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PubMed1998

[Medical behavior after colo-rectal cancer screening--comparison with that after stomach cancer screening].

Medical behavior for intensive examination after colo-rectal cancer screening was examined in comparison with that after stomach cancer screening. Examinees who were positive in colo-rectal or stomach cancer screening, provided by an Occupational Health Organization from April 1993 to March 1994, were monitored for their medical behavior through notifications from physicians. The main results were as follows: 1. The proportion of those with the notification from a physician after colo-rectal cancer screening was half of that after stomach cancer screening. 2. Among those notified the rate of those who undertook intensive examination by the end of 12 weeks after the screening was 79.7% for a colo-rectal site and 87.0% for the stomach. The time interval from the screening to the intensive examination for the colo-rectal site was significantly longer than that for stomach. 3. For colo-rectal cancer screening, the proportion of those with the notification was lower in females than in males, and in those aged less than 50 than in those aged 50 or older. There were no differences in the proportion between those screened at the work site and those at the occupational health service center, and between those positive in the fecal occult blood test and those negative in the test but positive in the health interview. These results indicated, assuming that the probability of the physicians' notification was unrelated to the type of examination, a smaller proportion of the examinees positive in the colo-rectal cancer screening consulted a physician for the intensive examination later than those positive in the stomach cancer screening. It is therefore necessary to make colo-rectal cancer screening effective to establish a collaborating system which effectively facilitates the medical behavior of the screening positives.

Adult↗
PubMed1999

Tuberculosis and the HIV epidemic: increasing annual risk of tuberculous infection in Kenya, 1986-1996.

OBJECTIVES: The purpose of this study was to assess the impact of the increased incidence of tuberculosis (TB) due to HIV infection on the risk of TB infection in schoolchildren. METHODS: Tuberculin surveys were carried out in randomly selected primary schools in 12 districts in Kenya during 1986 through 1990 and 1994 through 1996. Districts were grouped according to the year in which TB notification rates started to increase. HIV prevalence in TB patients and changes in TB infection prevalence were compared between districts. RESULTS: Tuberculous infection prevalence rates increased strongly in districts where TB notification rates had increased before 1994 (odds ratio = 3.1, 95% confidence interval = 2.3, 4.1) but did not increase in districts where notification rates had increased more recently or not at all. HIV prevalence rates in TB patients were 50% in districts with an early increase in notification rates and 28% in the other study districts. CONCLUSIONS: Countries with an increasing prevalence of HIV infection will need additional resources for TB control, not only for current patients but also for the patients in additional cases arising from the increased risk of TB infection.

AIDS-Related Opportunistic Infections↗
PubMed2001

Two years maternal mortality in Matebeleland north Province, Zimbabwe.

OBJECTIVE: To describe timeliness and completeness of maternal mortality notifications after the introduction of a revised national notification form in 1998, as well as socio-demographic and obstetric variables and causes of maternal deaths. DESIGN: Retrospective descriptive study. SETTING: Seven districts in Matebeleland North province. SUBJECTS: 95 maternal death notifications from 1 August 1998 to 31 July 2000. MAIN OUTCOME MEASURES: Delay in submission and completeness of reports, age, marital status, religion, reproductive history, booking and referral status, duration and outcome of pregnancy, place of death, cause of death. RESULTS: 92/95 notifications were true maternal deaths, 86% were notified within 48 hours and 79% were complete, 74% of the deaths took place in a health facility. Mean age of the women was 27.8 years, mean parity 3.0. Sixty percent had booked. The five main causes of death were obstetric haemorrhage (26%), malaria (24%), immune deficiency syndrome (13%), abortion (11%) and eclampsia (8%). The maternal mortality ratio per 100,000 reported home and institutional live births ranged from 155 to 532 per district. CONCLUSION: There is under reporting of maternal mortality in some districts, although from 1997 to 2000 a 200% increase in reporting was seen. Timeliness and completeness of reporting was satisfactory. With the exception of a high contribution from malaria the causes of maternal mortality in Matebeleland North province are similar to those reported elsewhere in Zimbabwe.

Cause of Death↗
PubMed1999

Impaired practitioners notified to the Medical Practitioners Board of Victoria from 1983 to 1997.

