Reporting of communicable disease conditions under surveillance by the APSU, 1 January to 30 September 2003.
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BACKGROUND: Because egg yolk has a high cholesterol concentration, limited egg consumption is often suggested to help prevent ischemic heart disease (IHD). OBJECTIVE: We epidemiologically examined the validity of this recommendation. DESIGN: We analyzed the relations of egg consumption to serum cholesterol and cause-specific and all-cause mortality by using the NIPPON DATA80 (National Integrated Project for Prospective Observation of Non-communicable Disease And its Trends in the Aged, 1980) database. At the baseline examination in 1980, a nutritional survey was performed by using the food-frequency method in Japanese subjects aged > or =30 y. We followed 5186 women and 4077 men for 14 y. RESULTS: The subjects were categorized into 5 egg consumption groups on the basis of their responses to a questionnaire (> or =2/d, 1/d, 1/2 d, 1-2/wk, and seldom). There were 69, 1396, 1667, 1742, and 315 women in each of the 5 groups, respectively. Age-adjusted total cholesterol (5.21, 5.04, 4.95, 4.91, and 4.92 mmol/L in the 5 egg consumption categories, respectively) was related to egg consumption (P < 0.0001, analysis of covariance). In women, unadjusted IHD mortality and all-cause mortality differed significantly between the groups [IHD mortality: 1.1, 0.5, 0.4, 0.5, and 2.0 per 1000 person-years, respectively (P = 0.008, chi-square test); all-cause mortality: 14.8, 8.0, 7.5, 7.5, and 14.5 per 1000 person-years, respectively (P < 0.0001, chi-square test)]. In men, egg consumption was not related to age-adjusted total cholesterol. Cox analysis found that, in women, all-cause mortality in the 1-2-eggs/wk group was significantly lower than that in the 1-egg/d group, whereas no such relations were noted in men. CONCLUSION: Limiting egg consumption may have some health benefits, at least in women in geographic areas where egg consumption makes a relatively large contribution to total dietary cholesterol intake.
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BACKGROUND & OBJECTIVES: A disease surveillance model developed in the North Arcot district, Tamil Nadu, was found to be practical, efficient, inexpensive and useful for public health action to monitor the success of ongoing interventions and to detect and intercept outbreaks. It was centred in the private (voluntary) sector with full co-operation and participation by the government sector. As Kerala state wanted to replicate this model in all districts, one district was chosen to pilot test it centred within the existing district public health system, soliciting participation from the private sector. A two-year (1999-2001) performance of this model is presented. METHODS: After elaborate preparations including the selection of 14 diseases to be reported and training of doctors in the private sector health care institutions and doctors and paramedical staff in all government health centres and hospitals, printed post cards were widely distributed. The business reply system was used so as to avoid handling postage stamps. Cards were received by the nodal officer in the district public health office and checked on a daily basis to detect disease prevalence and evidence of clustering in time and space. Swift action was taken on detecting case clustering. A monthly bulletin containing disease summaries and other useful information was freely distributed to all reporting centres. RESULTS: On an average, just over 100 disease reports were received every month. The most frequently reported diseases were, in the descending order, leptospirosis, acute dysentery, typhoid fever and acute hepatitis. Among vaccine-preventable childhood diseases, only measles was reported, but no diphtheria, tetanus or whooping cough. Several outbreaks were detected early and interventions applied to intercept them. The most striking example was that of cholera, the occurrence of which was detected swiftly for instituting highly successful control measures. INTERPRETATION & CONCLUSION: The district level disease surveillance system centred in the government public health system has been highly successful. Disease surveillance was responsible for the government to obtain information on the prevalence of leptospirosis in the district. The reports enabled the public health officers to detect disease-clustering as the early signals of outbreaks and to take quick remedial measures.
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Tuberculosis (TB) has been recorded in London for centuries but reports have declined over the last 100 years, with a 10-fold decrease between 1948 and 1987. However, from 1987-1993 notifications of TB in London rose by 34%, compared with 15% nationally. This rise, together with concerns about undernotification and the emergence of multi-drug resistance in New York, led to establishment of a London Consultants in Communicable Disease Control Working Party on TB to review current surveillance data. Notifications to the Office of Population Censuses and Surveys from the London Boroughs declined by approximately 6.5% per year from 1982-1987. If this had continued until 1993 there would have been 3579 fewer notifications than actually received. The proportion of cases in the 15-44 age group rose markedly in males. The proportion of notifications in those aged 65 and above was higher in the Thames Regions outside London, where the total TB notifications declined by 3.5% over the same period. Recommendations were made to improve TB surveillance in London; and a city-wide surveillance function was established in 1994 to collate and monitor data on TB.
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The Vermont Department of Health reviewed 2,035 reports of selected notifiable diseases received from January 1, 1986, through December 31, 1987. Laboratories provided 1,160, or 71 percent, of the initial reports on 1,636 confirmed cases. This demonstrates that laboratories, when required by law and when part of active surveillance, can make a significant contribution to surveillance of infectious disease. A survey of primary care physicians indicated that 18 percent always reported notifiable diseases. The most frequently mentioned reason for lack of reporting was an assumption that the laboratory would report the cases.
The non-communicable chronic diseases are important causes of death in Brazil, mainly in the great urban centres. There are various risk factors related to these diseases, whose remotion or attenuation would contribute to a fall in mortality. The methodology of the first comprehensive multicenter study into risk factors of non-communicable chronic diseases carried out in Latin America is explained. In Brazil, this study was carried out in the cities of S. Paulo, SP and Porto Alegre, RS. Preliminary results from the city of S. Paulo as to the prevalence of arterial hypertension (22.3%), tabagism (37.9%), obesity (18.0%), alcoholism (7.7%) and sedentarism (69.3%) are presented. These results are compared with existing data from Brazil and other countries, and the relationship between various risk factors and the mortality from cardiovascular diseases in S. Paulo and some developed countries is discussed.
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