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PubMed2006

Burden of malaria at community level in children less than 5 years of age in Togo.

A community-based baseline cross-sectional survey was conducted in three districts in Togo in September 2004 as part of a multidisciplinary evaluation of the impact of the Togo National Integrated Child Health Campaign. During this campaign, long-lasting-insecticide-treated bed nets (LLITNs) were distributed to households with children between 9 months and 5 years of age throughout the country in December 2004. The pre-intervention survey provided baseline malaria and anemia prevalence in children < 5 years of age during peak malaria transmission. Of 2,532 enrolled children from 1,740 households, 62.2% (1,352/2,172) were parasitemic and 84.4% (2,129/2,524) were anemic (hemoglobin < 11 g/dL). Moderate-to-severe anemia (< 8.0 g/dL) was found in 21.7% (543/2,524), with a peak prevalence in children 6-17 months of age and was strongly correlated with parasitemia (OR = 2.3, 95% CI: 1.8-2.5). Net ownership (mainly untreated) was 225/2,532 (8.9%). Subsequent nation-wide introduction of LLITNs and the introduction of artemisinin-based combination therapy have the potential to markedly reduce this burden of malaria.

Anemia↗
PubMed1990

Monofilament nylon filters for preventing dracunculiasis: Durability and copepod retention after long term field use in Pakistan.

Filtration of drinking water to remove the cyclopoid copepod intermediate hosts of guinea worm. Dracunculus medinensis, is one of the primary intervention strategies for preventing dracunculiasis. In early 1987, monofilament nylon filters with 200 microns pore size were distributed to households in selected guinea worm-infected villages in Pakistan. The filters proved popular with the villagers, although reports of "loss of filters" could diminish the community-wide effectiveness of this control measure. After 12 to 15 months of usage a sample of these filters was collected and examined for damage or impairment which would decrease their use or their capacity to retain potentially infective copepods. Although all naupliar stages and early copepodids (Stages CI-II) passed through these used filters, the larger copepodids including adults (Stages CIII-VI) were retained despite small tears in the fabric. This field trial showed that after 12 to 15 months of regular use, monofilament nylon filters of 200 microns pore size remained effective in removing copepodid stages capable of supporting development of D. medinensis larvae. Considering the ease of use, popularity and effective filtration of potentially infective copepods following prolonged field use, we recommend that monofilament filters be considered in any program of guinea worm elimination.

Animals↗
PubMedDate not supplied

Transferring health and family planning service innovations to the public sector: an experiment in organization development in Bangladesh.

The International Centre for Diarrhoeal Disease Research, Bangladesh, has launched a field experiment in two rural thanas of Bangladesh to test the transferability of its successful health and family planning experiment in Matlab to the Ministry of Health and Population Control service system. This paper reviews the Matlab experiment with particular attention to its organization and identifies elements for transfer. The intervention strategy and operations research design of the new experiment are discussed. The proposed design follows an organization development strategy in which collaborative diagnostic research is used to foster institutional change.

Bangladesh↗
PubMedDate not supplied

A validity analysis of residential magnetic fields estimated from high-voltage transmission lines.

Between November 1994 and May 1995, indoor power frequency magnetic fields of 407 residences in northern Taiwan were assessed by short-term on site measurements and by modeling computerized power lines information from high-voltage transmission lines. The study residences were selected according to the distance from the transmission lines with cutoff points of 50 meters (m), 100 m, and 150 m, which gave rise to four categories of residences. The analysis showed that the measured magnetic fields were higher than the calculated magnetic fields for most residences, especially for those with lower measured magnetic fields. The measured and calculated magnetic fields showed an agreement of 0.93 (intra-class correlation coefficient, [ICC] = 0.93) for the residences within 50 m of the transmission lines. The ICC declined with the distance from the transmission lines with a lowest ICC of 0.42 for the residences located more than 149 m away from power lines. When both measured and calculated magnetic fields were categorized into three levels with cutoff points of 1 milligauss (mG) and 2 mG, the indices of agreement were very similar for the three residential categories within 149 m of the lines with Kappa (K) between 0.51 and 0.55. The K for the residences more than 149 m from the lines was low at 0.29. The ICC and K observed from a reduced sample of 114 residences presumably representative of all residences in northern Taiwan with respect to the distribution of household magnetic fields was 0.90 and 0.64, respectively. Our data show that using exclusively computerized power lines information to assess residential magnetic fields exposure entails a certain degree of exposure misclassification, but in the absence of direct measurement, this way of doing provides reasonable estimates of magnetic fields exposure within 100 m of transmission lines.

Air Pollution, Indoor↗
PubMed1979

Epidemic mechanisms of type A influenza.

