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At least 739 records · Page 41Linked to original sources
PubMed2005

Analysis of incidence rates in cluster-randomized trials of interventions against recurrent infections, with an application to trachoma.

A method is developed for the Bayesian analysis of rate ratios of repeated events in matched cluster-randomized trials, and applied to the Flies and Eyes trial against trachoma in The Gambia. A non-mechanistic analysis estimates the incidence rate ratio for insecticide spray, relative to no intervention, as 0.59 (95 per cent credible interval 0.37--0.92), and for latrine provision as 0.67 (0.41--1.01). The method also yields incidence and clearance rate ratios for age. In the Flies and Eyes trial, the former rates are estimated to decrease with age, although no clear pattern is seen in the latter. Using clinical active trachoma as a marker of infection, and net catches to measure fly density, a mechanistic model is developed to estimate the proportion of transmission due to flies. However, it was not possible to estimate this proportion accurately, and a lack of association was noted between the magnitudes of reductions in fly density and in trachoma. The lack of knowledge on the relative importance of different transmission routes is a constraint on the current global programme for the elimination of trachoma.

Adolescent↗
PubMed2005

Vaccination of stem cell transplant recipients: recommendations of the Infectious Diseases Working Party of the EBMT.

Over the last 25 years, the numbers of hematopoietic stem cell transplant (SCT) patients have increased rapidly. Infections have been major obstacles for successful transplantation. Thus, infection prevention is very important in transplant recipients. As the results of transplantation have improved, the number of long-term survivors has increased. Vaccination is a potentially important strategy for reducing the risk for vaccine-preventable infections after SCT. The EBMT produced recommendations for vaccination of SCT recipients published in Bone Marrow Transplantation in 1995. This paper updates the previous recommendations based on current knowledge.

Clinical Trials as Topic↗
PubMed2005

Public health implications of substandard correctional health care.

US citizens face a growing threat of contracting communicable diseases owing to the high recidivism rate in state and federal prisons, poor screening and treatment of prisoners, and inferior follow-up health care upon their release. Insufficient education about communicable diseases--for prisoners and citizens alike--and other problems, such as prejudice against prisoners, escalating costs, and an unreliable correctional health care delivery system for inmates, all contribute to a public health problem that requires careful examination and correction for the protection of everyone involved.

Aftercare↗
PubMed2004

Controlling emerging diseases in the 21st century.

The presentation addressed the following points: the role of veterinary epidemiology in emerging and global disease outbreaks; the contribution of veterinary epidemiology discipline to understanding and prevention of infections and other emerging animal disease, and the challenges for the discipline of veterinary epidemiology in the near future. The emerging and re-emerging infections animal diseases have contributed to expand the outlook of veterinary epidemiology. Methods and approaches in this discipline have been modified to satisfy the needs of society and of the scientific community. Mistakes and "bad turns" were made and should be avoided in the future. Veterinary epidemiology is alive and growing.

Animals↗
PubMedDate not supplied

Infectious disease and mortality surveillance in Israel in peace and war.

The goals of infectious disease surveillance in war and in peace are the same: the detection of infectious diseases, outbreak identification and control, the assessment of vaccination programs, and the determination of the need for specific preventive measures. In the 1991 Gulf War, Israel's infectious disease surveillance system was utilized to follow the progress of a measles epidemic and to look for evidence of a concealed biological warfare attack. Stepped up mortality and morbidity surveillance, based on a prepared and smoothly functioning notification system, failed to uncover any suggestion that biological agents had been deployed.

Biological Warfare↗
PubMed2003

Public health. Grand Challenges in Global Health.

This week an international panel announces a list of 14 Grand Challenges in Global Health, and scientists throughout the world will be invited to submit grant proposals to pursue them with funds provided by the Bill and Melinda Gates Foundation. We describe the characteristics of these challenges and the process by which they were formulated and selected after receiving over 1000 responses to a "call for ideas" from the scientific community.

Animals↗
PubMed1993

Effects of vaccination programmes on transmission rates of infections and related threshold conditions for control.

This study addresses the problem of the existence of conditions for persistence or eradication of age-dependent directly transmitted infections. The usual system of differential equations describing the dynamics of the disease is transformed into integral equations. The authors show how to solve these equations and, by applying the contraction mapping theorem, give conditions for the persistence or eradication of the infection. A practical illustration of the application of the methods proposed is sketched, using data for rubella collected from a small Brazilian community.

