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Association of indoor and outdoor particulate level with chronic respiratory illness.

The effect of indoor and outdoor particulate level on respiratory health was examined in 1,576 never smokers, 40 to 69 yr of age residing in industrial, residential, and suburban areas. The health outcomes of interest in this report were physician-diagnosed bronchitis, asthma, and six respiratory symptoms including chronic cough, chronic phlegm, bouts of cough and phlegm, shortness of breath (SOB), wheeze, and wheeze with SOB. Households with coal stoves had substantially higher indoor particulate levels than those with gas stoves. Subjects were grouped into three exposure categories according to the indoor use of coal stoves for both cooking and heating (B), either cooking or heating (E), or neither (N). The adjusted odds ratios for chronic phlegm, bouts of cough and phlegm, wheeze, and wheeze with SOB were significantly higher in the B than in the N group; the odds ratios for chronic cough and SOB were also higher for B than N, although these were not significant. The odds ratios in the E group were significantly greater for wheeze with SOB than in the N group but not for the other symptoms. The global estimates of the odds ratios for the six symptoms were 1.4 and 2.0, respectively, for the E and B groups. The particulate level was highest in the industrial area and lowest in the suburban area. There was an excess risk of all respiratory symptoms among subjects residing in industrial and residential areas, with an increase in symptom prevalence with outdoor particulate levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The ability of mothers to read a thermometer.

The ability of 100 mothers in a suburban private pediatric practice and 100 mothers in an urban hospital-based practice to read a mercury glass thermometer accurately was assessed. Ninety-three percent of suburban practice parents could read three pre-set thermometers correctly, but only 10% of urban practice parents could perform the same task. Education level only partially explained the inability of most urban parents to read successfully. Because certain clinical situations require accurate fever assessment at home, simplified methods of fever assessment should be considered in populations with low competence in reading a thermometer by traditional methods.

Age Factors↗

Daily variations in air pollution and respiratory health in a multicentre study: the PEACE project. Pollution Effects on Asthmatic Children in Europe.

The Pollution Effects on Asthmatic Children in Europe (PEACE) study is a multicentre study of the acute effects of particles with a 50% cut-off aerodynamic diameter of 10 microm (PM10), black smoke (BS), sulphur dioxide (SO2) and nitrogen dioxide (NO2) on the respiratory health of children with chronic respiratory symptoms. The study was conducted in the winter of 1993/1994 by 14 research centres in Europe. A total of 2,010 children, divided over 28 panels in urban and suburban locations, was followed for at least 2 months. Exposure to air pollution was monitored on a daily basis. Health status was monitored by daily peak expiratory flow (PEF) measurements and a symptom diary. The association between respiratory health and air pollution levels was calculated with time series analysis. Combined effect estimates of air pollution on PEF or the daily prevalence of respiratory symptoms and bronchodilator use were calculated from the panel-specific effect estimates. Fixed effect models were used and, in cases of heterogeneity, random effect models. No clear associations between PM10, BS, SO2 or NO2 and morning PEF, evening PEF, prevalence of respiratory symptoms or bronchodilator use could be detected. Only previous day PM10 was negatively associated with evening PEF, but only in locations where BS was high compared to PM10 concentrations. There were no consistent differences in effect estimates between subgroups based on urban versus suburban, geographical location or mean levels of PM10, BS, SO2 and NO2. The lack of association could not be attributed to a lack of statistical power, low levels of exposure or incorrect trend specifications. In conclusion, the PEACE project did not show effects of particles with a 50% cut-off aerodynamic diameter of 10 microm, black smoke, sulphur dioxide or nitrogen dioxide on morning or evening peak expiratory flow or the daily prevalence of respiratory symptoms and bronchodilator use.

Air Pollution↗

Stroke prevalence among the Spanish elderly: an analysis based on screening surveys.