OBJECTIVE: To describe the characteristics of and outcome for impaired medical practitioners notified to the Medical Practitioners Board of Victoria. DESIGN: Retrospective review of records for all impaired practitioners notified to the Board for the first time from January 1983 to December 1997. OUTCOME MEASURES: Number of notifications per year; characteristics of impaired practitioners; source of notification; diagnosis and diagnostic categories; actions by the Board; and outcomes for impaired practitioners. RESULTS: In 15 years, 170 impaired practitioners were notified to the Board for the first time, 86 in the last four years. Significantly more men than women were notified to the Board (ratio, 4.2:1; P < 0.001). Reporting by patients was uncommon, but 46 impaired practitioners reported themselves. One hundred and five impaired practitioners had a psychiatric disorder, 73 had a drug use disorder, 35 had an alcohol use disorder, and 13 had a physical disorder (not exclusive categories). The Board suspended 73 practitioners and imposed conditional registration on 76. Subsequently, 88 practitioners were able to improve their registration status. Fifty-nine practitioners were renotified to the Board or tested positive to a urinary drug screen. Eleven practitioners died, four before the age of 55 years. CONCLUSIONS: Increasing numbers of notifications in recent years coincided with changes in the legislative framework, making notification compulsory but also giving the Board more flexibility in dealing with impaired practitioners. Nonetheless, comparison with population data suggests that impaired practitioners (particularly those with substance use disorders) may be under-reported.

Adult↗
PubMed1999

Altitude: a determinant for tuberculosis in Kenya?

OBJECTIVE: To determine to what extent tuberculosis incidence is associated with altitude. METHODS: Notification rates were obtained from all 41 districts in Kenya in the period 1988-1990; the mean altitude of each district was estimated. Data on indicators of socio-economic status such as literacy rate and infant mortality rate were obtained from the 1989 census, as well as data on other potential confounders such as urbanisation and median household size. RESULTS: The notification rate of new smear-positive tuberculosis was 32/100000 overall, varying between districts from 5 to 222/100000. Notification rates steeply reduced with increasing altitude (r = -0.71; 95% confidence interval [CI] -0.51 to -0.83). At altitudes of 1000 m or more the notification rates were less than 30% of those in districts at altitudes below 500 m, also after adjustment for confounding. CONCLUSION: Tuberculosis incidence in Kenya decreases strongly with increasing altitude. If the association is not due to unknown confounding factors, a range of potential biological explanations needs to be explored.

Altitude↗
PubMed1999

Surveillance of tuberculosis in Europe.

In 1995, countries of the WHO European Region approved WHO/IUATLD recommendations for the standardisation of tuberculosis in Europe including a common case definition, the notification of cases by both clinicians and laboratories, the computerisation of individual data and a common list of essential variables. Since 1996, the Euro TB programme started collecting data from European countries based on these recommendations. Data on tuberculosis cases, both definite (culture confirmed) and other cases, reported in 1995, 1996 and 1997 have been collected in the 51 countries of the WHO European Region. Close to 350,000 tuberculosis cases were reported each year, of which almost 2/3 were in countries of the former USSR. Most countries located in the eastern part of Europe, Portugal and Spain, reported 20 cases per 100,000 or over. Conversely, most countries situated in the western part of Europe, the Czech Republic and Israel, reported cases per 100,000. Notification rates were highest above 64 years of age in countries reporting cases per 100,000 and peaked in the 35-54 years old age group in other countries. Since 1995, notification rate declined or stabilised in most countries with cases per 100,000, but increased in several other countries, particularly in most republics of ex USSR. Tuberculosis surveillance systems are still heterogeneous among European countries. Regarding the case definition, a few countries notify only new cases, some countries notify only new and relapse cases and some also include other categories of recurrent cases in the notification. Only a few countries have a national reporting system of M. tuberculosis isolated which can be linked to clinical data. In 1997, 20 of the 51 countries had individual computerised data. The availability of essential variables differs between countries but is increasing over time. The standardisation and quality of epidemiological information on tuberculosis in Europe has clearly improved since the beginning of the Euro TB programme. It is hoped that this will help tuberculosis control efforts in the European Region.

Adult↗
PubMed1999

Tracking sexual contacts of HIV patients: a study of physician practices.

Notification of sexual partners of HIV-infected individuals has become a focus of debate at local, state, and national levels. Issues of confidentiality and ethical concerns continue to pose challenges to state and local health departments addressing this issue. We conducted a telephone survey with physicians in Syracuse, New York to ascertain opinions about HIV partner notification and the role of public health agencies in that notification process. In general, physicians mostly relied upon the HIV-infected individuals to notify their own partners but were supportive of enhanced efforts regarding partner notification.

AIDS Serodiagnosis↗
PubMed2000

Hepatitis C lookback in Canada.

