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PubMed2003

Epidemiological features of rotavirus infection among hospitalized children with gastroenteristis in Ho Chi Minh City, Vietnam.

An epidemiological study of the G serotype and P genotype distribution of group A rotaviruses by using ELISA and/or RT-PCR was conducted in children (aged 1 month to 15 years) with diarrhea that were admitted to the General Children's Hospital No. 1, Ho Chi Minh City, Vietnam from December 1999 to November 2000. The results showed that rotavirus is associated with 65.6% (889/1355) of diarrheal admissions. Rotavirus infection mostly affected children under 2 years of age with a peak incidence in children 1 to 2 years of age (75.7%) and it occurs year round with a slight seasonal pattern; 99.5% of the specimens could be G-typed: G1 was predominant (68.7%), followed by G4 (15.4%), G2 (12.3%), G3 (0.6%), and G9 (0.5%). High identities of VP7 nucleotide (96.3 to 96.9%) and deduced amino acid (98.1 to 98.4%) were found between two Vietnamese G9 strains and also the recent emergence of G9 strains US 1205, Brazilian R143, and Malawian MW69. Mixed infections were identified in 17 (2.0%), and 5 strains (0.5%) remained untypable. The four most common worldwide strains, G1P[8], G2P[4], G3P[8], and G4P[8], constituted 81.1% of all rotaviruses typed with G1P[8] being the most prevalent type (58.2%). Unusual G/P combinations (11 strains) were detected in 11.7% of all strains, of which, G1P[4] was the most prevalent, accounting for 5.6% of the total. Several combinations of G and P types were observed in this study, suggesting a complex rotavirus infection pattern in Vietnam. This study has provided for the first time clear indication on the circulating G and P genotypes among hospitalized children in Ho Chi Minh City, Vietnam. The results suggest that these viral infections are prevalent among hospitalized children and that the four most common worldwide G types as well as the four most common G-P combinations were also infecting children in Ho Chi Minh City, Vietnam. This result could have important implications for rotavirus vaccine programs and for understanding the epidemiological characteristics of human rotavirus in Ho Chi Minh City, Vietnam.

Adolescent↗
PubMed1987

Human immunodeficiency virus (HIV) seropositivity in intravenous (i.v.) drug abusers in three cities of Italy: possible natural history of HIV infection in i.v. drug addicts in Italy.

The prevalence of human immunodeficiency virus (HIV) antibodies and the symptoms induced [persistent generalized lymphadenopathy (PGL), AIDS-related complex (ARC), acquired immunodeficiency syndrome (AIDS)] was evaluated in several groups of intravenous (IV) drug abusers in three large Italian cities (Milan, Bologna, and Rome). The earliest evidence of seropositivity in sera collected from patients with acute viral hepatitis dates back to 1979 in Milan and to 1981 in Bologna with peaks in 1983 in both cities. In two groups of IV drug addicts on methadone-maintenance treatment at assistance centers, the prevalence of seropositivity differed sharply between Rome (33.3%) and Milan (69.3%) in 1985. Rates of seroconversion were also found to be higher in Milan than in Bologna and Rome. When a population of IV drug abusers voluntarily attending centers for surveillance of AIDS and/or ARC were investigated, high levels (range 55.2-81.5%) of seropositivity were found in the three cities. ARC prevalence among seropositives was very high (range 48.1-64.2% in 1985) in the three cities. The evolution rate to AIDS in Milan was higher among those attending a center for AIDS surveillance (7.4%) than among those attending an assistance center for methadone treatment (0.9%). These data are compatible with the hypothesis that virus infection among IV drug abusers originated in and then spread widely in Northern Italy (Milan first and then Bologna). Both the first appearance and subsequent spread of virus infection are in keeping with the reported occurrence of AIDS cases in the corresponding three regions of Milan, Bologna, and Rome.

AIDS-Related Complex↗
PubMedDate not supplied

A study of spirometry in children from Mexico City.