BACKGROUND: This study sought to describe stroke prevalence in Spanish elderly populations and compare it against that of other European countries. METHODS: We identified screening surveys--both published and unpublished--in Spanish populations, which fulfilled specific quality requirements and targeted prevalence of stroke in populations aged 70 years and over. Surveys covering seven geographically different populations with prevalence years in the period 1991-2002 were selected, and the respective authors were then asked to provide descriptions of the methodology and raw age-specific data by completing a questionnaire. In addition, five reported screening surveys in European populations furnished useful data for comparison purposes. Prevalence data were combined, using direct adjustment and logistic regression. RESULTS: The overall study population, resident in central and north-eastern Spain, totalled 10,647 persons and yielded 715 cases. Age-adjusted prevalences, using the European standard population, were 7.3% for men, 5.6% for women, and 6.4% for both sexes. Prevalence was significantly lower in women, OR 0.79 95% CI 0.68-0.93, increased with age, particularly among women, and displayed a threefold spatial variation with statistically significant differences. Prevalences were highest, 8.7%, in suburban, and lowest, 3.8%, in rural populations. Compared to pooled Spanish populations, statistically significant differences were seen in eight Italian populations, OR 1.39 95% CI (1.18-1.64), and in Kungsholmen, Sweden, OR 0.40 95% CI (0.27-0.58). CONCLUSION: Prevalence in central and north-eastern Spain is higher in males and in suburban areas, and displays a threefold geographic variation, with women constituting the majority of elderly stroke sufferers. Compared to reported European data, stroke prevalence in Spain can be said to be medium and presents similar age- and sex-specific traits.

Age Distribution↗

Breast cancer screening beliefs by practice location.

BACKGROUND: This study examines variations in breast cancer screening among primary care clinicians by geographic location of clinical practice. METHODS: A cross-sectional survey design was used to examine approaches to breast cancer screening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about breast cancer screening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location. RESULTS: Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four breast cancer screening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written breast cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas. CONCLUSION: Development of an evidence-based consensus statement regarding breast cancer screening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how breast cancer screening is approached across varied clinical settings.

Attitude of Health Personnel↗

Rural-urban differentials of premature mortality burden in south-west China.

BACKGROUND: Yunnan province is located in south western China and is one of the poorest provinces of the country. This study examines the premature mortality burden from common causes of deaths among an urban region, suburban region and rural region of Kunming, the capital of Yunnan. METHODS: Years of life lost (YLL) rate per 1,000 and mortality rate per 100,000 were calculated from medical death certificates in 2003 and broken down by cause of death, age and gender among urban, suburban and rural regions. YLL was calculated without age-weighting and discounting rate. Rates were age-adjusted to the combined population of three regions. However, 3% discounting rate and a standard age-weighting function were included in the sensitivity analysis. RESULTS: Non-communicable diseases contributed the most YLL in all three regions. The rural region had about 50% higher premature mortality burden compared to the other two regions. YLL from infectious diseases and perinatal problems was still a major problem in the rural region. Among non-communicable diseases, YLL from stroke was the highest in the urban/suburban regions; COPD followed as the second and was the highest in the rural region. Mortality burden from injuries was however higher in the rural region than the other two regions, especially for men. Self-inflicted injuries were between 2-8 times more serious among women. The use of either mortality rate or YLL gives a similar conclusion regarding the order of priority. Reanalysis with age-weighting and 3% discounting rate gave similar results. CONCLUSION: Urban south western China has already engaged in epidemiological pattern of developed countries. The rural region is additionally burdened by diseases of poverty and injury on top of the non-communicable diseases.

Journal Article↗

Positional error in automated geocoding of residential addresses.

BACKGROUND: Public health applications using geographic information system (GIS) technology are steadily increasing. Many of these rely on the ability to locate where people live with respect to areas of exposure from environmental contaminants. Automated geocoding is a method used to assign geographic coordinates to an individual based on their street address. This method often relies on street centerline files as a geographic reference. Such a process introduces positional error in the geocoded point. Our study evaluated the positional error caused during automated geocoding of residential addresses and how this error varies between population densities. We also evaluated an alternative method of geocoding using residential property parcel data. RESULTS: Positional error was determined for 3,000 residential addresses using the distance between each geocoded point and its true location as determined with aerial imagery. Error was found to increase as population density decreased. In rural areas of an upstate New York study area, 95 percent of the addresses geocoded to within 2,872 m of their true location. Suburban areas revealed less error where 95 percent of the addresses geocoded to within 421 m. Urban areas demonstrated the least error where 95 percent of the addresses geocoded to within 152 m of their true location. As an alternative to using street centerline files for geocoding, we used residential property parcel points to locate the addresses. In the rural areas, 95 percent of the parcel points were within 195 m of the true location. In suburban areas, this distance was 39 m while in urban areas 95 percent of the parcel points were within 21 m of the true location. CONCLUSION: Researchers need to determine if the level of error caused by a chosen method of geocoding may affect the results of their project. As an alternative method, property data can be used for geocoding addresses if the error caused by traditional methods is found to be unacceptable.

Journal Article↗

Use of drugs, alcohol and tobacco by people with schizophrenia: case-control study.