Child↗
PubMed2001

U.S. Public Health Service Guideline on Infectious Disease Issues in Xenotransplantation. Centers for Disease Control and Prevention.

Several developments have fueled the renewed interest in xenotransplantation--the use of live animal cells, tissues and organs in the treatment or mitigation of human disease. The world-wide, critical shortage of human organs available for transplantation and advances in genetic engineering and in the immunology and biology of organ/tissue rejection have renewed scientists' interest in investigating xenotransplantation as a potentially promising means to treat a wide range of human disorders. This situation is highlighted by the fact that in the United States alone, 13 patients die each day waiting to receive a life-saving transplant to replace a diseased vital organ.

Animals↗
PubMed2004

Emerging diseases and implications for global trade.

Emerging diseases could have a devastating impact on international trade unless there is a change in the traditional approach to disease control and new holistic prevention and control strategies are adopted. The impact that emerging diseases will have on international trade will depend on several factors, such as the nature of the pathogen, the degree of co-ordination and integration between Veterinary Services and Public Health authorities, the ability to rapidly detect and respond to a disease appearance, and the existing trade relationship between countries. Strategies to control emerging diseases will be more effective if competent authorities and veterinary infrastructures in particular, integrate their public and animal health objectives into a single strategy. The co-ordinating role of international standard setting organisations such as the World Organisation for Animal Health (OIE) will be crucial. This paper discusses the events contributing to the appearance and spread of new emerging diseases and examines the changing roles of Veterinary Services and international organisations. Reference is also made to measures that can be taken towards minimising potential trade disruptions caused by the appearance of an emerging disease.

Animals↗
PubMed2000

General non-specific morbidity is reduced after vaccination within the third month of life--the Greifswald study.

OBJECTIVES: The incidence of many serious infectious diseases fundamentally decline as a success of consequent vaccination regimens. However, it is a matter of discussion if vaccination might cause unspecific negative side effects on the immune system. To answer this, we performed a clinical study on children with the question as to whether there is an enhanced frequency of infection diseases after vaccination or not. METHODS: The study population (n=496) was randomized to a group of vaccinated children (first vaccination on the 60th day of life, n=201) and a group of unvaccinated children (first vaccination on the 90th day of life, n=295). Frequencies of unspecific, morbidity-related signs were recorded by the mothers with a diary card. These data were taken for further statistical analysis to determine if the factor "vaccination" does have a significant effect on the variable "morbidity". RESULTS: Various infectious disease-associated symptoms (vomiting, coughing, signs of rhinitis, restlessness, rash and pain) were significantly less often seen in vaccinated than in non-vaccinated children. CONCLUSIONS: Our study revealed that children who received vaccination against diphtheria, pertussis, tetanus, HiB and poliomyelitis simultaneously within the third month of life do not exhibit enhanced frequencies of infectious disease-associated symptoms. In contrary, the frequencies of infection-associated symptoms were found to be significantly reduced. This might be caused by a vaccination-associated unspecific enhancement of immunological activity (e.g. mediated by interleukin 2) or by other presently still unknown factors.

Age Factors↗
PubMed2001

PHLS overview of communicable diseases 1999.

Every other year since 1995 the Public Health Laboratory Service has undertaken a consultation exercise to identify communicable diseases of high public health priority. The purpose of identifying disease priorities is to guide rational and transparent service planning and resource allocation. Also, the process aims to ensure a customer sensitive service. This paper presents the results of the priority setting exercise undertaken in 1999. A postal questionnaire was sent to 1130 key professionals involved in communicable disease control in the United Kingdom. Respondents were asked to assess the relative priority of 61 communicable diseases and to identify priority areas of work associated with these diseases. Five criteria were used to assess relative priority. The five criteria were; present burden of ill-health, social and economic impact, potential threat to health, health gain opportunity and public concern and confidence. For each disease, respondents were asked to score the importance of each criterion. Forty six percent of participants (518/1130) returned completed questionnaires. There was no significant difference in response rate by professional group. Based on the scores assigned to each of the five criteria, the relative priority of 61 communicable diseases has been established. The top ten diseases in descending order of priority are, HIV/AIDS, meningococcal diseases, Chlamydia trachomatis, influenza, tuberculosis, E. coli O157, Methicillin resistant Staphylococcus aureus, salmonellosis, transmissible spongiform encephalopathies and Helicobacter pylori. The opinion of a large number of health care professionals has been used to establish a priority rank for a wide range of communicable diseases. This work provides planners and policy makers with a synthesis of current professional opinion that can be used as a foundation for making decisions on service developments.

