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At least 1,351 records · Page 75Linked to original sources
PubMed2002

Current epidemiological trend of tuberculosis in Japan.

OBJECTIVE: To observe the recent epidemiological trend of tuberculosis and to determine the factors related to the deteriorating trend in incidence and mortality rates in Japan. DESIGN: Descriptive analyses of tuberculosis notification rates and mortality rates by age, sex, year and birth-cohort. RESULTS: The decline in the tuberculosis notification rate has started slowing down since around 1980. Among the cohorts born before 1950, the trend of notification rate by age has levelled off since around 1980. The reduction in the tuberculosis mortality rate has also recently begun to slow down, but later and to a lesser extent than that of the notification rate. Although deaths due to tuberculosis occur mostly among the elderly, the rate of decline in mortality among middle-aged males has slowed down recently. The trend in the mortality rate of birth-cohorts has recently shown an upward trend with age. CONCLUSION: A major cause of the current stagnation of the decline in notification rates is the increase in the elderly population with a high prevalence of tuberculosis infection in the past, who are more likely to develop the disease as they approach biological senescence. Other possible causes are a gradual shift of the tuberculosis problem to socio-economically deprived segments of the urban population, and behavioural changes causing delay in case-finding.

Adolescent↗
PubMed2003

[Similarities and differences between the euthanasia laws in Belgium and the Netherlands].

Recently, a law on euthanasia has been adopted in both the Netherlands and Belgium. In both countries euthanasia has been legalized under strict conditions and after confirmation with a notification procedure. Although both laws are similar, the Belgian law is more extensive on the requirements of prudent practice. On the other hand, in Dutch society the norm-setting on euthanasia has been more widely developed through jurisprudence. Nevertheless, we expect that the implementation of the new law and the notification procedure in Belgium will be more difficult than in the Netherlands. In order to promote, safeguard and guarantee the quality of the euthanasia practice, the present euthanasia notification procedure in the Netherlands is supplemented with feedback to the physicians. The strict anonymous procedure in the Belgian notification procedure prevents this possibility. Therefore, Belgian physicians will not be supported by the notification procedure to improve their knowledge and skills in euthanasia.

Belgium↗
PubMedDate not supplied

[A comparative study of the euthanasia laws of Belgium and the Netherlands].

Recently, laws on euthanasia have been adopted in the Netherlands and Belgium. In both countries the legality of euthanasia is conditioned by adherence to strict conditions and by confirmation after a notification procedure. Although both laws are rather similar, the Belgian law is more fastidious on the requirements of prudent practice. The Belgian law does and the Dutch law does not distinguish between terminal conditions and non-terminal or slowly evolutive chronic conditions. In Belgium, the law only applies to adults, whereas in the Netherlands, minors over 12 years of age may under certain conditions receive euthanasia. However, the Belgian National Medical Disciplinary Board has recently mitigated differences by drafting guidelines which reflect a broad interpretation of the law. A major difference between the two countries is that in the Dutch society the norm setting on euthanasia developed more through jurisprudence and endorsement by the Medical Association than through legislation. We anticipate that the implementation of the new law and the notification procedure may be more difficult in Belgium than in the Netherlands. In order to promote the quality of the euthanasia practice, the euthanasia notification procedure in the Netherlands is followed by systematic feedback to the physicians. The strict anonymity of the Belgian notification procedure will be broken only when the control commission finds some anomaly or deficiency in the declaration. Therefore, unless the Evaluation and Control Commission makes ample use of its prerogative to contact the physician, the Belgian physicians may be less supported by the notification procedure to improve their knowledge and skills in euthanasia.

Belgium↗
PubMed2006

Private GPs contribute to TB control in Myanmar: evaluation of a PPM initiative in Mandalay Division.