BACKGROUND: Specialised services should be developed to help people with schizophrenia and associated substance misuse. The extent of the problem therefore needs to be known. AIMS: To determine the use of drugs, alcohol and tobacco by people with schizophrenia drawn from rural, suburban and urban settings, and to compare use by general population control subjects. METHOD: People with schizophrenia (n=316) and general population controls of similar gender distribution, age and postcode area of residence (n=250) were identified in rural, urban and suburban areas of Scotland. Use of drugs and alcohol was assessed by the Schedules for Clinical Assessment in Neuropsychiatry, and use of tobacco by a questionnaire. RESULTS: More patients than controls reported problem use of drugs in the past year (22 (7%) v. 5 (2%)) and at some time before then (50 (20%) v. 15 (6%)) and problem use of alcohol in the past year (42 (17%) v. 25 (10%)) but not at some time previously (99 (40%) v. 84 (34%)). More patients were current smokers (162 (65%) v. 99 (40%)). CONCLUSIONS: Problem use of drugs and alcohol by people with schizophrenia is greater than in the general population, but absolute numbers are small. Tobacco use is the greatest problem.

Adult↗

Age- and sex-dependent distribution of persistent organochlorine pollutants in urban foxes.

The colonization of urban and suburban habitats by red foxes (Vulpes vulpes) provides a novel sentinel species to monitor the spread of anthropogenic pollutants in densely populated human settlements. Here, red foxes were collected in the municipal territory of Zürich, Switzerland, and their perirenal adipose tissue was examined for persistent organochlorine residues. This pilot study revealed an unexpected pattern of contamination by polychlorinated biphenyls (PCBs), with significantly higher levels of the predominant congeners PCB-138, PCB-153, and PCB-180 in juvenile foxes relative to adult animals. Further data analysis demonstrated that the observed difference was attributable to an age-dependent reduction of PCB concentrations in females, whereas male foxes retained approximately the same PCB burden throughout their life span. A similar sex-related bias between population members has been observed, primarily in marine mammals. Interestingly, the reduction of organochlorine contents with progressive age is reminiscent of human studies, where an extensive maternal transfer of xenobiotics to the offspring has been shown to result in increased exposure levels of infants relative to adults. To our knowledge, this is the first example of an urban wildlife species that faithfully reflects the dynamic distribution of toxic contaminants in the corresponding human population. Suburban and urban foxes occupy habitats in close proximity to humans, depend on anthropogenic food supplies, are relatively long-lived and readily available for sampling, can be easily aged and sexed, have a limited home range, and, therefore, meet several important requirements to serve as a surrogate species for the assessment of toxic health hazards.

Adipose Tissue↗

Biomarkers for exposure to ambient air pollution--comparison of carcinogen-DNA adduct levels with other exposure markers and markers for oxidative stress.

Human exposure to genotoxic compounds present in ambient air has been studied using selected biomarkers in nonsmoking Danish bus drivers and postal workers. A large interindividual variation in biomarker levels was observed. Significantly higher levels of bulky carcinogen-DNA adducts (75.42 adducts/10(8) nucleotides) and of 2-amino-apidic semialdehyde (AAS) in plasma proteins (56.7 pmol/mg protein) were observed in bus drivers working in the central part of Copenhagen, Denmark. In contrast, significantly higher levels of AAS in hemoglobin (55.8 pmol/mg protein), malondialdehyde in plasma (0. 96 nmol/ml plasma), and polycyclic aromatic hydrocarbon (PAH)-albumin adduct (3.38 fmol/ microg albumin) were observed in the suburban group. The biomarker levels in postal workers were similar to the levels in suburban bus drivers. In the combined group of bus drivers and postal workers, negative correlations were observed between bulky carcinogen-DNA adduct and PAH-albumin levels (p = 0.005), and between DNA adduct and [gamma]-glutamyl semialdehyde (GGS) in hemoglobin (p = 0.11). Highly significant correlations were found between PAH-albumin adducts and AAS in plasma (p = 0.001) and GGS in hemoglobin (p = 0.001). Significant correlations were also observed between urinary 8-oxo-7, 8-dihydro-2'-deoxyguanosine and AAS in plasma (p = 0.001) and PAH-albumin adducts (p = 0.002). The influence of the glutatione S-transferase (GST) M1 deletion on the correlation between the biomarkers was studied in the combined group. A significant negative correlation was only observed between bulky carcinogen-DNA adducts and PAH-albumin adducts (p = 0.02) and between DNA adduct and urinary mutagenic activity (p = 0.02) in the GSTM1 null group, but not in the workers who were homozygotes or heterozygotes for GSTM1. Our results indicate that some of the selected biomarkers can be used to distinguish between high and low exposure to environmental genotoxins.