The antigenic varieties of influenza A virus isolated from 1968 to 1976 in a surveillance of a small, rather remote population were similar to those from England and Wales as a whole, despite frequent antigenic changes during the period. Household studies in the first two H3N2 influenza A epidemics found low attack rates within households, a high proportion (70%) of affected households with only one case of influenza, similar distributions of affected households in the two epidemics by the number of cases of influenza and similar distributions of the influenza cases by the day of their onset in the household outbreak. No serial interval could be demonstrated by cumulating household outbreaks. More than one minor variant was causing influenza contemporaneously in the same villages in several seasons, and different variants were on one occasion found on successive days in bedfellows. The regular occurrence of epidemics in winter was often accompanied by the disappearance of the epidemic variants and their replacement, after a virus-free interval, by new variants. These epidemiological findings seem best interpreted on the following tentative hypothesis. Influenza A sufferers do not transmit the virus during their illness; instead it rapidly becomes latent in their tissues so that they become symptomless carrier-hosts and develop specific immunity. Next season an extraneous seasonally mediated stimulus reactivates the latent virus residues so that the carrier-host becomes briefly infectious, though symptomless. Antigenic drift occurs because particles reconstituted to be identical with the progenitor virus cannot escape the specific immunity it has provoked in the carrier host. He can shed only mutants also determined by the progenitor virus. From the assortment of mutants shed by the carrier-host, his non-immune companions select that (those) which is best fitted to survive, and it rapidly causes influenzal illness. Epidemics consist largely or entirely of such persons sick with influenza caused by reactivated virus caught from symptomless carrier-hosts.

Antigens, Viral↗
PubMed1984

Distribution of moulds on stored grains in households in an area affected by endemic nephropathy in Yugoslavia.

The distribution of moulds on stored maize, wheat and beans in families affected and unaffected by nephropathy in the endemic area (Endemic nephrophaty - Balkan kidney disease) of middle Posavinain Yugoslavia was studied. Among 3 700 samples of stored grains, no significant difference was noted in the contamination by moulds of samples taken from affected and unaffected families. The predominant moulds on all the samples were 'storage moulds' from the genera Penicillium and Aspergillus, 'field moulds' among which Alternaria and Fusarium were encountered most frequently, and the 'spoilage moulds' Absidia, Mucor, Rhizopus, Trichoderma and Trichothecium.

Balkan Nephropathy↗
PubMedDate not supplied

[Differences in income distribution data between the population census and household surveys (PNAD): conceptual and operational aspects].

"The [purpose] of this article is to explain the main differences between the concepts and the [collection procedures] of income distribution data used in [the] 1980 demographic census and in [the] 1979 and 1981 household surveys in Brazil. The article also comments [on] some differences about the data information on income distribution produced by census and household surveys." (SUMMARY IN ENG)

Americas↗
PubMed1987

The influence of permethrin-impregnated bednets and mass drug administration on the incidence of Plasmodium falciparum malaria in children in Sabah, Malaysia.

A small-scale trial was carried out in the Upper Kinabatangan district of Sabah, Malaysia, to determine the effect of using permethrin-impregnated bednets on malaria transmission. A total of 306 nylon bednets with cotton borders, impregnated at a dose estimated to have been 0.062 g permethrin/m2 of nylon netting, were distributed to 139 households in five villages. At the time of distributing bednets, mass drug administration with Fansidar plus primaquine was also administered to the human population to clear all parasitaemias due to Plasmodium falciparum Welch. In another village, for comparison, mass drug administration was the only intervention. After intervention measures in December 1984 and January 1985, the parasite rates in children declined in all villages during the first month, significantly more in the villages with impregnated bednets than in the control, thus proving that the nets had an impact on malaria. However, after about 2 months, parasite rates started to increase again. After 4-6 months, parasite rates in the villages with bednets approached the rate in the control village without nets. The increase in parasite rates was paralleled by a significant deterioration in the quality, physical condition and the degree of non-utilization of bednets. Entomological evaluation proved the efficacy of permethrin-impregnated nets for controlling Anopheles balabacensis Baisas and other anophelines. Bioassays (1 h exposure) of permethrin-impregnated bednets gave 100% mortality initially and 44-61% mortality after 85-106 days. Mosquito collections in treated bednets were significantly reduced for at least 217 days. The project failed to achieve prolonged suppression of malaria transmission for a combination of entomological, sociological and practical reasons which are discussed in relation to the objectives and implementation of future bednet studies.

Animals↗
PubMed1990

Income distributions in an international perspective--the case of Hungary and the Netherlands.

