 1997. Both sources--each providing data on more than 10,000 respondents--have been large-scale surveys that have used different but complementary survey designs. The probabilistic sampling design of the Health Surveys assures representative findings; the Perma data, although obtained through a non-probabilistic sampling design, permits trend analysis as Perma uses multiple measurement points and therefore time-series methodology can be applied. Both Perma and the Health Surveys yielded approximately the same prevalence of 37% male smokers in 1992/93 and 39% in 1997. For females Perma gave 4% higher prevalence rates than the Health Surveys (Surveys 1992/93: 24%; 1997: 31%). For both sexes the increase in total smoking prevalence was accounted for mainly by adolescents and young adults. Whereas the Surveys showed an increase from 29% to 41% (18% to 39%) in males (females) aged 15 to 19 years, the corresponding increase derived from Perma was 50% less. Except for this youngest age-group, differences between the methods remained within standard statistical norms. There is no doubt, however, that smoking in adolescents increased between 1992/93 and 1997.

Adolescent↗
PubMed1976

The laboratory diagnosis and epidemiology of Mycoplasma pneumoniae in Switzerland.

The analysis of approximately 60,000 serum samples collected from patients with different clinical symptoms between 1965 and 1975 in Switzerland yielded positive reactions indicating a recent infection with Mycoplasma pneumoniae in 2-30% during this period. Among 1,555 patients with clinical symptoms of an acute respiratory infection, 359 patients or 23% had antibody titers indicating a recent infection with M.pneumoniae. On the basis of these results it is concluded that M.pneumoniae is the most frequent cause of acute infections of the respiratory tract.

Antibodies, Bacterial↗
PubMed1996

The last 3 months of life of cancer patients: medical aspects and role of home-care services in southern Switzerland.

The clinical data on terminal cancer patients who have died since the establishment of a program of collaboration between community services and the cancer center of Canton of Ticino, southern Switzerland, were retrospectively analyzed to describe the characteristics of patients seen and the effect on them of a home-care program coordinated by the cancer center. The home-care program is based on five geographically grouped community-based domiciliary services, with the addition of one nurse responsible for coordination and one physician from the oncology center. Selection criteria for participation in the home-care program are defined. The main outcome measures were: number of hospitalizations and median hospital stay during the last 3 months of life; reasons for and median length of last hospitalization; place of death of patients who had home care and those who did not. In the group of 993 patients analyzed, the median contact time with the cancer center was 9.5 months (10th percentile: 1 month, 90th percentile: 71 months); the most frequent neoplasm was lung cancer (22%) with the briefest contact time (7.5 months; 10th percentile: 1 month; 90th percentile: 21 months); 13.5% of patients were never hospitalized; half of the patients had a total hospital stay of 24 days or longer and 23% died at home. The sociodemographic and medical characteristics of home-care users were similar to those of the home-care non-users and to those of the overall group. In the group of home-care users (32% of the total) 22% were never hospitalized, half of the patients had a total hospital stay of 17 days or longer, and 43.5% of them died at home. These values were significantly different (P > 0.001) from those reported in the group of home-care non-users. Palliative care, provided at home through community-based domiciliary services, is associated with less frequent and shorter hospitalizations in the last 3 months of life. Medical oncology and palliative treatments should be mutually complementary to improve patients care. Cancer centers should be involved in the planning and coordination of supportive-care domiciliary services.

Aged↗
PubMed1996

Risk factors for sporadic salmonellosis in Switzerland.

A case-control study was conducted to identify determinants for the acquisition of sporadic Salmonella infection in Switzerland. Over a one-year period (1993), 223 case-control pairs were enrolled in the study and risk factors were assessed by means of self-administered questionnaires. Three-quarters of the isolates were identified as Salmonella enteritidis, most of which (80%) belonged to phage type 4. There were distinct differences in risk factors between infections with Salmonella enteritidis and those with other Salmonella serovars. In both groups recent travel abroad was positively associated with illness. This association was more pronounced for infections with non-enteritidis salmonellae [odds ratio (OR) 39.5; 95% confidence interval (CI) 6.6-236.8, compared to Salmonella enteritidis 4.0; 95% CI 1.8-9.1]. Among the presumably imported infections, Salmonella enteritidis was acquired mostly in other European countries, while other serovars were acquired mostly in countries outside of Europe. Eating food containing raw or undercooked eggs during the three days before the onset of illness increased the risk of infection with Salmonella enteritidis. Desserts made with raw eggs (OR 4.6; 95% CI 2.0-10.6) were more strongly associated with disease than consumption of soft-boiled eggs (OR 2.1; 95% CI 1.2-3.7), suggesting that the risk of infection was dependent on the extent to which eggs were cooked. Egg consumption was not associated with infections with serovars other than Salmonella enteritidis; however, the intake of medications other than antacids was found to be a risk factor (OR 3.5; 95% CI 1.1-11.4).

