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PubMed2005

Depressive symptoms in mothers of infants identified as genetically at risk for type 1 diabetes.

OBJECTIVE: This study describes maternal depression associated with newborn genetic screening for type 1 diabetes after risk notification. RESEARCH DESIGN AND METHODS: Mothers of at-risk infants (n = 192), identified through newborn genetic screening as part of the Prospective Assessment of Newborns for Diabetes Autoimmunity study, were administered a structured telephone interview assessing maternal depressive symptoms 1 and 3.5 months after risk notification. Statistical analyses were conducted to examine predictors and correlates of maternal depressive symptoms. RESULTS: For the total sample, maternal depressive symptoms in response to infant risk status were not elevated at 1 and 3.5 months after risk notification. However, at the first interview, mothers from ethnic minority backgrounds (P < 0.002), with limited education (P < 0.001), and with postpartum depression symptomatology (P < 0.001) reported significantly more depressive symptoms in response to risk notification (r2 = 0.354). At the second interview, postpartum depression symptomatology remained a powerful predictor of depressive symptoms in response to risk notification (P < 0.001). In addition, certain coping styles (wishful thinking, self-blame, and seeking social support) were associated with increased depressive symptoms. A history of major depression was a correlate of both postpartum depressive symptomatology (r = 0.26) and maternal depressive response to risk notification (r = 0.21). CONCLUSIONS: For the most part, mothers of infants genetically at risk for type 1 diabetes do not appear to evidence elevated depressive symptoms. This suggests that most mothers are resilient when notified of infant risk. However, certain maternal characteristics such as ethnic minority status, less than a high school education, postpartum depression symptomatology, a history of major depression, and certain coping strategies (wishful thinking, self-blame, and seeking social support) appear to be associated with a more difficult maternal response to the news of an infant's increased genetic risk for type 1 diabetes.

Adult↗
PubMedDate not supplied

[Cross infection in a high risk nursery: comparison of two epidemiologic surveillance methods].

Two methods of surveillance for nosocomial infection--routine notification and active case finding--were compared during three consecutive months at the high risk newborn unit of the Hospital de Base of the Federal District, involving 66 newborns, which represented 93% of the total patient population referred to that unit for specialized care. Our purpose was to measure the efficiency of routine notification. While this method involved infection notification forms routinely filled by the physician at discharge time, active surveillance consisted of physical examination and chart review of all the newborns, carried out, independently, twice a week: routine notification estimated a 27.3 per cent prevalence rate, versus a 30.3 per cent by active-case finding, considered by the authors a superior surveillance method. Although infection rates were similar, routine surveillance resulted in many false-positive and false-negative notifications, reaching a sensitivity of 60.0 per cent and a specificity of 86.9 per cent. The resulting positive predictive value was 66.7 per cent and negative, 83.3 per cent. The data collected by routine notification was often incomplete and inconsistent. In conclusion, the results seem to indicate that control programs based solely on routine surveillance could be producing inaccurate nosocomial infection rates and, consequently inadequate control measures.

Analysis of Variance↗
PubMedDate not supplied

[The incidence of tuberculosis in Romania in 1994].