BACKGROUND AND OBJECTIVES: Since March 1990, all blood donations in Canada are screened by enzyme-linked immunosorbent assay (EIA) for antibodies to HCV, with confirmatory testing done using a recombinant immunoblot assay (RIBA). Because HCV may cause chronic asymptomatic hepatitis, in 1995, the Canadian Red Cross began targeted HCV lookback studies on all confirmed positive donations. These have been continued by the two new operators of the blood system in Canada, Héma-Québec and the Canadian Blood Services. Subsequent to recommendations made in the public inquiry into the Canadian blood system, led by judge Krever, general lookback through letter notification of all patients transfused in the years prior to the introduction of anti-HCV testing was initiated in several pediatric hospitals, and later in several Canadian provinces. MATERIALS AND METHODS: Targeted HCV lookback was done for all donors confirmed positive by RIBA testing from the start of HCV testing in 1990. In 1999, stored RIBA 2 indeterminate samples were re-tested by RIBA 3, and lookback performed on confirmed positive donations. In the province of Quebec, hospitals were surveyed to determine methods and resources involved in lookback. Provinces performing general letter notification entered hospital transfusion records into a central transfusion data bank, and performed linkage with other provincial data banks to remove deceased patients and obtain current addresses. RESULTS: As of January 2000, targeted lookback had been completed on 4,859 components of 1,628 anti-HCV positive repeat donors. 2,991 recipients were deceased, and 451 were not found or tested. Of the 1,422 recipients tested, 954 (67%) were anti-HCV positive. Approximately half were already aware of their HCV status. Lookback efforts in hospitals were hampered by lack of resources and manual records. General letter notification in British Columbia (BC) and Prince Edward Island (PEI) led to the testing of 38,960 and 1,953 recipients respectively, with 5.0 and 2.2% of tested recipients found to be anti-HCV positive. CONCLUSION: In completed targeted lookback investigations, 19% of components are eventually linked to an anti-HCV positive recipient. These results are very similar to those obtained in other countries, such as Denmark and the UK. In general letter notification lookbacks, the frequency of anti-HCV in the tested recipients is approximately twice the frequency of the general population.

Antibodies, Viral↗
PubMed1975

Present effectiveness of BCG vaccination in England and Wales. A report from the Research Committee of the British Thoracic and Tuberculosis Association.

From a survey of notifications of tuberculosis in England and Wales it is estimated that each 100,000 BCG vaccination of school-children in 1966-71 prevented 15 notifications of persons aged 15-19 years in 1973. Making allowance for the declining infection risk, it is probable that each 100,000 vaccinations in 1966-71 will eventually prevent about 133 notifications in the 15 years following vaccination. It is estimated that one notification of tuberculosis will be prevented by 750 vaccinations given in 1968, by 1,500 vaccinations in 1973, by 3,000 vaccinations in 1978, and by 5,000-10,000 vaccinations in the 1980's.

Adolescent↗
PubMed2002

Disease surveillance in rural communities is compromised by address geocoding uncertainty: a case study of campylobacteriosis.

This study illustrates the impact of address geocoding uncertainty on rural estimates of reportable disease incidence using campylobacteriosis as an example. After all cases of campylobacteriosis notified from 1993 to 1997 had been geocoded, the minimum and maximum disease notification rates were calculated for rural and urban areas of New Zealand. The estimated maximum rural rates were four times higher than estimated minimum rural rates, whereas estimated minimum and maximum urban rates varied minimally. The impact of address geocoding on the estimation of disease notification rates across Public Health Service Regions showed considerable variation. The relative proportions of ungeocoded notifications to rural notifications ranged from 1.3:1 to 10.2:1, reflecting the range of uncertainty in estimated rural rates of campylobacteriosis. Unless the reliability of captured rural address data is improved significantly, disease surveillance systems will underestimate rural rates of disease and limit small area analyses.

Campylobacter Infections↗
PubMedDate not supplied

[The use of the capture- recapture method in evaluating the epidemiological meningococcal disease monitoring system in Tenerife, Spain (1999-2000)].

BACKGROUND: Meningococcal Disease is mainly monitored passively on the Canary Islands, the regular Compulsory Disease Notification channels being used. The objective of this study includes describing the qualitative and quantitative aspects of this system and evaluating the exhaustiveness, by means of the capture-recapture system, of three information sources. METHODS: This study covers the 1999-2001 period in Tenerife. The information was gathered from three sources: the Compulsory Disease Notification System, the Microbiology Laboratories and the hospital Minimum Basic Data Set. The Evaluation Protocols of the Monitoring System of the Atlanta Centers of Disease Control and Prevention were used. A log-linear model was used for estimating the number of cases. The calculations of the exhaustiveness and the 95% confidence intervals were done in the SPSS10 statistics package. RESULTS: The system was found to have an 84.9% sensitivity, and an 80.4% positive predictive value. The delay in notification (timeliness) fell within the 0.5-13-day range, averaging 3 days. The system was found to have a 76.6% overall acceptability. The exhaustiveness value was 98.1%. CONCLUSIONS: This disease is being monitored well, with a degree of sensitivity which would be revealing of a good notification level, also confirmed by its exhaustiveness. Although the positive predictive value is high, this could be indicative of the expeditious starting of antibiotic treatment which would hinder microbiological confirmation. The system is timely, affording the possibility of measures being taken for fast intervention.