Adult↗

Factors associated with variations in parental social support in primary care pediatric settings.

OBJECTIVE: To examine social support (SS) among parents across sociodemographically distinct pediatric outpatient settings. METHODS: We conducted a cross-sectional, self-administered, anonymous parent survey in 3 primary care sites in a Midwestern metropolitan area: inner-city health center, urban group practice, and suburban group practice. Participants were parents of children aged 6 weeks to 36 months. The main outcome measure was overall SS as measured by a previously validated 10-item instrument. Multivariate linear regression modeling was used to examine sociodemographic and health factors associated with overall SS scores. RESULTS: The study sample included 463 parents. The strongest sources of SS were a significant other or spouse and parent's parent or grandparent. The range for overall SS was 0 to 20, with a mean score of 12.1 (SD, +/-4.2). Parents with overall SS in the lowest quartile (n = 123) comprised 43% of parents at the inner-city health center compared with 23% of parents at the urban practice and 16% of parents at the suburban practice. In a multivariate model, factors associated with lower overall SS were race other than white or black, single or cohabiting marital status, poorer parental health, and parental depressive symptoms. CONCLUSIONS: Although parental SS was lowest in the most socioeconomically disadvantaged community in this sample, parents in all 3 communities had widely varying levels of support. Providers may gain insights about parents at increased risk for low SS by asking about parents' own physical and mental health.

Adult↗

Characteristics of metabolic and lifestyle risk factors in young Japanese patients with coronary heart disease: a comparison with older patients.

Coronary heart disease (CHD) is recognized as a lifestyle-related disease and is the second leading cause of death in Japan. However, the cardiac risk factor profile of young patients with CHD has not been clarified in suburban areas of Japan. Our study aimed to determine metabolic and lifestyle risk factors in young patients and compare them with older patients living in suburban areas of Nagano Prefecture. A multicenter study was conducted in 86 young (aged less than 40 years) and 91 older (aged 50 years and over) patients diagnosed with CHD from 1992 to 2002. There was a strong association between obesity and the occurrence of CHD events in young patients (odds ratio = 3.61, P = 0.006). Lifestyle in the young patients was characterized by a lack of physical activity and regular physical activity was found to decrease the risk of the CHD events in these patients (odds ratio = 0.31, P = 0.030). In older patients, hypertension was identified as an independent risk factor for CHD events. The results of the present study have demonstrated that obesity and a lack of regular physical exercise are independent risk factors for CHD events in younger patients. Thus, the data may be useful for the effective screening of high-risk individuals and the development of educational programs for the prevention of CHD, especially in younger Japanese.

Adult↗

Does culture confirmation of high-sensitivity rapid streptococcal tests make sense? A medical decision analysis.

OBJECTIVE: Since the 1990 publication of a decision analysis, in which the treatment of pharyngitis in children was evaluated, a number of assumptions important in that analysis have changed. Updating many of the assumptions and costs used in that analysis to reflect the conditions currently found in a large, suburban pediatric practice, a cost-effectiveness analysis was performed in which four strategies for the treatment of pharyngitis were considered: treat all, high-sensitivity antigen test, culture, and high-sensitivity antigen test with culture confirmation. DESIGN: Decision analysis. RESULTS: Using microbiology data from the 13 published studies in which a high-sensitivity antigen test (Strep A OIA; BioStar Inc., Boulder, CO) and blood agar plate culture were evaluated against a variety of gold standards, the sensitivity and specificity of the high-sensitivity antigen test were 89.1% and 95%, respectively. The sensitivity and specificity of blood agar plate throat culture were 83.4% and 99%, respectively. Penicillin V was used as the treatment of choice for uncomplicated pharyngitis; erythromycin was used in cases of penicillin allergy. Rates of suppurative and nonsuppurative complications reflect those currently seen in the United States. Other assumptions and cost data were taken from a large, suburban pediatric practice and its affiliated tertiary care medical center, except where noted. Despite the potential induction of resistance and the high number of allergic reactions associated with the treat-all strategy, this strategy had the lowest average cost per patient encounter and was the most cost-effective in terms of dollars per suppurative and nonsuppurative complication prevented. Of the strategies in which a diagnostic test was used, the high-sensitivity antigen test strategy had the lowest average cost and was the most cost-effective. The high-sensitivity antigen test with culture confirmation strategy had the highest average cost and was the least cost-effective. In the sensitivity analyses, a number of assumptions used in the original model were varied within a reasonable range. Under most conditions, the treat-all strategy remained the most cost-effective strategy used. One notable exception: when the wholesale cost of the antibiotic exceeded $10.76, as would be seen if any cephalosporin were used as the primary therapy of uncomplicated pharyngitis, the high-sensitivity antigen test strategy became the most cost-effective strategy. Under most conditions, the high-sensitivity antigen test strategy was the most cost-effective of the strategies in which a diagnostic test was used. Notable exceptions included: 1) conditions in which there was a low probability of streptococcal infection, 2) the use of an antigen test whose sensitivity is inferior to that of culture, and 3) during an epidemic of acute rheumatic fever. Culture confirmation of a negative high-sensitivity antigen test is the most cost-effective testing strategy only under conditions in which the probability of acute rheumatic fever approaches those levels last seen in the United States more than 40 years ago. CONCLUSIONS: Although most cost-effective, the treat-all strategy is not recommended because of concerns about antibiotic resistance, which could not be included in the model, and the high number of allergic reactions found in children who did not have streptococcal infection. Use of the high-sensitivity antigen test without culture confirmation of all negative results was the most cost-effective strategy in which a diagnostic test was used with respect to prevention of suppurative and nonsuppurative complications of streptococcal pharyngitis. Culture confirmation of negative high-sensitivity antigen tests was not cost-effective under any of those conditions currently seen in the United States.