The 1994 TB notification rate structure in Romania was based on the data reported in "New-case/relapse TB notification form", registered between 1.01.-31.12.1994 and stored in "National TB-Register" data base. The 21,422 TB patients notified in 1994 correspond to an annual incidence of 94.2%000, which means an increase of 5.41% as compared with 1993, of 34.6% as compared to 1990 and of 68.8% as compared to 1985. As compared with 1985 tb notifications, this increase supplied a commulative overload of 32,546 patients, out of which, 18,233 only in the last 5 years. Tb notification rate show large differences between districts, varying from 38.9%000 (Harghita district) to 130.2%000 (Giurgiu district). The great variations between the number of the quarterly reported cases for 1994 in different counties, having an alleatory distribution of the extreme values in different periods of the year, could represent an under-diagnosis. This hypothesis could be sustained also by the large differences in the ratio of the pleural tb effusions in various districts (from 16% of the TB-incidence in Braşov district to 1.4% in Satu Mare county) or the ratio of the other extra-pulmonary tb forms (that are dispersed between 1.5% in Salaj county to 8% in Constanţa county). 3,428 patients were registered more than 3 months after the start of the treatment, 500 after more than 6 months and even 24 patients were notified more than 1 year later. Taking into account this delay in reporting and the facts already mentioned, we could suppose a higher number of cases than reported for a given time interval. The ratio of bacteriologicaly prouved pulmonary-TB cases was 76.4% (i.e. 61.6%000), varying in different counties between 48.4% (Argeş) and 95.4% (Sibiu). These variations could rather be explained by the quality of the sputum-examination than by the profile of the registered patients. A large proportion (81%) of the confirmed cases are smear-positive, varying between 47.6% (Argeş) and 88.6% (Bistriţa). The high percentage of the smear-positive cases underscore the large number of "sources" whereas variations between the ratios are perhaps due to the quality of the smear examination. Ratio of pulmonary cases confirmed only by cultures (14.5% in Romania) revealed also teritorial differences, on a scale between 2.9% (Teleorman) and 34.5% (Botoşani). To the number of the smear-positive cases notified during 1994, another 6,136 chronic patients (at the end of 1994) had to be considered. The peak prevalence of sputum positiv cases in 1994 (positive cases at the beginning of the year, plus positive cases added during 1994) was of 24,568 (108%000 inhabitants, 137%000 adults). New notified bacteriologicaly positive TB-cases (13,914) added to all chronic TB-cases (6,136) reported, represent a lower number than "maximal bacilli excretors prevalance" reported. The lacking 4,500 positive patients could represent either cases reported as having no culture results (the culture results could have been registered two months later) or unreported cases. This situation could be corrected by a "double-reporting" with matching of the reports, starting in 1995. The TB notification rate in children was 19.8%000 (949 cases). The 2,405 tb deaths correspond to a TB-mortality of 10.6%000 in 1994. During 1994, 66,779 patients were hospitalised with "pulmonary tb" diagnosis, 44,915 (67.3%) were repeatedly negatives and 1,545 had no examination for mycobacteria reported. Out of the total of 20,248 positive cases, 15,398 became negative whereas 4,834 (23.9%) were released sputum-positive. The number and notification rate of tb cases by sex and age groups, localisation and bacterial confirmation (for pulmonary TB), by districts, are presented in tables and graphs (drown on the same scale), printed as supplement of this issue.

Adolescent↗
PubMed1995

Tuberculosis in London: a review, and an account of the work of the London Consultants in Communicable Disease Control Group Working Party.

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.

Adolescent↗
PubMed2004

The management for tuberculosis control in Greater London in comparison with that in Osaka City: lessons for improvement of TB control management in Osaka City urban setting.

The tuberculosis (TB) notification in Osaka City has been persistently high compared with other urban areas in Japan. Although the TB notification in Greater London has kept much lower level compared with that in Osaka City, it has been also persistently high compared with other urban areas in the UK. Nonetheless, the contexts of the two cities relating TB control programme as well as the epidemiological situation greatly vary; there must be some lessons to be learnt from each other to improve each TB control programme to tackle against TB more effectively. Comparing the epidemiological situation of TB in both cities, it is obvious that Osaka City suffers TB more than Greater London in terms of the TB notification rate. Concerning the context of the TB control programme, Osaka City has centralised approach with strong local government commitment; Greater London, on the other hand, has an approach that is greatly fragmented but coordinated through voluntary TB Networks. This paper aims to draw some constructive and practical lessons from Greater London TB control management for further improvement of Osaka City TB control management through literature review and interview to health professionals. TB epidemiology in Greater London shows distinct features in the extent of TB in new entrants and TB co-infected with HIV in comparison with those in Osaka City. TB epidemiology in Osaka City is to a great extent specifically related to homeless people whereas in Greater London, this relationship occurs to a lesser extent. Both areas have relatively high TB-notification rates compared with national figures, and they have "TB hot spots" where remarkably high TB-notification rates exist. TB control in Greater London is characterised with decentralised and devolved services to local government health authorities supplemented with co-ordinating bodies across sectors as well as across Greater London. Sector-wide TB Network as well as London TB Group (LTBG) and London TB Nurses Network are major key functioning bodies to involve relevant professionals as wide as possible. The specialist TB nurses play key roles for TB case management across Greater London, while in Osaka City, TB control is characterised with strong leadership and commitment of Osaka City Government for the TB control programme. The Osaka City Public Health Centre (PHC) takes initiatives to expand "Cohort Analysis and Case Management Conferences" at each of the 24 Ward Health and Welfare Centres as well as "DOTS Conferences" at hospitals for improvement of case management by physicians and nurses at hospitals as well as by the health centre staff. Public health nurses (PHNs) play very important roles for TB case management as frontline in Osaka City. Comparing the TB control in both cities, the following suggested recommendations are made to both cities for further improvement. Four suggested recommendations to Osaka City are: more resource re-allocation to community-based TB care than to hospital-based TB care should be done; Cohort Analysis and Case Management Conferences should be strengthened through involving more multi-disciplinary sectors; specialist TB PHN at each of the 24 Ward Health and Welfare Centres should be assigned in order to concentrate more on TB control activities; and accessibility to laboratory data such as drug susceptibility test for health centre staff should be improved. Two suggested recommendations to Greater London are: screening for TB high-risk group like homeless people should be strengthened, and regular sector-wide multi-disciplinary case conferences for proper case management should be strengthened.