"This article describes the comparison of the income distributions of Hungary and the Netherlands. In this comparison harmonised micro-data have been used to reach a high degree of comparability. The empirical results show that the inequality of household incomes was the same in both countries in the early eighties. After adjustments for differences in size and composition of households the income distribution was less equal in the Netherlands than in Hungary. The equivalence scales used were based on national budget surveys."

Developed Countries↗
PubMed2007

Estimates of microbial quality and concentration of copper in distributed drinking water are highly dependent on sampling strategy.

The numbers of bacteria generally increase in distributed water. Often household pipelines or water fittings (e.g., taps) represent the most critical location for microbial growth in water distribution systems. According to the European Union drinking water directive, there should not be abnormal changes in the colony counts in water. We used a pilot distribution system to study the effects of water stagnation on drinking water microbial quality, concentration of copper and formation of biofilms with two commonly used pipeline materials in households; copper and plastic (polyethylene). Water stagnation for more than 4h significantly increased both the copper concentration and the number of bacteria in water. Heterotrophic plate counts were six times higher in PE pipes and ten times higher in copper pipes after 16 h of stagnation than after only 40 min stagnation. The increase in the heterotrophic plate counts was linear with time in both copper and plastic pipelines. In the distribution system, bacteria originated mainly from biofilms, because in laboratory tests with water, there was only minor growth of bacteria after 16 h stagnation. Our study indicates that water stagnation in the distribution system clearly affects microbial numbers and the concentration of copper in water, and should be considered when planning the sampling strategy for drinking water quality control in distribution systems.

Biofilms↗
PubMed2004

Disposal frequencies of selected recyclable wastes in Dar es Salaam.

A statistical survey of households based upon questionnaires distributed via primary schools has been carried out in five wards of Dar es Salaam, Tanzania, to estimate disposal frequencies (number of items disposed per week) for newsprint, metal cans, glass and plastic containers and plastic shopping bags. Plastic shopping bags are disposed most frequently while glass containers are disposed least frequently. The statistical distribution of disposal frequencies, which seems to be influenced by household income, is well described by Poisson distribution. Disposal frequencies are mutually correlated at 95% level of probability despite the differences in disposal patterns of individual households.

Conservation of Natural Resources↗
PubMed1999

Can community leaders' preferences be used to proxy those of the community as a whole?

BACKGROUND: Community-based distribution of ivermectin and other drugs requires people in the endemic communities who are capable of distributing the drug. It is essential also to collect information on local people's views concerning different financing mechanisms and approaches to distributing ivermectin. However, studies at household level are resource-intensive. Eliciting the preferences of the community by interviewing a smaller number of community leaders offers an alternative strategy. METHODS: A comparison of information from community leaders and household heads on the financing and distribution of ivermectin through communities was conducted in three communities in Nigeria to determine whether rapidly collected information from key community leaders could represent broad community preferences. RESULTS: The preferences of community leaders and household heads were comparable in relation to the method of collecting payments, managing payments and making payments, who should set the level of payments and the drug distribution mechanisms. However, there were differences between community leaders' views and those of heads of households concerning how the scheme should be supervised. CONCLUSIONS: This study has shown that community leaders' views can only be used as a partial substitute for more laborious methods of data collection insofar as they have the attraction of being quicker and less costly to use. However, they should not be assumed to be identical with the views of the community as a whole.

Attitude to Health↗
PubMed1994

An epidemiological study of leprosy infection by serology and polymerase chain reaction.

A population-based study has been carried out in two adjacent villages in a highly leprosy-endemic area of South Sulawesi, Indonesia. The prevalence of clinical leprosy was 10.0 per 1000 inhabitants. A total of 1015 serum samples and 1228 nasal swab specimens were collected. IgM antibodies in blood to phenolic glycolipid-I (PGL-I) of Mycobacterium leprae were demonstrated by the gelatin particle agglutination test (MLPA) and by indirect ELISA (IgM-PGL). IgG antibodies to PGL-I (IgG-PGL) and lipoarabinomannan-B (IgG-LAM) were measured by indirect ELISA. The presence of M. leprae in nasal swab specimens was established by a polymerase chain reaction (PCR). The seropositivity rates in the population were 32% for MLPA, 30.8% for IgM-PGL, 6.7% for IgG-PGL, and 11.6% for IgG-LAM. Seropositivity rates for MLPA and IgM-PGL were highest in the younger age groups. There was no difference in seropositivity in any of the tests between household contacts of leprosy patients and noncontacts. The seropositivity rates in the MLPA and IgM-PGL were not randomly distributed among all households. The presence of M. leprae by PCR was demonstrated in 7.8% of the nasal swab specimens. No correlation was found between the results of the PCR and serology. This study indicates that M. leprae is widespread in the population, and that in endemic areas many individuals carry M. leprae in their nasal cavities without having obvious symptoms of leprosy.

