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PubMed2005

[Health and disease in the Netherlands: the Dutch National Public Health Compass as a source of information].

--The Dutch National Public Health Compass has been available on the Internet (www.nationaalkompas.nl) since 2001. This website, developed and managed by the National Institute for Public Health and the Environment, contains data and information on the population's health status, its determinants, prevention and care. The Compass brings together information from various data sources, research and expert opinions. --On the basis of this Compass, an overview has been made of the health of the Dutch population. --Both the life expectancy and the healthy life expectancy in the Netherlands increased after 1980. --Mortality from coronary heart disease, cerebrovascular accidents and lung cancer decreased, but they are still the most important causes of death. --Especially psychological disorders (alcohol dependence, anxiety disorders and depression), coronary heart disease and COPD are associated with a significant decrease in quality of life. --There are important health differences in the Netherlands between rich and poor, urban and rural areas, natives and immigrants. --The difference in life expectancy between men and women will decrease from more than 5 years in 2000 to less than 4 years in 2020. --A permanent facility for the provision of accurate public-health information is of great importance. The collaboration of registration holders and experts in maintaining the Compass is and will remain essential so that an integral overview of the health of the Dutch population can also be made in the future.

Actuarial Analysis↗
PubMed2005

[Side effects of tramadol: 12 years of experience in the Netherlands].

Tramadol is a synthetic opioid that has been available in the Netherlands since 1992 and is usually used as a centrally-acting analgesic when paracetamol or an NSAID provides insufficient relief. In the period 1 January 1992--30 November 2003, the Netherlands Pharmacovigilance Centre Lareb received 299 reports concerning 522 adverse drug reactions associated with the use of tramadol. Some of the frequently reported side effects with a high reporting odds ratio were nausea, constipation and withdrawal symptoms. These side effects are very similar to those of the other opioids due to the affinity of tramadol for the micro-opioid receptor. Because tramadol is often not recognised as an opioid, it is important that such opiate effects be recognised as an adverse drug reaction on time.

Analgesics, Opioid↗
PubMed2005

[Effect of vaccination against pertussis on the incidence of pertussis in The Netherlands, 1996-2003].

OBJECTIVE: To determine whether booster vaccination of 4-year-old children with an acellular pertussis vaccine, which has been included in the national vaccination programme since October 2001, has decreased the incidence of pertussis. DESIGN: Descriptive. METHODS: Surveillance data were studied: mandatory notifications to the Health Inspectorate and reports of hospital admissions from the National Medical Register. RESULTS: During the past 7 years, there has been an increase in the incidence of pertussis every 2-3 years (1996, 1999, 2001). Moreover, the annual incidence in 1996-2003 was higher than in 1989-1995. As in previous years, the yearly peak incidence for hospital admissions due to pertussis was observed among nurslings, especially those younger than 3 months of age. In 2002 compared to 2000, the incidence among 3-4-year-olds on the basis of notifications and hospitalisations was 45% and 62% lower, respectively, very likely due to the booster vaccination for 4-year-olds introduced in 2001. The greatest decrease in the incidence was also observed among the 4-year-olds in 2003. CONCLUSION: Pertussis is still endemic in The Netherlands with a higher incidence than before the epidemic of 1996-1997. Severe disease often occurs, especially among unvaccinated children < 1 year of age. From January 2005 onwards, the vaccinations in the first year of life have been given with an acellular pertussis vaccine. However, since such infants are too young to be protected by vaccination alone, more information is needed on the most important sources of infection of nurslings in The Netherlands.

Adolescent↗
PubMed2005

Effect of climate changes on waterborne disease in The Netherlands.