A study was conducted in two elementary schools in Mexico City to determine values for pulmonary function tests in school-aged residents of Mexico City. The schools were located in Xalostoc, a highly industrialized area of Mexico City, and San Lorenzo, a suburban area of the city. Although data regarding atmospheric pollution were not available, there is an acknowledged higher level of macroenvironmental air pollution in Xalostoc. Pulmonary function tests were performed on 468 children in San Lorenzo and 405 children in Xalostoc. No differences between residents of the two communities for acute or chronic respiratory conditions were detected by questionnaire. The pulmonary function data demonstrate that boys have larger forced vital capacities (FVC) and forced expiratory flows over the middle half of the FVC (FEF25-75) than girls. Slopes of regression lines for FVC but not for FEF25-75 are greater in boys and girls from Xalostoc than in boys and girls from San Lorenzo. This suggests that young children from Xalostoc may experience ill effects of air pollution but develop catch-up growth later. There were no important community or gender effects on slopes of regression lines for height and weight on age. In general, the regression lines for FVC and FEF25-75 were below regression lines reported for children of Mexican ancestry living at sea level.

Adolescent↗
PubMed2005

Incidence of hip fractures in the city of Rosario, Argentina.

In order to determine the incidence of hip fractures (HFx) in the city of Rosario, Argentina, (population, about 900,000), all HFx admitted to 26 medical centers from August 2001 to July 2002 were surveyed. Exclusion criteria were pathological fractures, violent trauma, and fractures in patients living outside urban limits. Demographical data were obtained from the 2001 national census, and the 1991 national census with projections made by the city's statistics department. In the study period, there were 763 HFx in persons aged 50 or older (608 in women and 155 in men). The annual incidence among inhabitants over the age of 50 years was 290 per 100,000 (405 for women, and 137 for men; female/male ratio: 2.96). In the population aged 65 or older, the global incidence was 646 per 100,000 (847 for women, and 343 for men; ratio: 2.47). The mean age (+/-SD) of fractured patients was 79.5+/-9.2 years; median age was 81 years (range: 50-104). Fractured men were younger (76.2+/-9.8 years vs 80.7+/-8.3 years; p <0.0001) and leaner (body mass index [BMI], 24.5+/-3.0 kg/m(2) vs 26.0+/-2.8 kg/m(2); p <0.0001) than fractured women. Most fractured patients either had normal BMI (35%) or were overweight (BMI, 25.1-30.0 kg/m(2); 47.5%). The incidence of fractures increased exponentially with advancing age. Relative risks of HFx (females/males) were calculated for each decade of life; the risk in individuals below the age of 69 was the same in both sexes; in those aged 70 or more the risk was significantly higher among women. Parental origin of fractured patients was mainly Spanish or Italian, reflecting the city's ethnic composition. Most fractures (72.5%) occurred in houses; 20% in apartments, and 7.5% in nursing homes. HFx were trochanteric in 54.4% of cases. Female patients with trochanteric fractures were older than those with cervical ones (80.0+/-9.4 years vs 78.2+/-11.4 years; p <0.01); their weights and BMIs did not differ significantly. The majority of HFx were treated surgically (91.8%); in-hospital mortality was 1.4%. In conclusion, incidence rates of HFx were somewhat higher in Rosario than those found in two other cities of central Argentina one decade earlier.

Aged↗
PubMed2001

Variations of ochratoxin A concentration in the blood of healthy populations in some Croatian cities.

The nephrotoxic mycotoxin ochratoxin A (OTA), a common contaminant of cereals, has been implicated in the etiology of endemic nephropathy. It was also frequently found in low concentrations in blood of healthy populations in countries where endemic nephropathy is not known. However, data on regional and seasonal differences in the frequency and concentration of OTA in human blood are scarce. In June, September and December 1997, and March 1998, about 50 human blood samples were collected randomly from blood donors for blood banks in the Coatian cities of Osijek, Rijeka, Split, VaraZdin and Zagreb. OTA was measured in the total of 983 samples using an HPLC technique with fluorescent detection. The daily intake of OTA was estimated from the mean concentration found in different cities and at different times of year. Samples containing OTA above the detection limit (0.2 ng/ml of plasma) were found in populations from all Croatian cities at all collecting periods. The highest frequency (59%) of samples containing OTA above the detection limit and the highest mean concentration (0.39 ng/ml) were found in June. Both the frequency and the mean concentration were lowest in all samples in December (36% and 0.19 ng OTA/ml, respectively). Osijek was the city with the highest frequency of OTA-positive samples (81%) and the highest mean OTA concentration (0.56 ng/ml). The total mean concentration of OTA in blood of healthy population in Croatia is lower (0.30 ng/ ml) than the mean concentration in European countries as a whole (0.90 ng/ml). The estimated daily intake, calculated from the mean concentration in all blood samples, is 0.40 ng OTA/kg body weight, which is much lower than that proposed by World Health Organization as the tolerable daily intake (16.0 ng/kg body weight). Healthy populations of Croatia are exposed to low, but seasonally and regionally variable amounts of OTA.