Adult↗
PubMed1995

Occurrence of different genospecies of Borrelia burgdorferi sensu lato in ixodid ticks of Valais, Switzerland.

A total of 825 adult ticks (727 Ixodes ricinus, 72 Dermacentor marginatus and 26 Haemaphysalis punctata) was collected from vegetation in Valais (Switzerland) in 1987 to 1992. They were examined for the presence of Borrelia burgdorferi sensu lato, the etiologic agent of Lyme borreliosis. B. burgdorferi sensu lato was detected by indirect immunofluorescence assay, dark field microscopy and/or culture in 221 out of 727 I. ricinus (30.4%) and none in the other two species. From these 221 infected ticks we obtained 50 isolates. Indirect immunofluorescence assay and culture were used for all ticks but dark field examination has also been performed and compared to the two above mentioned methods for 231 I. ricinus. Indirect immunofluorescence assay and culture were used for all ticks but dark field examination has also been performed and compared to the two above mentioned methods for 231 I. ricinus. Indirect immunofluorescence was found the most efficient method for the detection of Borrelia in ticks with 54 positive out of 231, followed by dark field examination with 35 positive and culture with 12 isolates. We found no site free of Borrelia where I. ricinus is present. The rate of infection varied from 9.7 to 47.5%, as detected by the addition of the three methods. Typing of the 50 isolates revealed also a nonhomogeneous distribution of the Borrelia species. Based on the electrophoretic mobility of the OspA and B and immunostaining with species specific monoclonal antibodies (H3TS for B. burgdorferi sensu stricto, D6 for B. garinii and J8.3 for B. afzelii) 4 groups could be observed. Half of the isolates (n = 26) were typed as B. burgdorferi sensu stricto, 19 as B. garinii, 3 as B. afzelii and 2 as group VS116. This forth group formed of two isolates from one location is genetically distinct from the 3 former species described in Europe so far. The Borreliae of this group are unreactive with any of the three monoclonal antibodies used.

Animals↗
PubMed1990

Religious intermarriage in Switzerland, 1969-72 and 1979-82.

"Patterns of marriage between Protestants and Roman Catholics in Switzerland during 1969-72 and 1979-82 are investigated using magnitudes of marriage attraction, measures that reflect the propensity to marry independent of population composition. The results show high levels of intermarriage, with religious differences becoming less salient in marriage choice. There is no evidence that the propensity to intermarry is influenced by 'minority group' effects." (SUMMARY IN FRE)

Developed Countries↗
PubMed1992

Epidemiology of vertically transmitted HIV-1 infection in Switzerland: results of a nationwide prospective study. Swiss Neonatal HIV Study Group.

A nationwide study involving 286 children of human immunodeficiency virus (HIV)-infected mothers living in Switzerland has been performed with the participation of all paediatricians interested in HIV infection in the country. Of these children 201 could be followed up prospectively from birth up to a median age of 22 months. Prevalence of HIV infection in Swiss parturients was estimated at 0.1% and apparently remained stable from 1986 to 1989. Vertical transmission rate was estimated at 14%-20%. Variables of maternal or perinatal history were not associated with transmission rate. Transmission to pairs of siblings of the same mothers was discordant in 33% (6 of 18), with always the elder sibling being infected. Postneonatal mortality in infants of HIV-infected mothers followed up from birth was increased 15-fold over the general population with a very high incidence (2 in 100) of sudden infant death apparently unrelated to HIV infection.

Child↗
PubMed1989

Prevalence of antibodies to Borrelia burgdorferi in forestry workers and blood donors from the same region in Switzerland.