Effects of climate change in The Netherlands in the 21st century on the microbiological quality of water for drinking water production and recreation were evaluated. The following was concluded: increased temperature leads to significant additional inactivation of enteric pathogens in surface waters with residence times of more than a month, but not in waters with residence times of up to ten days. Increased precipitation, runoff and storm water overflow lead to more peak concentrations of waterborne pathogens in surface water. Peak concentrations strongly determine the infection risk through drinking water consumption. Drought lowers and increased precipitation elevates groundwater tables, but an effect on the risk of groundwater contamination with waterborne pathogens is not clear. Climate effects are not noticeable near a groundwater well, where the groundwater table and flow rate are mainly determined by the pumping rate. Exposure of recreants to waterborne pathogens that can grow in the water is expected to increase due to increased recreation and increased growth opportunities of these pathogens. Due to warmer summers, pathogens, like amoeba, that have not caused problems up to date in The Netherlands, may now emerge in recreational waters.

Disease Transmission, Infectious↗
PubMed1992

[Incidence of postpartum thyroid function disorders in The Netherlands].

In a longitudinal study the incidence of postpartum thyroid dysfunction in the Netherlands was investigated in an unselected open population. There were 293 women who were screened by repeated assessments of thyroid function until 34 weeks postpartum at 6-week intervals. Thyroid dysfunction was defined as abnormal TSH values accompanied by abnormal FT4 and (or) FT3 values. The frequency of postpartum thyroid dysfunction was 7.2% (n = 21). Most of the thyroid dysfunction occurred between 16 and 28 weeks postpartum. There were five women with subclinical thyroid dysfunction: abnormal TSH values with complementary FT4 and (or) FT3 changes within normal limits. Four of them showed (marked) increase in antimicrosomal antibody titres. With the inclusion of the five women the frequency rose to 8.9%. These data appear representative for the Netherlands as a whole, suggesting that every year 14,000 women suffer from (transient) postpartum thyroid dysfunction.

Adult↗
PubMed2005

[Epidemiology of 25 years of crib death (sudden infant death syndrome) in the Netherlands; incidence of crib death and prevalence of risk factors in 1980-2004].

OBJECTIVE: To describe the prevalence of risk factors and the incidence of cot death (sudden infant death syndrome; SIDS) in the Netherlands during the last 25 years. DESIGN: Descriptive. METHOD: The incidence of cot death/SIDS in infants aged 7-365 days in 1980-2004 was derived from Statistics Netherlands, the Dutch Central Bureau of Statistics. The prevalence of risk factors for cot death/SIDS in the general population was derived from national surveys of baby clinics (0-9 months; 1985-2004) and studies of cot death/SIDS victims (0-23 months; 1984-1991 and 1996/'04). RESULTS: The prevalence of the following risk factors for cot death/SIDS has decreased: primary prone sleeping position (from 60% to 8%), the use of a duvet (from 85% to 18%), maternal smoking (from 34% to 20%), paternal smoking (from 48% to 32%). The prevalence of routine bed-sharing with a parent increased from nearly 0% to 5%. The registered incidence of cot death/SIDS per 100,000 live births decreased from 103 in 1986 to < 15 in 2003 and 2004. The incidence of cot deaths/SIDS that occurred during habitual bed-sharing with a parent, in a playpen, in child-care settings, or in a secondary prone sleeping position increased. CONCLUSION: The incidence of cot death/SIDS and the prevalence of known risk factors for cot death/SIDS has decreased. New risk factors have emerged in recent years. Considering the evolving conditions of infant care, an ongoing study on the special features of child care and the factors involved in cases of cot death/SIDS is warranted. This knowledge is essential for periodic adaptation of the national prevention programme.

Bedding and Linens↗
PubMed2005

[Pharmacological therapy in Alzheimer's disease. Current clinical practice in The Netherlands].

Pharmacological therapy in Alzheimer's disease. Current clinical practice in The Netherlands. Dementia affects 195,000 patients of 65 years and older in The Netherlands currently. Rivastigmine and galantamine, both cholinesterase inhibitors, and memantine, an NMDA (N-methyl-D-aspartate) antagonist, are licensed for the treatment of AD. In clinical practice, these drugs have limited effects on cognitive and other symptoms of dementia. We describe the practical care of some patients treated with these drugs and discuss the pros and cons of pharmacotherapy in AD. Extensive knowledge of the drugs, other treatment options and of dementia are necessary for good clinical practice in the treatment of these patients and the counselling of their caregivers.