Chromatography, High Pressure Liquid↗
PubMed2000

The urban heat island in a small city in coastal Portugal.

This project arose from the need to study the phenomenon of the urban heat island, since only by recognising this phenomenon can we moderate it to improve the human and urban environments. Not only big cities develop urban heat islands. This study detected the presence and recorded the characteristics of an urban heat island in the small coastal city of Aveiro, Portugal. The study was developed through the scheduled measurements of air temperature and the analysis of the geographical, meteorological and urban conditions. The form and intensity of Aveiro's heat island are a response to the interaction of three principal factors: the urban morphology (the hottest zones in the city are those with the tallest and the highest density of buildings, without green spaces and with intense generation of heat from traffic, commerce and services); the meteorological conditions (the intensity of the island is at its maximum when the sky is totally clear and there is no wind, and at its minimum in those situations when there is atmospheric instability, such as wind, cloud and precipitation); and the proximity of the coastal lagoon (which borders the city to the west and northwest and moderates seasonal temperatures. The urban heat island influences the comfort and health of its inhabitants, thus urban planning is very important in the moderation and prevention of this phenomenon.

Air Movements↗
PubMed2000

Epidemiology of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan.

The goal of this study was to determine the incidence of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan. Kaohsiung City is the industrial and commercial center of southern Taiwan, with a population of 1,433,621 in 1996. The number of individuals over 65 years of age accounted for 6.2% of the total population. Data from the archives of reimbursement of the National Health Insurance program were used to investigate the incidence of fractures of the proximal femur. This study detected 580 cervical and trochanteric fractures (40.5 fractures per 100,000 population per year) in 261 males (35.8 fractures per 100,000 men per year) and 319 females (45.3 fractures per 100,000 women per year), with 420 (72%) of these fractures occurring in individuals over 65 years of age. The age-specific incidences of cervical and trochanteric fractures increased exponentially with age in both genders. The overall ratio of cervical to trochanteric fractures was 1:1.04. The mean ages of women with cervical or trochanteric fractures (71.6 and 74.0 years, respectively) were significantly higher than those of males (59.9 and 64.8 years, respectively; P < 0.01). The age-adjusted incidences of fractures of the proximal femur in Kaohsiung City were higher than in other Asian countries, but were lower than in Western countries such as the United States and Norway. The urban lifestyle and low daily calcium intake may be responsible for this increased incidence of proximal femoral fractures in Kaohsiung City.

Adult↗
PubMed2005

Perinatal periods of risk: analysis of fetal-infant mortality rates in Kansas City, Missouri.