SETTING: Mandalay Division, Myanmar. AIM: To assess the effect of an initiative to involve private general practitioners (GPs) in the National Tuberculosis Programme (NTP) and to identify lessons learnt for public-private mix scale-up. METHODS: Source of referral/diagnosis and place of treatment were included in the routine recording and reporting systems to enable disaggregated analysis of the contribution of GPs to case notification and treatment outcomes. Case notification trends were compared between the intervention and control areas over a 4-year period. RESULTS: Private GPs contributed 44% of new smear-positive cases registered during the study period (July 2002-December 2004). The notification of new sputum smear-positive TB in the study area increased by 85% between the year prior to the GP involvement and 2 years after (from 46 to 85/100,000). Case notification increased by 57% in the control townships and by 42% in all of Mandalay Division. The treatment success rate for new smear-positive cases treated by GPs was 90%. CONCLUSIONS: The involvement of private GPs substantially increased TB case notification, while a high treatment success rate was maintained. Success factors include a well-developed local medical association branch, strong managerial support, training and supervision by the public sector and provision of drugs and consumables free of charge by the NTP.

Family Practice↗
PubMed2003

Development of mortality statistics at governmental hospitals, Egypt.

Mortality statistics are of crucial importance to epidemiological research. Sources of mortality data in Egypt are many. The first records are hospital records, which submit its data to health office records and lastly civil register office records. Hospital records include hospital death notification certificate and hospital mortician register. Health office records include mortality register, death certificate and death notification report to civil register office. The latter is designed to have a coded data and cause of death according to ICD-10. It is supposed that the death notification report that originates from the hospital is the source of data for the rest of records and registers. So, all these data for the same dead person must be the same. Quality of the original data will reflect itself on the rest of data. This study aims at establishment and assessment of automated system for management of mortality data at (hospital 1, affiliated to Ministry of Scientific Research) and comparing this system and its output with another one (hospital 2, affiliated to the Ministry of Health). The tools of this study are review of the above mentioned records and registers and personal interviews. Death certificate itself is not reviewed, as it is not found in the health office. One-year data sample was chosen for the study. Development of the system at hospital 1 is based on system analysis, design, implementation, and evaluation. Results showed that automated system of hospital1 have the values of automation as timely retrieval and decreasing the error of transcription. Epi-Info software package gives easy statistical analysis and the potential for record linkage. Comparison between hospital death notification certificate that originated from the hospital and health office register showed 97.4% matching for words or expressions in hospital 1 and 50.0% in hospital 2. Comparing hospital death notification report with that originated from health office to related civil office, showed 100.0% matching for hospital1 and 86.7% for hospital 2. As regards correctness of reporting the cause of death, 97.4% of deaths in hospital1, and 29.9% in hospital 2 showed non-specific cause of death reported as circulatory and respiratory distress, that is the actual cause of death is not reported. It is concluded that, unification and automation of the systems is a requirement. Record linkage between different locations of mortality data is recommended. Training on reporting and coding the cause of death is also recommended.

Data Collection↗
PubMedDate not supplied

Maintaining confidentiality in a look-back investigation of patients treated by a HIV-infected dentist.

The spread of human immunodeficiency virus (HIV) from a Florida dentist with acquired immunodeficiency syndrome (AIDS) to several of his patients has generated considerable concern about the risk of HIV transmission during dental treatment. Accordingly, self-reporting of HIV infection and subsequent AIDS by a dentist at our medical center prompted notification and testing of patients at risk. Key features of the notification and testing process were (a) only patients who had undergone procedures deemed to pose appreciable risk of exposure to the dentist's blood were notified, (b) the identity of the dentist was shielded by not including in notification letters any identifying information other than the name of the medical center, and (c) patients' blood specimens were tested promptly for HIV antibodies and results were reported immediately to each patient to minimize the period of anxiety. HIV antibody testing was requested by 41 of the 88 patients to whom notification letters were sent, and all 41 were HIV negative after having undergone 395 procedures by the HIV-infected dentist. Review of the 88 patients' medical and dental records showed that at least 77 had received treatment by other health care providers at the medical center so that they would not be able to ascertain which provider had HIV infection. None of the patients who were notified by the medical center subsequently queried the dentist concerning possible HIV infection. Our experience demonstrates that look-back investigations can be conducted by institutions in a manner that substantially protects the identity of health care workers with HIV infection, minimizes the number of patients discomfitted, and avoids excessive utilization of personnel time. Even greater protection of the identity of health care workers with HIV infection presumably can be achieved when notification is undertaken by a public health agency.