Aged↗
PubMed2005

[Increasing trend in prescription of methylphenidate in general practices in the north-east of The Netherlands, 1998-2003].

OBJECTIVE: To obtain information on the frequency of and the indications for prescription of methylphenidate in general practices in the north-east of The Netherlands. DESIGN: Descriptive. METHOD: Data were collected from 1998 to 2003 from 6 general practices in the north-east of The Netherlands (17 general practitioners, approximately 30,000 patients) that were affiliated to the Registration Network in Groningen. The number of new and existing patients who were prescribed methylphenidate was calculated by age group per 1000 person-years per calendar year. The indication on which the drug was prescribed was looked at, as was the number of patients who were referred to a specialist on that indication. RESULTS: The number of new users per 1000 person-years more than doubled from 17 in 1999 to 42 in 2003. In all years studied the highest number of new users fell into the age group 5-9 years. The total number of users per 1000 person-years tripled (boys: 1.8 in 1998 and 6.2 in 2003; girls: 0.5 in 1998 and 0.8 in 2003). The prevalence of use in boys was 3 to 8 times as high as that of girls and increasing more quickly. In people under 59 years of age attention deficit hyperactivity disorder (ADHD) was the most frequent indication (55%). In the group aged > or = 60 years methylphenidate was mainly prescribed in the palliative phase of somatic morbidity. Over half of the 140 new patients (57%) were referred nor to a specialist in the year before neither in the year after the first prescription of methylphenidate.

Adolescent↗
PubMed2005

[No conspicuous changes in the practice of medical end-of-life decision-making for neonates and infants in the Netherlands in 2001 as compared to 1995].

OBJECTIVE: To establish whether the practice of end-of-life decision-making for neonates and infants under the age of 1 in the Netherlands in 2000 was different from that in 1995. DESIGN: Retrospective descriptive and comparative study. METHODS: In both years, all deaths of children under the age of one year that took place in August-November (1995: n = 338; 2001: n = 347) were studied. The response rate was 96% in 1995 and 84% in 2001. The questionnaires which were sent to the physicians who reported the deaths, included structured questions about whether or not death had been preceded by end-of-life decisions, i.e. decisions to withhold or withdraw potentially life-prolonging treatment or to administer (potentially) life-shortening drugs, and questions about the decision-making process. RESULTS: The proportion of end-of-life decisions increased slightly from 62% to 68% of all deaths in the first year of life, but the difference was not statistically significant. The large majority of these decisions involved withholding or withdrawing life-sustaining treatment. The frequency of decisions to actively terminate the life of an infant who was not dependent on life-sustaining treatment remained stable at 1%. The proportion of decisions that had been discussed with the parents increased slightly, from 91% in 1995 to 97% in 2001; similar percentages of the decisions had been discussed with other physicians. The percentage of decisions that had been discussed with the nursing staff decreased from 40 in 1995 to 28 in 2001. CONCLUSION: The findings suggest that the practice of end-of-life decision-making in neonatology was rather stable between 1995 and 2001. The frequency of the active termination of life had not increased, despite the new euthanasia regulation in the Netherlands.

Attitude of Health Personnel↗
PubMed2005

[Smoking, alcohol and drug use in Utrecht, The Netherlands, risk groups and socioeconomic differences in 1999 and 2003].