Attitude of Health Personnel↗
PubMed1995

Disinfection and wildlife.

Capture, handling or transport of wildlife for purposes such as research, disease monitoring, wildlife damage control, relocation, and collection of zoological specimens can create risks of disease spread. Cleaning and disinfection procedures for equipment used in these activities must be routine and designed to eliminate the spread of pathogens to either animals or humans. General methods and materials for cleaning and disinfection apply to wildlife studies. Concepts involved in preparing a protocol specific to a wildlife investigation are discussed. The control of the spread of livestock and poultry pathogens via free-ranging mammals and birds prior to disinfection of contaminated premises is approached through an accurate assessment of the problem and, where necessary, the selection of appropriate wildlife control measures. The authors discuss the development of a problem assessment, and review potential methods for use in the control of wildlife. For an accurate problem assessment, information is needed on the presence of wild mammals and birds at the site, exposure of wild mammals and birds to the pathogen, and the potential for further transmission. When wildlife control is deemed necessary, techniques may be selected to disperse or exclude animals from premises or to depopulate the site. Dispersal or exclusion from premises is appropriate when movement of animals within or away from the contaminated premises would not result in further transmission of the pathogen. Depopulation is necessary when the continued presence or dispersal of wild mammals or birds would potentially result in further spread of the disease.

Animals↗
PubMed1998

The refugee crisis in Africa and implications for health and disease: a political ecology approach.

Political violence in civil war and ethnic conflicts has generated millions of refugees across the African continent with unbelievable pictures of suffering and unnecessary death. Using a political ecology framework, this paper examines the geographies of exile and refugee movements and the associated implications for re-emerging and newly emerging infectious diseases in great detail. It examines how the political ecologic circumstances underlying the refugee crisis influences health services delivery and the problems of disease and health in refugee camps. It has four main themes, namely, an examination of the geography of the refugee crisis: the disruption of health services due to political ecologic forces that produce refugees; the breeding of disease in refugee camps due to the prevailing desperation and destitution; and the creation of an optimal environment for emergence and spread of disease due to the chaotic nature of war and violence that produces refugees. We argue in this paper that there is great potential of something more virulent than cholera and Ebola emerging and taking a big toll before being identified and controlled. We conclude by noting that once such a disease is out in the public rapid diffusion despite political boundaries is likely, a fact that has a direct bearing on global health. The extensive evidence presented in this paper of the overriding role of political factors in the refugee health problem calls for political reform and peace accords, engagement and empowerment of Pan-African organizations, foreign policy changes by Western governments and greater vigilance of non-governmental organizations (NGOs) in the allocation and distribution of relief aid.

Africa↗
PubMed2004

[On the 2004 edition of case definitions for the surveillance of notifiable infectious diseases in Germany].

With the beginning of the year 2004, new case definitions of the Robert Koch Institute (RKI) replace those introduced in 2001. The new edition provides definitions for 53 categories of cases that are to be reported by local health departments through state health authorities to the RKI according to the German infectious disease control act. The new case definitions take into account recent developments in laboratory methods and indications for improvement identified through systematic evaluation. The case definitions consist of three types of evidence-clinical picture, laboratory detection, and epidemiological confirmation-all of which list disease- or pathogen-specific test criteria. Combining the three evidence types results in five case definition categories: clinically diagnosed illness, clinically and epidemiologically confirmed illness, clinically and laboratory-confirmed illness, laboratory-detected infection not fulfilling clinical criteria, and laboratory-detected infection with unknown clinical picture.

Communicable Disease Control↗
PubMed2005

[Management of bioterroristic attacks with dangerous infectious agents].

The ongoing discussion on threats by terrorist attacks leads to a realignment of tasks and responsibilities within the health care system. Especially the public health services are developing from exercising mainly an advisory function to becoming an integral part in disaster response to devastating biological scenarios. Recent risk assessment recommends authoritative integration of public health officials into disaster response planning and to define their role inside the command and control structures of disaster management. Interdisciplinary networks of public health services, medical treatment centres, emergency medical services, reference laboratories and hospital hygiene services have appeared to be successful in the management of life-threatening, contagious diseases and unexpected bioterrorist incidents as well. In March 2003 the "StAKoB" was established as a permanent working group of the centres for prepared ness and treatment. Major objectives of the working group are ex change of information, mutual support in cases of emergency and standardisation in staff training.

Biological Warfare↗