OBJECTIVES: The Perinatal Periods of Risk (PPOR) technique was used to analyze resident fetal and infant death data from Kansas City, Missouri, for the period 1998-2002. Results offer important information that can be used to develop community-based prevention strategies related to racial/ethnic disparities in infant mortality rates (IMR). METHODS: The PPOR approach for fetal and infant mortality can be mapped by birthweight at delivery and time of death into four strategic prevention areas: 1) Maternal Health/Prematurity (MHP), 2) Maternal Care (MC), 3) Newborn Care (NC), and 4) Infant Health (IH). For this analysis, all fetal and infant death certificates from the metropolitan Kansas City area were linked to their birth certificates and those associated with residents of Kansas City, Missouri, proper were used to create the dataset used in this analysis. Due to the small number of fetal and infant deaths among other ethnic groups, the analysis was restricted to a comparison of the disparity of IMR between Blacks, Whites, and a national non-Hispanic white reference group. The Kitagawa formula was used to determine contribution to excess deaths from birthweight-specific mortality and birthweight distribution rates. Logistic regression techniques were used to identify risk factors for death among Black fetuses and infants with very low birthweights and also deaths due to sudden infant death syndrome (SIDS). RESULTS: The PPOR analysis showed that of the excess deaths among black infants, when compared to a national reference group, 47% was attributable to MHP and another 29% was attributable to IH. Differences in MC and NC only accounted for 27 and 8% of the total excess deaths. During the study period, rates of sudden infant death syndrome (SIDS) were found to be significantly higher among Blacks as compared to Whites (2.12 vs. 0.81 per 1,000). An analysis of maternal characteristics for SIDS deaths among blacks using a step-wise logistic regression model, found that maternal age less than 20 years old, previous births, inadequate prenatal care, and being a Medicaid recipient were significant-adjusted odds ratios of 23.7 (95% Cl 10.48, 53.67), 8.4 (95% Cl 3.64, 19.21), 2.9 (95% Cl 1.38, 6.05) and 2.5 (95% Cl 1.04, 5.84), respectively. CONCLUSIONS: PPOR is an easy to use approach that helps focus community initiatives for improving maternal and infant health. In Kansas City, Missouri, efforts to further lower IMR in blacks can be achieved through the reduction of risk factors affecting maternal health and through maternal education to improve infant health.

Adolescent↗
PubMed2006

A framework for improving health in cities: a discussion paper.

This paper considers health in cities from the perspective of complex adaptive systems. This approach has a number of important implications for intervention that do not emerge in traditional accounts of cities and health. The paper reviews various accounts of the nature of cities and of health as well as the traditional urban health and Healthy Cities movements. It then provides a framework for intervention and tests it against an actual case study. It concludes that a complex adaptive systems framework opens up fresh possibilities for improving health in urban contexts.

Attitude to Health↗
PubMed1993

The effect of city curfew ordinances on teenage motor vehicle fatalities.

Of 149 large cities surveyed, 72 were found to have nighttime curfew ordinances applying to teenagers of various ages. The typical city curfew identified starts at midnight, ends at 5 A.M., and affects all activity of teenagers ages 13-17 in a public place and unaccompanied by a parent. In comparisons of 47 cities with curfews covering 13- to 17-year-olds and 77 cities without curfews, curfews were associated with a 23% reduction in fatal injury for 13- to 17-year-olds for the 9 P.M.-5:59 A.M. time period. This is identical to the 23% reduction estimated for both fatal and nonfatal motor vehicle injuries for 13- to 17-year-olds in an earlier, more limited study of curfews in Detroit, Cleveland, and Columbus, Ohio.

Accidents, Traffic↗
PubMed1992

The transport of airborne trace elements copper, lead, cadmium, zinc and manganese from a city into rural areas.

The fluxes of the elements lead, zinc, copper, cadmium and manganese have been measured in the insoluble component of bulk deposition derived from Christchurch, New Zealand. Lead, zinc, copper and cadmium fluxes follow approximately exponential decay curves away from the city whereas manganese deposition showed little spatial variation. A similar composite source originating in the city is indicated for the lead zinc, copper and cadmium and a different major source occurs for manganese. In the city and nearby rural areas soil is not a major source of atmospheric lead, zinc, copper and cadmium, whereas at remote sites atmospheric levels of these elements are mostly soil derived. Seasonal variations in the bulk deposition are large within the city, and at upwind rural sites. The variations are controlled by meteorological conditions, in particular wind speed and the height of the mixing layer. Compared with overseas studies, the proportion of the metals occurring in the soluble fraction of the bulk deposition is low. This may be due to the relatively dry climate of the area.

Air Pollutants↗
PubMed1995

Inner-city tuberculosis in the USA.