OBJECTIVE: To investigate trends in socio-economic inequalities in smoking, alcohol and drug use in the community of Utrecht, the Netherlands. DESIGN: Repeated cross-sectional population surveys. METHOD: Questionnaires were used to collect information about smoking, (problematic) alcohol use and the use of cannabis, ecstasy and other drugs in the general population aged 15-64 years in Utrecht, the Netherlands. Data were collected in 1999 on 2485 responders (response: 56%) and in 2003 on 1840 responders (54%). The male-female ratio was 4:6. RESULTS: The percentage of smokers was 43 in 1999 and 34 in 2003. Excessive use of alcohol was reported by 21% in both 1999 and 2003, cannabis use was reported in 13% and 14%, respectively, and use of hard drugs was reported in 1-3% in both 1999 and 2003. Native Dutch people, men, unmarried people and people with a low education or income level were at increased risk for drinking, smoking and using drugs. People with a low socio-economic status were just as likely to smoke in 1999 as in 2003, while the use of alcohol, cannabis and ecstasy increased. Those with a higher socio-economic status were much less likely to smoke in 2003 than in 1999, while fewer used cannabis and ecstasy use remained the same. CONCLUSION: Socio-economic inequalities in substance abuse were greater in 2003 than in 1999 in the studied population in Utrecht. People with a low socio-economic status showed an increase in unhealthy behaviour concerning the use of alcohol, cannabis and ecstasy.

Adolescent↗
PubMed2005

Completeness of malaria notification in the Netherlands 1995-2003 assessed by capture-recapture method.

In 1999 in the Netherlands, the duty to notify malaria was transferred from physicians to laboratories by the new Infectious Diseases Law. To evaluate the effect of this change, we aimed to estimate completeness of malaria notification in the Netherlands from 1995-2003. We calculated it relative to sentinel laboratory and hospital admission data. Using the two-source capture-recapture method (CRM), we estimated the total number of cases to assess the completeness relative to this number. The completeness of notification relative to sentinel data was 18.2 % (95% CI of 15.7-20.7) from 1995-1998 and 56.4 % (95% CI of 47.0-65.8) for 2000-2003. The completeness relative to the number of malaria cases admitted to the hospital was 35.1 % for the period 1995-2003. The estimated numbers of cases of malaria between 1995 and 1998 were 3123 (95% CI of 2796-3449) and 5043 (95% CI of 4343-5742) between 2000 and 2003. The completeness relative to this numbers changed from 35.5 % (95% CI of 32.1-39.7) in 1995-1998 to 36.1 % (95% CI of 31.7-41.9) for the years 2000-2003. Laboratory-based notification has significantly increased the absolute number of malaria notifications, but there was no change in completeness relative to hospital admissions. The increase in estimated malaria cases may be artificial, due to the extent of violation of CRM requirements over the study period.

Disease Notification↗
PubMed2005

[A survey of implant-retained superstructure types in the edentulous mandible in The Netherlands].

Treatment of mandibular edentulousness with endosseous permucosal implants has evolved to a common treatment option during the last decades. In The Netherlands, the relative cheap prosthetic treatment of implant-supported overdentures is considered a qualitatively adequate treatment. The aim of the study described in this article was to survey the treatment of edentulous mandibles by fixed implant-supported prostheses and implant-supported overdentures, and to register the different mesostructures used. All clinics of special dental care and all larger clinics for implant dentistry in The Netherlands received a questionnaire. The data provided showed that more than 90% of patients treated with implants because of mandibular edentulousness, were provided with an overdenture. In 85% of cases a bar-clip mesostructure was used. Cost control was the most important reason to choose an overdenture above a fixed implant-supported prosthesis.

Dental Prosthesis Retention↗
PubMed2005

[Background on recent trends in mortality in the Netherlands].