Adolescent↗
PubMed2004

Spatial-temporal analysis of Ross River virus disease patterns in Queensland, Australia.

Ross River virus is the most common vector-borne disease in Australia, with the majority of notifications being in Queensland. This study describes a retrospective spatial analysis of Queensland Ross River virus disease notifications spanning a 10-year period. Notifications were mapped to the local government area (LGA) of the residence of the patient. Ross River virus disease outbreaks within each LGA were detected by applying a Poisson model. Estimates of the seasonal incidence rates indicated wide variation between seasons and LGAs. Positive spatial autocorrelation between LGAs experiencing outbreaks indicated that LGAs within the same region often experience outbreaks at the same time. A hierarchical cluster analysis of the outbreak data was used to group LGAs with similar temporal outbreak patterns. This analysis highlights the variability in Ross River virus disease notification rates across Queensland, and provides a robust method for identifying disease outbreaks.

Adolescent↗
PubMed2005

[Clinical investigation of the effect of blood sampling day on serum phosphorus concentration].

Whether the presence or absence of notification about the blood sampling date affects the serum phosphate concentration was examined. After periodical sampling at the beginning of the week with 2-day interval for regular dialysis, the blood was sampled on the midweek day with 1-day interval for dialysis upon the patient's consent right before sampling without an advance notification. In the next month subsequently periodical sampling at the beginning of the week and the sampling on the midweek day were performed after notification of the twice blood sampling before 1 week in advance. Then both serum phosphorus data were comparably investigated. In case the sampling was not notified, there is no difference in the serum concentration between the beginning of the week and the midweek day. On the other hand, in case the sampling was notified, the serum concentration significantly decreased on the weekday compared to that at the beginning of the week. It therefore was risky that the serum phosphorus concentration at the beginning of the week with 2-day interval for dialysis was presumed to be higher value than that on the midweek day with 1-day interval for dialysis. We need to consider the possibility that the presence or absence of notification about the blood sampling date affects the level of serum phosphorus concentration.

Blood Specimen Collection↗
PubMed1990

[Eleven years in a specialist practice dealing with reporting of occupational diseases can be rewarding].

During a period of 11 years in specialist practice, the authors notified 309 cases of occupationally-conditioned disease and occupational accidents. The majority of diseases were in the locomotor system. The authors reviewed the sex and age distributions and the distribution of the conditions involved. Their share of notifications from specialist practice during the period 1983-1986 was also reviewed together with the relevant specialties and the action taken by the Workers Supervision Authorities. The authors found their share in the notifications was relatively excessive but that it was declining because a great number of specialists have begun to notify conditions in the locomotor system. In addition, the authors have observed a considerable reduction in the rime taken to analyse cases by the Workers Supervision Authorities and an increase in the number of factory visits. The number of factory visits on account of the authors' notifications constituted 11% which shows that notification of occupationally-conditioned diseases is worth while.

Accidents, Occupational↗
PubMed1988

[Tuberculosis in the Department of Seine-Saint Denis. I. Cases under treatment in 1984].

A prospective study of notified cases of tuberculosis started on treatment during 1984 in the department of Seine-Saint-Denis situated in the northern suburb of Paris was undertaken with the help of the Ministry of Health, and the National Committee for the Prevention of Tuberculosis. Fifty-seven hospitals were involved as were 42 sanatoria, 19 clinics and private hospitals and 157 doctors enabled 578 cases of tuberculosis to be registered. For these 578 cases there were 884 notifications coming principally from the control services of the Social Security and public hospitals. Although several sources of notification had declared the same patient, no source had registered all the patients of whom they had knowledge. The notifications made on 12 different forms were often incomplete and sometimes erroneous. Of the 578 patients declared there were 34 different nationalities, of whom 190 were French, approximately 33%; 87 were Algerian, or 15%; 83 came from Mali, or 14%. The study compared the level of notification of tuberculosis in the French, Algerians and those from Mali and has shown that they are six times higher amongst Algerians than the French population and 39 times higher in those from Mali than in the French population. The proportion of patients already treated were 11% and those patients suffering from exclusively extra-respiratory tuberculosis was 16%. A bacteriological and/or histological confirmation was obtained in 70% of cases. The study of the socio-demographic characteristics of the patients has enabled a portrayal of the representation of unskilled workers and the unemployed in comparison to the general population of the department.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Whooping cough in The Netherlands, 1989-1994].