Sera from 259 forestry workers and 100 blood donors in the Canton of Solothurn, Switzerland, were tested for IgG antibodies to Borrelia burgdorferi in two EIAs using as antigen either sonic extract of whole organisms or purified flagella. Applying a 95% specific cut-off value based on results in the sera of 100 blood donors, 86 (33%) and 91 (35%) of the forestry workers respectively showed an elevated specific IgG level in the two EIAs. None of the 259 forestry workers had clinical signs of active infection at the time blood was taken, and only nine could recall experiencing erythema-migrans-like skin lesions within the last ten years. Thus, asymptomatic infections must be frequent. Elevated specific antibody levels increased significantly with the age of the forestry workers (p less than 0.0001) and the duration of occupational exposure to ticks (p = 0.0001). Thus serological results in individuals with high exposure to ticks must be interpreted with caution in view of the high a priori prevalence of antibodies to Borrelia burgdorferi in such persons. The prevalence of antibody to the Borrelia burgdorferi flagellum in a control population not selected for tick exposure, in this case blood donors, seems to be independent of geographical origin.

Adult↗
PubMedDate not supplied

[The quantitative evaluation of alcohol use in German and Western Switzerland].

Within the scope of a comprehensive study of social mechanisms of the drinking habits, a household survey was conducted among the 15 to 74-year-old population (sample size: 902). Overall per-capita-consumption figures have been, so far, the only available information on drinking in Switzerland. The data collected on various dimensions, i.e. quantity, frequency and variability of alcohol intake show a wide variety of drinking patterns among the 89% of the population using alcohol. Frequency of beer, wine and fermented cider consumption falls mainly into the three categories: daily use, up to twice weekly, rarely (once a month or less). For hard liquor we found: up to twice weekly, rarely. The Swiss have no definite preferences as to wine, beer or other alcoholic beverages. Yet, in the French speaking part wine is used significantly...

Adolescent↗
PubMedDate not supplied

[Fatal kidney diseases due to analogesic abuse in Switzerland].

As part of an investigation into death by poisoning in Switzerland we were able to examine the register of deaths at the Swiss Federal Bureau of Statistics. All the medical reports which named analgesic nephropathy as being the basic illness and the main cause of death have been taken into consideration in this work. 331 deaths occurred in the five year period 1967-1971, and were studied as closely as the documents allowed. The earliest cases of death arose in the thirties, the maximum number however occurring between the age of 60 and 70. Between the onset of kidney damage and the actual death elapses a period of about 10 years. The ratio from woman to man is almost 2,8:1. The occurrence is particularly frequent among childless housewives. The victims are people of widely different occupations and social classes. The analgesic nephropathy resulting from addiction and leading to death is most frequently encountered among the population of the cities, and the German Swiss Cantons, as well as among people of protestant faith. The shocking number of 331 deaths in five years (in 1973 there were a further 79 cases) bears witness to the need for adequate preventive measures.

Adolescent↗
PubMedDate not supplied

[Regional variation in mortality from ischemic heart disease in Switzerland].

Age standardized mortality from coronary heart disease was found to be higher in the German speaking parts of Switzerland than in the French speaking parts. Mortality from other diseases of the heart does not show a contrary gradient. The same pattern was confirmed among a cohort of Swiss physicians, observed over a 18-year period. Differences in smoking habits cannot explain the differential mortality rates.

Adult↗
PubMedDate not supplied

[Social mechanisms of drinking habits in Switzerland].

In the sociological Section of this interdisciplinery study data are collected on the consumption pattern, the social contexts of drinking, the drinking rules, the attitudes and behavior toward and the social distance to the alcoholic, on popular conceptions of the etiology of alcoholism, social attitudes and on socio-demographic characteristics. The household survey is representative for the French, German and Romanic speaking parts of Switzerland. The psychological section is complementary in the sense that it is, on a smaller scale, based on the same population. However, it deals with the functions of drinking at the individual level. First results will be available in summer 1975.

Alcohol Drinking↗
PubMed1985

Detection of anti-HTLV-III/LAV antibody by enzyme-linked immunosorbent assay in high-risk individuals in Switzerland 1974-1985.

Anti-HTLV-III antibody was tested in frozen sera from high-risk individuals, collected between 1974 and 1985 in Switzerland. All but one of the 262 sera of a control group were negative. Among drug addicts, none of the 78 samples collected from 1974 to 1979 was positive. Antibody was first detected in 1980 and thereafter with progressively increasing frequency. Three of 63 samples from 24 dialyzed patients who had received multiple transfusions showed borderline positive values. None of the seropositive subjects has developed AIDS or AIDS-related complex.

Acquired Immunodeficiency Syndrome↗