Acute Disease↗

The lingering academic deficits of low birth weight children.

OBJECTIVE: To estimate the influence of low birth weight (LBW; < or =2500 g) on academic achievement in reading and mathematics in 12th grade in 2 socioeconomically and racially disparate, geographically defined communities. METHODS: Representative samples of LBW and normal birth weight (NBW) children who were born in 1983-1985 and were from the inner city of Detroit and nearby middle class suburbs were assessed longitudinally. Woodcock-Johnson Psycho-Educational Battery-Revised standardized tests of reading and mathematics were used at ages 11 and 17 (n = 773). Multiple regression analysis applying generalized estimating equations was used to assess the independent effects of LBW on test scores. RESULTS: Compared with NBW children, LBW children manifested deficits of 3 to 5 points in age-standardized tests of academic achievement at age 17 that had persisted with little change from age 11. LBW-related deficits were similar in urban and suburban communities and were independent of family factors. At age 17, LBW children were approximately 50% more likely than NBW children to score below the standardized population mean in both reading and mathematics. The LBW-related deficits in academic achievement in adolescence were largely accounted for by LBW-related deficits in general cognitive abilities, measured by IQ tests at age 6. CONCLUSIONS: Interventions to address the lingering effects of LBW on the acquisition of core academic skills during the school years should focus on preschool LBW children in both inner city and suburban communities.

Adolescent↗

Otitis media in 2253 Pittsburgh-area infants: prevalence and risk factors during the first two years of life.

OBJECTIVE: As part of a long-term study of possible effects of early-life otitis media on speech, language, cognitive, and psychosocial development, we set out to delineate the occurrence and course of otitis media during the first 2 years of life in a sociodemographically diverse population of infants, and to identify related risk factors. METHODS: We enrolled healthy infants by age 2 months who presented for primary care at one of two urban hospitals or one of two small town/rural and four suburban private pediatric practices. We intensively monitored the infants' middle-ear status by pneumatic otoscopy, supplemented by tympanometry, throughout their first 2 years of life; we monitored the validity of the otoscopic observations on an ongoing basis; and we treated infants for otitis media according to specified guidelines. RESULTS: We followed 2253 infants until age 2 years. The proportions developing > or = 1 episode of middle-ear effusion (MEE) between age 61 days (the starting point for data analysis) and ages 6, 12, and 24 months, respectively, were 47.8%, 78.9%, and 91.1%. Overall, the mean cumulative proportion of days with MEE was 20.4% in the first year of life and 16.6% in the second year of life. Tympanostomy-tube placement was performed on 1.8% and 4.2% of the infants during the first and second years of life, respectively. By every measure, the occurrence of MEE was highest among urban infants and lowest among suburban infants; these differences were greatest in the earliest months of life. Overall, unadjusted mean cumulative proportions of days with MEE were higher among boys than girls, higher among black than white infants, and higher among Medicaid than private health insurance enrollees. Cumulative proportions of days with MEE varied directly with the number of smokers in the household and with the number of other children to whom infants were exposed, whether at home or in day care, and varied inversely with birth weight, maternal age, level of maternal education, a socioeconomic index, and duration of breastfeeding. After adjustment, using multivariate analysis, the only variables that each remained independently and significantly related to the cumulative proportion of days with MEE were: during the first year of life, study site grouping, sex, the socioeconomic index, breastfeeding for > or = 4 months, the number of smokers in the household, and an index rating the degree of exposure to other children at home or in day care; and during the second year of life, sex, the socioeconomic index, and the child exposure index. The duration of breastfeeding and the degree of exposure to tobacco smoke contributed little to the explained variance; most was attributable to differences in the socioeconomic index and the child exposure index. CONCLUSIONS: Contrary to findings in many previous reports, the prevalence of otitis media during the first 2 years of life among lower-socioeconomic-status black infants appears to be as high as, if not higher than among lower-socioeconomic-status white infants, and certainly higher than among middle-class white infants. Among middle-class white infants the prevalence may also be higher than commonly assumed. The most important sociodemographic risk factors for otitis media appear to be low socioeconomic status and repeated exposure to large numbers of other children, whether at home or in day care.