AIDS-Related Opportunistic Infections↗
PubMed2002

Underreporting of malaria incidence in The Netherlands: results from a capture-recapture study.

The aim of this study was to estimate the completeness of notification of malaria by physicians and laboratories in the Netherlands in 1996. We used a capture-recapture (CRC) analysis of three incomplete, partially overlapping registers of malaria cases: a laboratory survey, the Notification Office and the hospital admission registration. The response of the laboratories was 83.2%. In 1996 the laboratories microscopically identified 535 cases of malaria, 330 patients with malaria were admitted to hospital and physicians notified 311 malaria cases. 667 malaria cases were recorded in at least one register. CRC analysis estimated the total number of malaria cases at 774 (95 % CI of 740-821). This implies a completeness of notification of 40.2% for physicians and 69.1% for the laboratories. It can be concluded that laboratory-based notification can considerably increase the number of officially reported malaria cases as compared to notification by physicians. However, possibly one-third of the cases may still go unreported.

Animals↗
PubMed2000

Evaluation of the SIMI system, an experimental computerised network for the surveillance of communicable diseases in Italy.

In Italy, the current communicable disease notification system is organised as follows: in each region, Local Health Units (LHU) fill in and forward case report forms (CRF) to the Regional Health Authority, which send aggregated and individual notifications to several central-level institutions. In most regions, all data are recorded manually on hardcopy. Although most relevant data from CRFs are eventually entered into a computerised database at the National Institute of Statistics (ISTAT), the national database is only available 3-4 years later and no data-quality control is performed at that time. To improve the quality and timeliness of notification, in 1994, the Istituto Superiore di Sanità (the National Institute of Health) began to develop an experimental computerised surveillance network for communicable diseases (referred to as 'SIMI'). Specifically, a software was created and distributed to the LHUs and the Regional Health Authorities; staff training was performed; and feedback and analyses of collected data was promoted. SIMI was evaluated in the 13 regions that were participating in 1997 (out of a total of 20 regions in Italy), using criteria commonly used for surveillance systems (i.e., completeness and coherence of data, case definitions, costs, timeliness, and feedback). SIMI was implemented at a limited cost and the data collected were observed to have had a high degree of completeness and internal consistency. The SIMI system has since been adopted for the routine notification of communicable diseases in nearly all regions. Similar evaluations will be necessary for assessing the performance of the various notification systems used across Europe and to include them in a European network.

Communicable Disease Control↗
PubMed2001

Laboratory enhanced surveillance for meningococcal disease in Victoria.