Confidentiality↗
PubMed1995

Methicillin-resistant Staphylococcus aureus in Western Australia, 1983-1992.

A statewide screening programme has prevented imported strains of methicillin-resistant Staphylococcus aureus (MRSA) from becoming established in any hospital in Western Australia (WA). Recently, notifications of MRSA in WA have increased, prompting a review of surveillance data for the period 1983-1992. Our aims were to determine: (i) the distribution by age and sex of persons with MRSA; (ii) changes in notification rates over time and by location in WA; and (iii) temporal changes in antimicrobial resistance patterns. There were 631 notifications of MRSA for the 10 year period 1983-1992, ranging from a low of 36 in 1988 to a high of 117 in 1992. When the distribution by age and sex was examined, three age group peaks were apparent: 0-9 years, 20-39 years and 60-79 years. There was a predominance of females in the 20-39 years age group, reflecting a greater proportion of hospital nursing staff carrying MRSA. In those aged 50 years or more, there was a marked predominance of males. The highest notification rates overall occurred in the remote Kimberley region of WA, however, rates increased significantly in all regions of the state in 1992. Based on antimicrobial resistance patterns, MRSA was classified into two groups: multiresistant imported strains which often caused outbreaks in hospitals; and a less resistant MRSA (WA MRSA). WA MRSA appears to have originated in the Kimberley region and then spread widely in the community to other regions of the state, and the proportion of WA MRSA has increased significantly since 1989.

Adolescent↗
PubMed1994

Pediatricians' views of access to health services for adolescents.

PURPOSE: The American Academy of Pediatrics (AAP) carried out a member survey to measure pediatricians' views of parental permission and notification for selected health services for two age groups of adolescents, the 13 to 15 year olds and the 16 to 17 year olds. METHODS: Through an AAP Periodic Survey, a sample of 1000 members of the AAP were sent questionnaires to fill out and return. The response rate was 77%. RESULTS: The majority of pediatricians in all groups examined believed parental permission and notification were important for general medical and surgical care. But for most other types of care delineated, related to substance abuse and sexuality, most pediatricians did not believe parental permission should be required, except for requests for abortion for 13-15 year olds. For several types of care most pediatricians believed parental notification should be required for 13-15 year olds. Older pediatricians, male pediatricians, and self-employed pediatricians were more apt to support both parental permission and notification for all types of care. When age, gender and self versus not self-employed were introduced together through a logistic regression procedure differences in views were accounted for by self versus not self-employed, and age and gender had no additional impact. CONCLUSIONS: Most pediatricians supported the right of minors to seek care without parental permission for care related to substance abuse and sexuality. The majority were less likely to grant confidentiality to adolescents, particularly those 13 to 15 years.

Adolescent↗
PubMed1997

Tuberculosis in health service employees in Northern Ireland.

Tuberculosis can be transmitted from patients to health care workers. However, where the incidence of tuberculosis is low, and good infection control practices exist, the risk of health care workers acquiring the disease is likely to be small. The objective of this study was to determine the rate of notification of tuberculosis in health care workers in Northern Ireland compared with the general population. Information from the statutory tuberculosis notification forms for the period 1982-1991 was entered on to a computer database. Those patients involved in health care occupations were identified and age and sex standardized incidence rates were calculated. The overall notification rate for tuberculosis was 7.4 cases per 100,000 of general population. There was no significant increase in notification of tuberculosis among health care workers [standardized incidence ratio: 126% (95% CI 91-170)]. No cases were diagnosed as a result of screening methods performed during employment. It was concluded that health care workers in Northern Ireland did not have a significantly increased incidence of tuberculosis compared with the general population over the 10-year period studied. This suggests that the risk of transmission from patients to health care workers is negligible in the setting of a low general incidence of tuberculosis and good infection control practice. Under these circumstances, the present findings support the cessation of routine screening of health care workers.