Black People↗

Solar ultraviolet-B radiation in urban environments: the case of Baltimore, Maryland.

Ultraviolet-B radiation (UV-B, 280-320 nm) has important effects in urban areas, including those on human health. Broadband UV-B radiation is monitored in Baltimore, MD, as part of the Baltimore Ecosystem Study, a long-term ecological research program. We compare broadband UV-B irradiance in Baltimore with UV-B at two nearby locations: a more rural station 64 km southeast and a suburban station 42 km southwest. The monitoring station in Baltimore is on the roof of a 33-m-tall building; there are no significant obstructions to sky view. The U.S. Department of Agriculture UV-B Monitoring and Research Program provided all sensors, which were calibrated at the National Oceanic and Atmospheric Administration Central UV Calibration Facility. UV-B irradiances at the three sites generally were similar. Over all conditions, Baltimore and the suburban site measured 3.4% less irradiance than the rural site. This difference is within the anticipated +/-3% calibration uncertainty of the pyranometers. On 59 days with cloud-free conditions at all three sites, average differences in measured UV-B among the three sites were even smaller; Baltimore measured 1.2% less irradiance than the rural site. High aerosol optical thickness strongly reduced daily UV-B dose, whereas [SO2] had no influence. Surface O3 increased with increasing UV-B dose when [NO2] exceeded 10 ppb.

Baltimore↗

Echinococcosis in southern Brazil: efforts toward implementation of a control program in Santana do Livramento, Rio Grande do Sul.

This investigation aimed to design a strategy for echinococcosis control in Santana do Livramento county, an endemic area in state of Rio Grande do Sul (Brazil). Fecal samples from 65 dogs were obtained from urban, suburban and rural areas. Purging with Arecoline Bromhidrate (AB) was done to visualize Echinococcus granulosus, and Enzyme Linked Immunosorbent Assay (ELISA) was performed to detect parasite coproantigen. Samples were obtained at the beginning and at the end of treatment with Praziquantel. A third fecal sampling was also done in rural areas four months after the end of treatment. Each dog was treated immediately after the first purging and every 30 days for eight months. In urban and suburban areas no infected dogs were found. In rural areas, first evaluation showed 11.36% and 27.69% of infected dogs by AB and ELISA, respectively. No infected dogs were diagnosed in the second evaluation and in the third evaluation 36.84% and 47.37% infected dogs were identified by AB and ELISA, respectively. Medication program to combat dog infection resulted in successful interruption of parasite transmission, but the project failed to create awareness of the need for dog prophylaxis among rural populations as well as to establish a permanent control program in this municipality.

Animals↗

[Modification of the perihabitational biotype in the prevention of Chagas disease].

In zones endemic for the American trypanosomiasis the modification of the biotopes surrounding human, rural, sylvatic or suburban housing, involves the arrangement of a clean perimetral area completely free of shrubs and chaparral, devoid of dens of wild animals and dwellings of domestic animals, to hinder the persistence of peridomestic foci where the proliferation of Triatomine bugs encourage the reinfestation of the human lodgings. The success of insecticide spraying campaigns, even with simultaneous amelioration of housing, are enhanced by the modification of the biotopes. A pilot field experience is presented; a 2 year active campaign in a suburban area of Villa Carlos Paz, province Cordoba, Argentina, confirming the methods to eliminate reinfestation of houses from peridomestic sites, in an area of low vector density.

Animals↗