OBJECTIVE: To describe the epidemiological and microbiological characteristics and notification patterns of invasive meningococcal disease (IMD) in Victoria between 1990 and 1999. METHODS: Cases of IMD occurring between 1990 and 1995 identified in any of three databases were combined, matching where possible. Statistical modelling provided estimates of cases missing from all datasets. Notification sources for 1999 and 2000 cases were identified. Cases identified from notification and laboratory results provided the data to describe IMD epidemiology between 1990 and 1999. RESULTS: Between 1990 and 1995, 479 cases of IMD were identified. Three individual datasets each identified between 62 and 82% of cases and 47% of cases were identified in all three datasets. Statistical modelling estimated that between 37 and 83 additional cases were not identified by any dataset. Serogroup B and C strains caused 63 and 33% of culture-positive cases, respectively, with a substantial rise in serogroup C cases in 1999. Epidemiological characteristics remained relatively constant between 1990 and 1998, but an increase in patient age was seen in cases with serogroup C disease in 1999. In addition to three clonal strains seen elsewhere, an additional strain was identified that was unique to Victoria. Since January 1999, only 72% of notifications have come from treating doctors. CONCLUSIONS: Meningococcal disease is of increasing public health significance in Victoria. Laboratory enhanced notification has improved case identification and detailed microbiological information has improved our understanding of the changing epidemiology of this disease. Collaboration with laboratories and other agencies, active investigation of putative cases and microbiological monitoring are important elements in supporting public health decisions about the control of IMD.

Age Distribution↗
PubMed1994

Surveillance for sexually transmissible diseases in Victoria, 1983 to 1992.

Surveillance systems have been developed in Victoria to determine trends in sexually transmissible diseases (STDs). Notifications to the Health Department (including laboratory notification since May 1990) have been supplemented by data about strains of Neisseria gonorrhoeae and cultures for Chlamydia trachomatis processed by the Microbiological Diagnostic Unit, enhanced laboratory surveillance of syphilis, and data on genital herpes and genital warts from the Melbourne Sexual Health Centre. During the period under review the incidence of gonorrhoea declined, rapidly at first, and then more slowly. For women, this trend has continued, while gonorrhoea acquired abroad by men has become relatively more important. Since 1988, gonorrhoea in homosexual men has increased, and rectal isolates have increased concurrently, raising concerns about HIV risk behaviour. Cases of syphilis are likely to be ascertained through STD, antenatal and refugee screening, rather than because of symptoms or contact tracing. Chlamydia is a the most common notifiable STD, despite underreporting and underdiagnosis. In 1991, 832 cases were notified, increasing to 1377 in 1992. In 1992, of the 73 cases (65 per cent of notifications) where the doctor identified a risk, 15 per cent was attributed to homosexual contact, and 27.4 per cent to heterosexual exposure. Limitations in the data include inadequate standard case definitions for many STDs, changes in the statutory requirement for notifications in 1990, underreporting, changes in diagnostic and screening patterns, and lack of detailed demographic data. Education of general practitioners is needed to improve diagnosis and notification of chlamydia.

Adult↗
PubMed2000

International patterns of tuberculosis and the prevalence of symptoms of asthma, rhinitis, and eczema.

BACKGROUND: An ecological analysis was conducted of the relationship between tuberculosis notification rates and the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 85 centres from 23 countries in which standardised data are available. These essentially comprised countries in Europe as well as the USA, Canada, Australia, and New Zealand. METHODS: Tuberculosis notification rates were obtained from the World Health Organization. Data on the prevalence of symptoms of asthma, rhinitis, and eczema in 235 477 children aged 13-14 years were based on the responses to the written and video questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC). The analysis was adjusted for gross national product (GNP) as an estimate of the level of affluence. RESULTS: Tuberculosis notification rates were significantly inversely associated with the lifetime prevalence of wheeze and asthma and the 12 month period prevalence of wheeze at rest as assessed by the video questionnaire. An increase in the tuberculosis notification rates of 25 per 100 000 was associated with an absolute decrease in the prevalence of wheeze ever of 4.7%. Symptoms of allergic rhinoconjunctivitis in the past 12 months were inversely associated with tuberculosis notification rates, but there were no other significant associations with other ISAAC questions on allergic rhinoconjunctivitis or atopic eczema. CONCLUSIONS: These findings are consistent with recent experimental evidence which suggests that exposure to Mycobacterium tuberculosis may reduce the risk of developing asthma.