Contact Tracing↗
PubMed2006

Is the major increase in notified campylobacteriosis in New Zealand real?

Notifications of campylobacteriosis by New Zealand medical practitioners have increased steadily in the last two decades. To determine if this increase is real, as opposed to a surveillance artefact, we examined both available notification (1980-2003) and hospitalization data (1995-2003). The similarity in the temporal pattern of increasing hospitalizations for campylobacteriosis, with that of notifications, is suggestive that this increase is indeed real. Although some risk factors for this disease have been identified (e.g. uncooked poultry consumption) it is unclear what the likely causes of the increasing rates are. The overall disease burden is also high compared with other developed countries (an annual notification rate of 396 cases per 100000 population in 2003), with highest rates in children aged 1-4 years, males, Europeans, and those living in urban areas. Given the large disease burden, further research and intervention studies should be public health priorities in this country.

Adolescent↗
PubMed2003

Diagnostic testing and discharge coding for whooping cough in a children's hospital.

OBJECTIVE: To evaluate the diagnostic pathways for whooping cough in a large urban paediatric hospital to inform assessment of the relative merits of notification and hospitalization data for measuring pertussis disease burden in Australian children. METHODS: All laboratory requests for Bordetella pertussis (BP) culture or serology between 30 June 1997 and 30 June 1999 were reviewed and cross-checked against discharge diagnoses with International Classification of Disease (ICD) codes A37.0, 033.0 (whooping cough due to BP) or 37.9, 033.9 (whooping cough due to unspecified organisms). Culture-positive (CP) cases were defined as a positive culture or polymerase chain reaction for BP. Culture-negative (CN) cases either fulfilled the current Australian clinical case definition (>/=14 days of cough with one or more of paroxysms, whoop, post-tussive vomiting), or had a cough illness with either positive BP serology or documented contact with an individual coughing for >14 days. In infants <6-months-old, a coughing illness with apnoea and negative investigations for other causes was also accepted. Culture positive and CN cases were cross-referenced with notification data. RESULTS: During the study period, laboratory tests for BP were performed in 677 children, of whom 230 were hospitalized and 71 (31%) had an eligible ICD code at discharge; 29 were CP, 40 CN, and two (3%) were misclassified. A further 14 CP children were not admitted. Although 61 hospitalized cases (88%) fulfilled notification criteria, including 32 (80%) of CN cases, only 26 (90%) of CP and eight (20%) of CN cases were notified. CONCLUSIONS: Notifications substantially under-enumerate hospitalized infant cases, especially those without positive laboratory tests. Hospital discharge data add significantly to surveillance for pertussis, particularly in infancy where most severe cases occur.

Age Distribution↗
PubMedDate not supplied

Psychological distress in blood donors notified of HTLV-I/II infection. Retrovirus Epidemiology Donor Study.

BACKGROUND: Blood donations in the United States have been screened for antibody to human T-cell lymphotropic virus types I and II (HTLV-I/II) since November 1988. Although clinically diagnosed illness associated with HTLV-I/II remains relatively uncommon, blood donors notified of HTLV infection frequently report negative psychological and social effects following notification. STUDY DESIGN AND METHODS: To assess psychological outcomes, the General Well-Being Scale, a standardized 18-item questionnaire, was administered to 464 HTLV-I/II-positive donors and 91 sex partners at five blood centers in the United States following notification of HTLV-I/II infection. The questionnaire was also given to 735 HTLV-I/II-negative donors. RESULTS: Scores for donors seropositive for HTLV-I and HTLV-II showed significantly more psychological distress than did scores for seronegative donors (p < 0.0005) or a large national sample (p < 0.05). Both HTLV-I (p = 0.02) and HTLV-II (p = 0.01) seropositivity remained significant predictors of lower overall well-being scores after analysis controlling for race, age, gender, education, income, donation type, time since notification, self-reported health status, and intravenous drug use. Variables that predicted higher overall scores were negative HTLV status, older age, higher income, better health, fewer sick days, and fewer work limitations due to health problems. CONCLUSION: Increased psychological distress may be related to notification of HTLV infection among blood donors in the United States.