In the Netherlands, a considerable reduction in the annual number of deaths occurred in 2004. This reduction was largely caused by a decrease in the number of deaths from cardiovascular disease. - The risk of dying from cardiovascular disease has decreased in an almost linear manner during the past few decades. This reduction, which was well above average in the case of ischaemic heart disease, was registered for both sexes and across all age groups. The risk reduction in men aged 30-59 years was particularly large. - The contribution of neoplasms to total mortality continues to increase. However, the risk of dying from certain forms of cancer (lung for men, colon for women, stomach, gall-bladder, breast, prostate, uterus and ovaries) has been decreasing since the 1990s. - The risk of dying from breast cancer has decreased since the end of the 1990s. If present trends continue, Dutch women will be more likely to die from lung cancer than breast cancer from 2007 onwards. - The remarkably low mortality in 2004 may be attributed to the equable climatic conditions and the absence of an influenza epidemic. The drop in mortality was short-lived: in the first quarter of 2005, influenza caused a very strong increase in mortality among those aged over 80 years. - Even a further substantial reduction in mortality risks will not be able to prevent the predicted increase in the annual number of deaths in the Netherlands. This increase is estimated to end by the middle of this century.

Adult↗
PubMed2005

Human-to-human transmission of avian influenza A/H7N7, The Netherlands, 2003.

An outbreak of highly pathogenic avian influenza A virus subtype H7N7 began in poultry farms in the Netherlands in 2003. Virus infection was detected by RT-PCR in 86 poultry workers and three household contacts of PCR-positive poultry workers, mainly associated with conjunctivitis. To determine the magnitude of and risk factors for human-to-human transmission of influenza A/H7N7 in the Netherlands, a retrospective cohort study among household members of infected poultry workers was undertaken. In total, 33 (58.9%) of 56 (among 62) participants who provided blood samples had positive H7 serology, using single convalescent serum samples obtained at least 3 weeks after onset of symptoms of the index case. Eight household members (12.9%) reported symptoms (conjunctivitis and/or ILI), of which four of five (80.0%) tested seropositive. On univariate analysis, significant risk factors for seropositivity included having at least two toilets, a pet bird, and using cloth handkerchiefs. It was not possible to obtain a stable model for binomial regression for the outcome of A/H7N7 infection. Further seroprevalence studies among contacts of asymptomatic H7 cases should be conducted.

Adolescent↗
PubMed2005

[The treatment of oesophageal atresia in The Netherlands].

The first description of oesophageal atresia dates back to 1670. Oesophageal atresia used to be regarded as a lethal disease, but since the successes of Leven and Ladd in 1939 and Haight in 1941 surgical correction is possible. The Dutch history ofoesophageal atresia begins in 1946. After the successes in America became known, several Dutch surgeons started to treat patients with oesophageal atresia, notably J.ten Kate, L.D.Eerland, M. Schoorl and P.J.Kooreman. In those days, paediatric surgery did not yet exist as a separate specialty. Today, paediatric surgery is concentrated in 6 paediatric surgical centres in the Netherlands. Thanks to the pioneers mentioned and the concentration of knowledge and expertise in the centres, the mortality ofoesophageal atresia patients in the Netherlands has decreased to approximately 9%, despite the fact that currently the gestational age and birth weight of patients is lower and the number of patients with comorbidity is higher.

Child↗
PubMed2006

[Resistance of Teladorsagia circumcincta in goats to ivermectin in the Netherlands].