Adolescent↗
PubMed1997

Tuberculosis in England and Wales in 1993: results of a national survey. Public Health Laboratory Service/British Thoracic Society/Department of Health Collaborative Group.

BACKGROUND: A national survey of tuberculosis notifications in England and Wales was carried out in 1993 to determine the notification rate of tuberculosis and the trends in the occurrence of disease by ethnic group in comparison with the findings of similar surveys in 1978/79, 1983, and 1988. The prevalence of HIV infection in adults notified with tuberculosis in the survey period was also estimated. METHODS: Clinical, bacteriological, and sociodemographic information was obtained on all newly notified cases of tuberculosis in England and Wales during the six months from 2 January to 2 July 1993. The prevalence of HIV infection in 16-54 year old patients with tuberculosis notified throughout 1993 was assessed using "unlinked anonymous" testing supplemented by matching of the register of patients with tuberculosis with that of patients with AIDS reported to the PHLS AIDS centre. Annual notification rates were calculated using population estimates from the 1993 Labour Force Survey. RESULTS: A total of 2706 newly notified patients was eligible for inclusion in the survey of whom 2458 were previously untreated the comparable figures for 1988 were 2408 and 2163. The number of patients of white ethnic origin decreased from 1142 (53%) in 1988 to 1088 (44%) in 1993 whereas those of patients of Indian, Pakistani, or Bangladeshi (Indian subcontinent (ISC)) ethnic origin increased from 843 (39%) in 1988 to 1014 (41%) and those of "other" (non-white, non-ISC) ethnic origins increased from 178 (8%) to 356 (14%). The largest increase was seen in the black African ethnic group from 37 in 1988 to 171 in 1993. Forty nine per cent of patients had been born abroad and the highest rates were seen in those who had recently arrived in this country. The overall annual notification rate for previously untreated tuberculosis in England and Wales increased between 1988 and 1993 from 8.4 to 9.2 per 100,000 population. The rate declined in the white, Indian, and black Caribbean ethnic groups and increased in all other groups. In the white group the rate of decline has slowed since the last survey: in several age groups the rates were higher in 1993 than 1988 but the numbers in these groups were small. Thirty six (4.1%) of the 882 previously untreated respiratory cases were resistant to isoniazid and three (0.3%) to isoniazid and rifampicin. Sixty two (2.3%) adults aged 16-54 years were estimated to be HIV-infected. Evidence of under-reporting of HIV positive tuberculosis patients was found. CONCLUSIONS: The number of cases and annual notification rate for previously untreated tuberculosis increased between 1988 and 1993. Although the decline in rates in the white population has continued, the rate of decline has slowed. The high rates in the ISC ethnic group population have continued to decline since 1988 whereas rates in the black African group have increased. An increased proportion of cases were found among people born abroad, particularly those recently arrived in this country. In previously untreated cases the level of drug resistance remains low and multi-drug resistance is rare. A small proportion of adults with tuberculosis were infected with HIV but there may be selective undernotification of tuberculosis in these patients.

Adolescent↗
PubMed2004

A new method for assessing the impact of emerging infections on global trade.

In this paper, the authors describe a new method for assessing the impact of emerging infections on global trade flows. When one compares notifications to the World Trade Organization (WTO) of the emergency measures taken to control certain animal and plant diseases with the trade values of certain products from the United Nation's Commodity Trade Statistics Database (Comtrade) (identified through the World Customs Organization's harmonised system of tariff product codes [HS]), it is possible to estimate the extent to which trade has been diverted from the affected economies. The authors study in detail the example of bovine spongiform encephalopathy (BSE). When member countries of the WTO change their import policies towards the goods of a trading partner, as the result of an emerging disease such as BSE, they must file notifications of such changes through the Sanitary and Phytosanitary Committee of the WTO. To quantify the impact of BSE on trade, the authors compared these notifications against Comtrade statistics, using the HS 1996 tariff code variable. (The HS 1996 tariff codes allow the tracking and recording of the volumes of exports and imports, in quantity and value, between any two member countries between 1998 and 2000 in the database.) The authors then used this linked dataset to describe the dollar impact of the BSE-related notifications filed in 2000 on the trade flow of imports. The results of this study suggest that economies affected by BSE notifications saw a decline of US$5.6 billion from hypothetical projections in designated products. At the same time, unaffected economies saw an increase of US$1.5 billion from hypothetical projections in the same products. Thus, it may be concluded that import restrictions to control the spread of emergent spongiform encephalopathy infection had a significant effect on trade flows. These results also emphasise the interconnectedness of global trade: trade restrictions for some economies may enhance trade opportunities for others. Further studies using these methods are warranted.