Adolescent↗
PubMed2000

Public health surveillance of hepatitis C: can it identify incident cases?

OBJECTIVES: To evaluate a follow-up system to identify incident cases among individuals notified with the hepatitis C virus (HCV). METHOD: A cross-sectional survey of medical practitioners treating individuals notified to the NSW Health Department as having HCV between August 1996 and August 1997 was conducted. RESULTS: Five hundred and fifty-four new notifications were received during the study period (70.7 per 100,000 people). Ninety-six per cent of notifications were followed up with 54 individuals (9.7%) identified as incident cases. Incident cases were significantly younger than prevalent cases (median age 30 vs. 39, p < 0.001) with drug and alcohol notifications being more likely to be incident cases. CONCLUSION: HCV transmission is continuing at relatively high levels with incident cases being significantly younger than prevalent cases. IMPLICATIONS: An efficient notification follow-up strategy that identifies incident cases could be routinely used to assess the effectiveness of population-based initiatives aimed at reducing HCV transmission.

Adult↗
PubMed1996

Are healthcare workers in England and Wales at increased risk of tuberculosis?

OBJECTIVE: To determine whether healthcare workers in England and Wales are at increased risk of tuberculosis and to examine the frequency of drug resistance in this population. DESIGN: Comparison of notification rates by occupation obtained from national tuberculosis notification surveys in 1988 and 1993, with denominators from the 1991 census. SUBJECTS: People with notified tuberculosis in professional and associate professional occupations from the two surveys. MAIN OUTCOME MEASURES: Rates of notified tuberculosis in health professionals (mainly doctors) and health associate professionals (mainly nurses) compared with rates in other professional and associate professional occupations, adjusted for ethnic group, sex, and age. RESULTS: 119 cases of tuberculosis were identified in healthcare workers, including 61 nurses and 42 doctors. The crude notification rate in healthcare workers was 11.8 per 100,000 per year (95% confidence interval 9.8 to 14.1) compared with 3.3 per 100,000 per year (2.9 to 3.6) in other professional and associate professional occupations; rate ratios were higher (range 1.7 to 3.2) in all ethnic groups. The relative risk adjusted for ethnic group, sex, and age was 2.4 (95% confidence interval 2.0 to 3.0), slightly higher for health professionals (2.7 (1.9 to 3.8)) than for associate professionals (2.0 (1.5 to 2.6)). No multiple drug resistant strains of tuberculosis were identified in healthcare workers. CONCLUSIONS: Better detection and notification of cases of tuberculosis in healthcare workers may account for some of the apparent increased risk, but these findings imply that tuberculosis remains a hazard for healthcare workers and highlight the importance of ensuring that occupational health monitoring and protection workers are not neglected.

Disease Notification↗
PubMed2006

Improving tuberculosis control through public-private collaboration in India: literature review.

OBJECTIVE: To review the characteristics of public-private mix projects in India and their effect on case notification and treatment outcomes for tuberculosis. DESIGN: Literature review. DATA SOURCES: Review of surveillance records from Indian tuberculosis programme project, evaluation reports, and medical literature for public-private mix projects in India. DATA EXTRACTION: Project characteristics, tuberculosis case notification of new patients with sputum smear results positive for acid fast bacilli, and treatment outcome. DATA SYNTHESIS: Of 24 identified public-private mix projects, data were available from 14 (58%), involving private practitioners, corporations, and non-governmental organisations. In all reviewed projects, the public sector tuberculosis programme provided training and supervision of private providers. Among the five projects with available data on historical controls, case notification rates were higher after implementation of a public-private mix project. Among seven projects involving private practitioners, 2796 of 12 147 (23%) new patients positive for acid fast bacilli were attributed to private providers. Corporate based and non-governmental organisations served as the main source for tuberculosis programme services in seven project areas, detecting 9967 new patients positive for acid fast bacilli. In nine of 12 projects with data on treatment outcomes, private providers exceeded the programme target of 85% treatment success for new patients positive for acid fast bacilli. CONCLUSIONS: Public-private mix activities were associated with increased case notification, while maintaining acceptable treatment outcomes. Collaborations between public and private providers of health care hold considerable potential to improve tuberculosis control in India.