Resistance of Teladorsagia circumcincta in goats to ivermectin In 2005, suspected ivermectin resistance of gastrointestinal nematodes was investigated in 17 goats on a farm in the Netherlands, using a faecal egg count reduction test combined with faecal larval cultures. Eight goats were treated orally with 0.2 mg/ kg ivermectin on 1 August 2005 and the other nine goats served as untreated controls. Faeces were collected from all goats on 1 August and on 12 August. Faecal egg counts were reduced by 80.6% in goats receiving ivermectin. On the basis of faecal larval cultures and the egg counts, ivermectin was found to be 100% effective against Haemonchus contortus, 15.0% effective against Teladorsagia circumcincta, and 93.3% effective against Trichostrongylus spp. The effect of levamisole and oxfendazole on gastrointestinal nematodes was also evaluated. Nine goats were treated subcutaneously with 5 mg/kg levamisole and seven goats orally with 4.5 mg/kg oxfendazole on 12 September On the basis of faecal egg counts performed on 12 and 22 September, levamisole reduced the total egg count by 95.4% and oxfendazole reduced the egg count by 85.8%. Differentiation of pooled faecal larval cultures revealed that levamisole was 99.9% effective against H. contortus, 81.9% effective against T. circumcincta, and 99.5% against Trichostrongylus spp. Oxfendazole was 75.5% effective against H. contortus, 33.2% effective against T. circumcincta, and 100% effective against Trichostrongylus spp. On 28 October the nine goats that were still present on the farm were orally treated with 0.4 mg/kg ivermectin. Faecal egg counts and differentiation of pooled larval cultures of faecal samples collected on 28 October and 9 November, respectively, revealed that total egg counts were reduced by 93.1%. Ivermectin was 49.1% effective against T. circumcincta but 100% effective against H. contortus and Trichostrongylus spp. Thus H. contortus appears to be resistant to oxfendazole and T. circumcinta appears to be resistant to oxfendazole and ivermectin. This is the first documented case of ivermectin resistance of a gastrointestinal nematode of small ruminants in the Netherlands.

Animals↗
PubMed2006

[Optimising antibiotic policies in the Netherlands. IX. SWAB guidelines for antimicrobial therapy in adults with acute infectious diarrhoea].

The 'Stichting Werkgroep Antibioticabeleid' (SWAB; Dutch Working Party on Antibiotic Policy) develops evidence-based guidelines for the use of antibiotics in hospitalised adults. This guideline on acute infectious diarrhoea (AID) concerns the antibiotic treatment of acute infectious inflammation of the gastrointestinal tract, manifesting primarily as diarrhoea. AID can be subdivided into community-acquired diarrhoea, traveller's diarrhoea and hospital-acquired (nosocomial) diarrhoea. In the first 2 categories, the need for antibiotic treatment is generally restricted to individuals with severe illness, dysentery or a predisposition to complications. High rates of primary fluoroquinolone resistance can be found in human Campylobacter isolates from the Netherlands and from other parts of the world. Therefore, if antibiotic treatment is necessary for community-acquired AID or AID in travellers returning to the Netherlands, it is advised to use oral azithromycin for 3 days as empirical treatment. If intravenous treatment is necessary, the combination of ciprofloxacin and erythromycin for 5-7 days may be considered. As soon as the identity of the causative organism is known, antimicrobial treatment should be tailored accordingly.

Acute Disease↗
PubMed2006

HIV prevalence among tuberculosis patients in The Netherlands, 1993-2001: trends and risk factors.

OBJECTIVES: To describe the prevalence and predictive factors of human immunodeficiency virus (HIV) infection among tuberculosis (TB) patients in The Netherlands during the period 1993-2001. DESIGN: Data were obtained from the national surveillance register of all patients notified with TB (all forms) during the period of the study. In addition, records or discharge notes were checked of a random sample of 200 TB patients notified in 1995 and another 200 in 2001. RESULTS: Of 13 269 patients diagnosed with TB, 542 were HIV-positive (4.1%). Prevalence was 4.1% in 1993-1995, 3.8% in 1996-1998 and 4.4% in 1999-2001. The highest prevalence was observed among drug users (29.2%), homeless patients (20.1%) and patients residing illegally in the country (9.1%). Compared with the period 1993-1995, the relative risk of HIV infection in the periods 1996-1998 and 1999-2001 decreased significantly for drug using patients (P = 0.006), and increased for patients from African countries (P < 0.001). According to patient records, 29/184 (16%) had been tested for HIV in 1995 and 39/190 (21%) in 2001 (P = 0.289); 18 patients tested positive (4.8%). CONCLUSION: Although the prevalence of HIV among TB patients in The Netherlands remained stable between 1993 and 2001, the distribution of risk groups changed over this period.

AIDS-Related Opportunistic Infections↗