Tuberculosis (TB) has become more common during the past five years in several areas of the USA. Occurrence has been facilitated by the increasing number of patients with concurrent HIV infection, by cases due to multiple-drug-resistant strains, by incomplete TB therapy among homeless and non-compliant patients, and by cases in immigrants from other countries where TB prevalence is high. These features mean that the major burden of TB today is being borne by inner-city health care facilities that care for the poor. This is illustrated by data from Atlanta, Georgia, where a large proportion of the new cases recognized in the metropolitan area are reported by Grady Memorial Hospital, the public hospital serving the indigent and working poor of the inner city. Similar patterns are recognized in the other USA cities where TB has again become a blight. In view of these epidemiological features, minimizing inner-city TB will require careful attention to diagnosis and isolation procedures in the hospital. Engineering changes at hospitals providing acute care of TB have recently been ordered by the federal government. These promise to be very expensive, and primarily affect the public hospitals, which can least afford them. Innovative treatment programmes are essential, as follow-up after acute care is difficult in this setting. Directly observed therapy can help, but for some cases the era of the TB hospital may have returned. Current attention focuses on legal and ethical issues associated with detaining non-compliant and recalcitrant patients to complete their therapy. Bacille Calmette Guerin (BCG) vaccine is not a priority for this setting at this time.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1994

Estimation of absorbed dose to evacuees at pripyat-city using ESR measurements of sugar and exposure rate calculations.

The external absorbed doses in Pripyat-city resulting from the Chernobyl nuclear power plant accident have been evaluated from eight ordinary granulated sugar samples using the electron spin resonance method. The indoor and outdoor external doses to the people evacuated from Pripyat-city at about 36 h after the Chernobyl accident have been estimated using both data from the eight household sugar samples present in Pripyat-city prior to and during the accident and information on the type of buildings and survey-meter measurements of the exposure rates there. The absorbed dose to the evacuated people, as estimated from the exposure rates calculated in combination with the sugar dosimetry data, agree approximately with the reported average effective dose equivalent to such people, which was derived from both calculations and exposure-rate surveys. If each person in Pripyat-city could remember exactly the proportion of time spent indoors before being evacuated after the accident, the absorbed dose could roughly be estimated from the relationship between the documented external dose outdoors during the period between the accident and evacuation and the length of the period spent indoors by each individual prior to evacuation. It is suggested that as little as 1 g of sugar would be one of the most useful emergency dosimeters for people inside their dwellings, at least for absorbed doses greater than about 0.02 Gy.

Accidents↗
PubMed1992

A comparison of inner-city and upper-middle class youths' exposure to violence.

Exposure to violence in healthy adolescents has not been explored. We questioned 838 youths (ages 11-24 years; 620 females) from two medical clinics. The Exposure to Violence Questionnaire was completed by 403 inner-city adolescents (inner-city group), and 435 middle-to-upper class youths (resort group). Inner-city participants were more often victims, knew of victims, and witnessed more assaults, rapes, knifings, life-threatening events, and murders than their resort group counterparts. In both groups, males were more likely to have been victims, witnesses, and to have known victims personally than were females, except for sexually related crimes. In both settings, youths often did not seek medical or psychological help after victimization. Adolescents are exposed to a startling amount of violence. Violence prevention should be targeted to the inner-city male population.

Adolescent↗
PubMed1994

A comparative analysis of infant mortality in major Ohio cities: significance of socio-biological factors.

"Using linked birth and infant death records for Ohio for the 1984-87 birth cohorts, this paper examines differentials in neonatal, postneonatal, and infant mortality rates in four major Ohio cities....It was found that, compared to Toledo, Cleveland had 51% higher risk of infant death, Cincinnati had 45% higher risk, [and] Columbus had 13% higher risk of infant death. Although in each of these cities, black infants had significantly higher risk of death than white infants, controlling for race alone reduced but did not eliminate the infant mortality differentials among the cities. The results of the hazards analyses reveal that maternal education, marital status, maternal age, birth order, prenatal care, gestational age, and birth weight had a profound net impact on the risk of infant death and that, even after controlling for these and other maternal and infant characteristics, significant city differentials persisted in infant mortality."

Black or African American↗
PubMed2004

Relationship between fluorine in drinking water and dental health of residents in some large cities in China.