Animals↗
PubMed2001

Australia's notifiable diseases status, 1999: annual report of the National Notifiable Diseases Surveillance System.

In 1999 there were 88,229 [corrected] notifications of communicable diseases in Australia reported to the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 1999 was an increase of 3 per cent on notifications in 1998 (85,227) and the second largest reporting year since the NNDSS commenced in 1991. Notifications in 1999 consisted of 29,977 bloodborne infections (34% of total), 22,255 gastrointestinal infections (25%), 21,704 sexually transmitted infections (25%), 5,986 vector borne infections (7%),5,228 vaccine preventable infections (6%), 1,967 (2%) other bacterial infections (legionella, meningococcal, leprosy and tuberculosis), 1,012 zoonotic infections (1%) and 3 quarantinable infections (0.003%). Notifications of bloodborne viral diseases particularly hepatitis B and hepatitis C and some sexually transmitted infections such as gonorrhoea and chlamydia continue to increase in Australia. Steep declines in vaccine preventable diseases such as Haemophilus influenzae type b, measles, mumps and rubella continued in 1999. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Surveillance Scheme (LabVISE) and sentinel general practitioner schemes. In addition this report comments on other important developments in communicable disease control in Australia in 1999.

Australia↗
PubMed1995

Changing epidemiology of methicillin-resistant Staphylococcus aureus in Western Australia.

OBJECTIVE: To assess the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Western Australia. DESIGN: Retrospective review of statutory notification data. SETTING: Western Australia (WA), 1993. OUTCOME MEASURES: Notification rates, antibiotic resistance patterns and classification of isolates as imported or WA MRSA strains on the basis of antibiotic susceptibility. RESULTS: There were 204 notifications of MRSA, 78% of which were classified as WA MRSA. Three outbreaks of MRSA infection and colonisation occurred in separate WA hospitals. Notification rates per 100,000 were highest in the rural regions: the Kimberley (86.32), Goldfields (62.47), Mid West (37.21) and Pilbara (27.38) regions; and lowest in the metropolitan regions (5.52). All MRSA isolates were susceptible to vancomycin. Most imported strains were susceptible to amikacin, bacitracin, chloramphenicol, framycetin, fusidic acid and novobiocin, but only 23% to gentamicin. WA MRSA strains remained predominantly susceptible to all antibiotics tested, except beta-lactams, erythromycin and tetracycline, but a few strains resistant to rifampicin (1%) and fusidic acid (3%) appeared in the second half of 1993. CONCLUSIONS: The epidemiology of MRSA in WA is changing rapidly, with increases in both the numbers of notifications and the proportion from country regions. A new strain of MRSA (WA MRSA) that is less resistant to antibiotics than imported MRSA has emerged and is threatening the State's success in preventing establishment of MRSA in its hospitals.

Disease Notification↗
PubMed1999

[A universal method to correct underreporting of communicable diseases. Real incidence of hydatidosis in Chile, 1985-1994].

BACKGROUND: There is evidence to postulate that undernotification is the reason for the great decrease in the reported incidence of hydatidosis in Chile. AIM: To develop and propose a method to assess the notification of transmissible diseases, based on observed lethality and hospital discharges. MATERIAL AND METHODS: Human hydatidosis in the period 1985-1994 was used as a model to develop the method. Official reports and mortality were analyzed first, determining the first lethality rate. A second lethality rate was calculated based on hospital discharges and a third, based on all Chilean surgical series published in the last two decades. Adjusting official notification of lethality to the true lethality according to surgical series, the number of unreported cases was calculated and the true incidence of hydatidosis was calculated, summing these cases to the official notification. RESULTS: According to this method, the real rates of human hydatidosis in the period 1985-1994, would fluctuate between 6.5 and 11.4 per 100,000. This figure is four times higher than the official notification in the analysed period. CONCLUSIONS: The correction of under notification based on hospital discharges, with or without correction for repeated hospital admissions, or real mortality of surgical series gave similar results, suggesting that both methods are correct.