OBJECTIVE: To obtain insight into the present incidence of pertussis. DESIGN: Observational study of data from different sources of surveillance. METHOD: For the years 1989-1994 the incidence of pertussis was estimated from the number of pertussis notifications, from laboratory data or serodiagnosis, from isolations of Bordetella and from the national registration of clinical diagnosis of hospital admissions. RESULTS: The numbers of notifications and positive serology yielded similar average yearly incidences for the period 1989-1994 (2.4 and 2.3/100.000 respectively). According to notifications and positive serodiagnosis, respectively, peak incidences occurred in 1989 (3.5 and 2.4/100.000) and 1994 (4.2 and 4.1/100.000). In 1993 the incidence of positive serodiagnosis (3.2 per 100.000) was also higher than in the other years. The incidence based on hospitalizations, notifications and positive serology was highest among children under 1 year of age. In the period 1989-1993 no deaths were recorded. The vaccine efficacy amounted to 91%. CONCLUSION: For 1989-1994 the pattern over time was mostly consistent with pertussis being an endemic disease in childhood with 4-yearly peaks. The incidence of hospitalizations emphasized the seriousness of the illness in infants. It is important that general practitioners are on the alert for the occurrence of pertussis in vaccinated and unvaccinated children and adults.

Adolescent↗
PubMedDate not supplied

[The incidence of tuberculosis in Romania in 1993].

The situation of tuberculosis in Romania has been progressively deteriorated since 1986. Using the data from the TB notification forms and demographic data for the number of inhabitants by sex and age groups in various districts in 1993, there have been calculated the main TB epidemiometric indicators for 1993. TB notification rate in 1993 in Romania (89.4%000) is plotted against values in other countries of the Europe Region WHO in figure 1 and against the mean values for in the six WHO regions in figure 2; the dynamic of the annual values 1991-1994 in the 41 districts of Romania are presented in figure 3 and a comparison of the annual values 1985-1993 in Romania versus other countries with rising values (USA, Denmark and Lithuania) in figure 4. Data concerning TB notification rate in children (20.7%000 in 1993) and its dynamic during the last 8 years is presented in table II, high values districts in table III, the prevalence of sources in tables IV and the TB mortality (10.1%000 in 1993) and its trend during the last 11 years in table V. A series of 8 annexes presents 1993 data on TB notification number and rate by disease localisation, bacteriologic confirmation and sex, for each of the 41 districts of the country. All data are meant to reveal the magnitude of "TB problem" in Romania, to allow optimisation of the main control actions and planning of the necessary means.

Adolescent↗
PubMed1994

[Adverse reactions from angiotensin-converting enzyme inhibitor drugs reported by the yellow card].

BACKGROUND: The aim of the present study was to analyze the adverse reactions (AR) to captopril (CP) and enalapril (EN) reported by voluntary notification by the yellow card (YC) over the first five years of the foundation of the Drug Surveillance Center of the Valencian Community. METHODS: The AR described were classified by organs and systems, evaluating the age and the sex of the patient, the indication for the drug, dosage used, and the level of health care assistance received since notification. Previous knowledge of the reported AR was analyzed, as was the possible relation of causality with the drug and severity of the same. The rates of notification were calculated with respect to the consumption of both drugs, expressed in daily dosage defined (DDD). RESULTS: Two hundred one YC were evaluated, 111 for CP and 90 for EN referring 160 and 133 clinical manifestations, respectively. The rate of notification was 2.51 YC/million DDD for CP and 5.57 for EN. The AR in the respiratory tract were the most frequently reported with cases of dry cough representing 33.7% of the total YC for CP and 33.8% for EN. Cutaneous AR followed for both drugs. Angioedema was reported in 0.09 AR/million DDD for CP and 0.56 for EN. Reactions were most frequently observed in patients over the age of 50 with a predominance of the female sex, being usually slight and with 80% having been notified from primary health care centers. CONCLUSIONS: The high number of reports of cough demonstrate that this is the most frequently observed adverse reaction. The distribution of reactions and the characteristics of the patients with the same coincide with other studies. The low number of yellow cards reporting severe adverse reactions may support the favorable safety profile of this pharmacologic group, or, to the contrary, be a consequence of the under-reporting of adverse reactions.

Adult↗