Communicable Disease Control↗
PubMed1997

Estimates of reports of notifiable diseases by general practitioners in regional Western Australia.

We surveyed the attitudes of general practitioners to the notification of gazetted diseases in the south-west of Western Australia. Notification rates were calculated from the number of notifications recorded by the Southern Public Health Unit or the Communicable Disease Control Program of the State Health Department, and the estimated population of the region, the metropolitan area and the State. Of the 80% of general practitioners responding to the survey, 96% advised they intended to notify all gazetted diseases they diagnosed. Notification rates in the south-west of Western Australia ranged from 380 to 900 per 100,000 population, compared with approximately 450 per 100,000 population in the metropolitan area.

Attitude of Health Personnel↗
PubMed1998

Measles in Victoria 1992 to 1996: the importance of laboratory confirmation.

Australia had a major measles epidemic in 1993 and 1994, which appeared to by-pass Victoria. Victorian notification and laboratory testing data for measles, and public hospital discharge codes, from 1992 to 1996, were reviewed. The rate of measles notification in Victoria fell between 1992 and 1996. By contrast the national notification rate increased markedly in 1993 and 1994. The proportion of measles tests performed at the Victorian Infectious Diseases Reference Laboratory (VIDRL) which were positive increased for all age groups in 1993 and 1994. This increase was highest for the 15 to 19 years age group. The hospital discharge codes demonstrated an increase in the number of admissions for measles in 1993 and 1994, largely for adolescents and younger adults. These data suggest Victoria had an age group specific measles outbreak, the magnitude of which was not reflected by the passive notification system. Reasons why younger age groups in Victoria appeared to avoid the epidemic are unclear.

Adolescent↗
PubMed2003

Australia's notifiable diseases status, 2001: annual report of the National Notifiable Diseases Surveillance System.

In 2001 there were 104,187 notifications of communicable diseases in Australia reported to the National Notifiable Diseases Surveillance System (NNDSS). The number of notifications in 2001 was an increase of 16 per cent of those reported in 2000 (89,740) and the largest annual total since the NNDSS commenced in 1991. In 2001, nine new diseases were added to the list of diseases reported to NNDSS and four diseases were removed. The new diseases were cryptosporidiosis, laboratory-confirmed influenza, invasive pneumococcal disease, Japanese encephalitis, Kunjin virus infection, Murray Valley encephalitis virus infection, anthrax, Australian bat lyssavirus, and other lyssaviruses (not elsewhere classified). Bloodborne virus infections remained the most frequently notified disease (29,057 reports, 27.9% of total), followed by sexually transmitted infections (27,647, 26.5%), gastrointestinal diseases (26,086, 25%), vaccine preventable diseases (13,030 (12.5%), vectorborne diseases (5,294, 5.1%), other bacterial infections (1,978, 1.9%), zoonotic infections (1,091, 1%) and four cases of quarantinable diseases. In 2001 there were increases in the number of notifications of incident hepatitis C, chlamydial infections, pertussis, Barmah Forest virus infection and ornithosis. There were decreases in the number of notifications of hepatitis A, Haemophilus influenzae type b infections, measles, rubella, Ross River virus infections and brucellosis. This report also summarises data on communicable diseases from other surveillance systems including the Laboratory Virology and Serology Reporting Scheme and sentinel general practitioner schemes. In addition, this report comments on other important developments in communicable disease control in Australia in 2001.

Australia↗