In this project, the relationship between fluorine content in drinking water and dental health of residents in some large cities in China was evaluated. The concentration of fluorine in tap water and in urine of local subjects of 28 cities and 4 high fluorine villages in China shows a strong positive correlation (r(2)=0.96, S.E.=0.9881). Our studies indicate that drinking water is the most important source of fluorine intake for Chinese people, and in more than 90% of urban cities, fluorine concentrations in drinking water are below levels recommended by the WHO (approximately 0.5-1.0 mg/l). A 1995 investigation by The National Committee on Oral Health of China (NCOH) shows the relationship between average number of decayed, missing and filled teeth (DMFT) of urban residents and fluorine concentration in drinking water to be negatively correlated but not forming a good linear relationship. Our results, together with the previous study, suggest that: (1) dental caries of the study population can be reduced by drinking water fluoridation and that (2) other factors such as economic level, weather, lifestyle, food habits, living condition, etc., of a city can also affect the incidence of dental caries that cannot be predicted by fluoridation alone. Research on the relation between index of fluorosis (IF) and the fluorine concentration in drinking water for the four high fluorine villages showed that the recommended concentration of fluorine in drinking water can protect from dental fluorosis.

Adolescent↗
PubMed2005

Indoor exposures to air pollutants and allergens in the homes of asthmatic children in inner-city Baltimore.

This paper presents indoor air pollutant concentrations and allergen levels collected from the homes of 100 Baltimore city asthmatic children participating in an asthma intervention trial. Particulate matter (PM), NO2, and O3 samples were collected over 72 h in the child's sleeping room. Time-resolved PM was also assessed using a portable direct-reading nephelometer. Dust allergen samples were collected from the child's bedroom, the family room, and the kitchen. The mean PM10 concentration, 56.5+/-40.7 microg/m3, is 25% higher than the PM2.5 concentration (N=90), 45.1+/-37.5 microg/m3. PM concentrations measured using a nephelometer are consistent and highly correlated with gravimetric estimates. Smoking households' average PM2.5 and PM10 concentrations are 33-54 microg/m3 greater than those of nonsmoking houses, with each cigarette smoked adding 1.0 microm/m3 to indoor PM2.5 and PM10 concentrations. Large percentages of NO2 and O3 samples, 25% and 75%, respectively, were below the limit of detection. The mean NO2 indoor concentration is 31.6+/-40.2 ppb, while the mean indoor O3 concentration in the ozone season was 3.3+/-7.7 ppb. The levels of allergens are similar to those found in other inner cities. Results presented in this paper indicate that asthmatic children in Baltimore are exposed to elevated allergens and indoor air pollutants. Understanding this combined insult may help to explain the differential asthma burden between inner-city and non-inner-city children.

Air Pollutants↗
PubMed2005

Airborne mouse allergen in the homes of inner-city children with asthma.

BACKGROUND: Airborne mouse allergen has not previously been measured in inner-city homes, and its relationship to settled dust mouse allergen levels is unknown. OBJECTIVE: To quantify airborne and settled dust Mus m 1 levels in homes of inner-city patients with asthma and to identify risk factors for mouse allergen exposure. METHODS: One hundred inner-city school-age children with asthma in Baltimore underwent skin testing to a panel of aeroallergens, and their homes were inspected by a trained technician. Air and settled dust were sampled in the child's bedroom. Mus m 1, particulate matter smaller than 10 microns (PM 10 ), and particulate matter smaller than 2.5 microns were quantified in air samples, and Mus m 1 was quantified in settled dust samples. RESULTS: Mus m 1 was detected in settled dust samples from 100% of bedrooms. Airborne mouse allergen was detected in 48 of 57 (84%) bedrooms, and the median airborne mouse allergen concentration was 0.03 ng/m 3 . The median PM 10 concentration was 48 microg/m 3 . Airborne and settled dust mouse allergen levels were moderately correlated ( r = .52; P < .0001), and airborne Mus m 1 and PM 10 levels were weakly correlated ( r = .29; P = .03). Having cracks or holes in doors or walls, evidence of food remains in the kitchen, and mouse infestation were all independently associated with having detectable airborne mouse allergen. CONCLUSION: Airborne mouse allergen concentrations in many inner-city homes may be similar to those found in animal facilities, where levels are sufficiently high to elicit symptoms in sensitized individuals. Exposed food remains, cracks and holes in doors or walls, and evidence of mouse infestation appear to be risk factors for having detectable airborne Mus m 1.

Air Pollution, Indoor↗