Adolescent↗
PubMed1991

Characteristics and economic implications of migration.

Factors affecting rural-urban migration in India are explored. "The study, based on the sample of 205 migrant households, conducted in the hill region of Uttar Pradesh, attempts to highlight the characteristics of migration and its effects on the pattern of income distribution among the households....[It is found that] migration...is primarily motivated by...socioeconomic condition of households, development of road transport and communication sources, level of education...and various geographical and physical conditions."

Asia↗
PubMed2004

Tracking the concentration of heterotrophic plate count bacteria from the source to the consumer's tap.

The goal of this project was to quantify the concentration of heterotrophic plate count (HPC) bacteria within water reaching consumer's taps, and from the sources used by a major utility serving the City of Tucson, AZ. With this information, the amounts and sources of HPC bacteria consumed at the tap could be determined. Samples of water were collected on a monthly basis from two well fields, the CAVSARP recovery well field and Southern Avra Valley well field which serves as one of the groundwater sources for Tucson, AZ, and the distribution system which serves the same homes from which tap water was also tested. The average concentration of HPC in source waters within Southern Avra Valley Wells was 56 CFU/ml (range 1-1995/ml). From the CAVSARP recovery well field, corresponding values were 38 CFU/ml (1 to 502 CFU/ml). Unblended groundwater in the chlorinated distribution system averaged 22 CFU/ml (range 1-794). Blended water at the chlorinated distribution site averaged 47 CFU/ml (range 10-158). There was a major shift in the percentage of gram negative to gram-positive bacteria from the wells to the distribution system, to the tap. In the surface CAP source water, 76% of the bacteria were gram-negative compared to 27% gram-negative in the CAVSARP recovery wells. In contrast, Avra Valley wells contained 17% gram-negative bacteria. In both the Tucson groundwater distribution sites and blended distribution sites, the corresponding number of gram negative bacteria was 12%. Finally at the tap, only 0.2% of the bacteria were gram-negative. The average number of bacteria in household taps averaged 3072 HPC/ml and was equal or greater than 500 ml 68% of the time. This study shows that the number of HPC bacteria increases dramatically from the distribution system to the consumers tap. Thus, the major source of bacteria ingested by the average consumer in Tucson originates from bacteria within the household distribution system or the household tap, rather than from source waters or the distribution system. It is also clear that consumers' regularly consume more than 500 HPC/ml from drinking water taken from the household tap.

Arizona↗
PubMed2004

Predictors for spread of clinical group A streptococcal tonsillitis within the household.

OBJECTIVE: The objectives of this study were to explore how frequently group A streptococci (GAS) were giving additional cases of clinical GAS tonsillitis within the households and to analyse predictors for such spread of GAS infection. SETTING: Two Norwegian general practice populations in Stokke and Kongsberg communities. PATIENTS: 110 households with at least one member with sore throat lasting less than 7 days, and GAS demonstrated in throat culture. Among the 110 index patients 51 (46%) were parents, 35 mothers and 16 fathers; 23 were children 6 years and younger, while 36 were children aged 7-15 years. MAIN OUTCOME MEASURES: Frequency of spread of clinical GAS infection to another household member within 4 weeks. Distribution of age and size of household in families with and without spread of GAS infection. RESULTS: In 30 (27%) households one or more new cases of GAS tonsillitis was found, adding 40 new infections. No spread of GAS disease was found in households with only adult members. A significantly higher proportion of spread was found in households with 4 or more members compared with households with fewer members, and low age of the index person. Short duration of symptoms before seeing a doctor was also associated with spread of GAS. In a logistic regression analysis carried out in the households with children, short duration of symptoms before diagnosis and treatment and low age of index person were significantly associated with spread of the infection. CONCLUSIONS: Even with standard penicillin treatment, GAS infection is frequently spread within households, and most frequently in households with children and many members.

Adolescent↗
PubMed1991

[Use and misuse of an outpatient casualty department].

During periods of five weeks before and five weeks after distribution of a pamphlet entitled "Before you go to your doctor or to the casualty department" which was distributed to all households, the patterns of attendance at a casualty department were investigated with subdivision into degrees of indication for attendance. A significant decrease in the number of attendances was observed after distribution of the pamphlet. Patients with lesser indications remained away. It was estimated that at least 56% of the cases could have been treated in the primary sector. 37% of the attendances outside normal working hours were considered as being postponable until daytime.

Adolescent↗