Chile↗
PubMed2001

[Considerable underreporting of malaria in the Netherlands; a capture-recapture analysis].

OBJECTIVE: To estimate the completeness of notification of malaria by physicians and laboratories in the Netherlands. METHOD: Capture-recapture analysis was applied to three incomplete, partially overlapping registers of malaria cases in 1995 and 1996: a laboratory survey, the Notification Office and the hospital admission registration. RESULTS: The average response of the 107 laboratories approached was 83.6% over both years. In 1995 and 1996 581 and 535 malaria cases respectively were microscopically diagnosed. In each year physicians officially notified 311 patients. 350 and 330 patients respectively were admitted to hospital. Capture-recapture analysis estimated the total number of new malaria cases at 933 (95% confidence interval: 849-1072) in 1995 and at 774 cases (740-821) in 1996. The estimated completeness of notification in 1995 and 1996 was therefore 33.3% and 40.2% for physicians and 62.3% and 69.1% for the laboratories. CONCLUSION: Laboratory-based notification, introduced in the Infectious Diseases Act, can considerably increase the number of officially reported malaria cases as compared with notification by physicians. However, approximately one-third of the estimated number of cases may still go unreported.

Data Interpretation, Statistical↗
PubMed2001

Trend in HIV prevalence among tuberculosis patients in Tanzania, 1991-1998.

OBJECTIVE: To determine the trend in human immunodeficiency virus (HIV) prevalence among tuberculosis patients in Tanzania and estimate what proportion of the increase in notification rates between the surveys was directly attributable to HIV infection. METHODS: Consecutive tuberculosis patients were enrolled over 6-month periods in most regions. Demographic and clinical data were collected on standard forms and a single HIV ELISA test performed. Trends in tuberculosis incidence were estimated from regional notification data. RESULTS: Of 10612 eligible tuberculosis patients, 44% had HIV infection, compared with 32% in the previous survey. The largest increase was observed in the youngest birth cohorts, suggesting active HIV transmission. Approximately 60% of the increase in notification rates of smear-positive tuberculosis between surveys was directly attributable to HIV infection. CONCLUSION: The HIV epidemic has had a strong influence on tuberculosis incidence. However, since 1995, tuberculosis notification data have increased less steeply, AIDS notifications have gone down, and HIV prevalence in blood donors has not increased a great deal. Another survey among tuberculosis patients in 5 years' time may show whether the HIV epidemic in Tanzania has reached a maximum or steady state.

Adolescent↗
PubMed2006

Epidemiology of notified campylobacteriosis in Western Australia.

Campylobacteriosis is one of the most common causes of gastroenteritis in Australia and the rates are thought to be increasing. This study has included all cases of campylobacteriosis that were notified in Western Australia between 1991 and 2001. The data for the study were received from Western Australian Notifiable Infectious Diseases Database located at the Communicable Disease Control Directorate of Western Australia. Rates of notification were calculated using the census data from 1991 for the general population and 1996 census data for the Aboriginal population. The notification rate of campylobacteriosis 89 per 100000 (95.0% confidence interval (CI) 87.6-91.4) for males and for females it was 78 per 100 000 (95.0%CI 87.6-91.4). Increased notification rates were seen in the very young, in males, in non-metropolitan areas and in the spring season. Aboriginal people had a much higher incidence than the rest of the population. Rates increased when laboratory notification was introduced. This study concludes that the rate of campylobacteriosis notification in Western Australia is increasing and is affecting younger children and young adults. The rate is higher in the Aboriginal population. As there were missing data from some cases the study faced some difficulties in interpreting the results. Recommendations for an improved surveillance system are made in order to minimise missing data.

Adolescent↗