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PubMed2005

[Pertussis: its evolution in Argentina at the end of the twentieth century].

The objective of this study was to analize data of pertussis morbidity and mortality in Argentina and vaccination coverage with combined pertussis vaccine (DwPT), which was available from 1969 until 2000 inclusive, and to investigate their interrelation. A retrospective study was performed based on National Registers. Notification and mortality annual mean variation rates and geometric mean rates, by periods, were analyzed, and correlation coefficients between each one of them and with vaccination coverage were calculated. Notification annual mean variation rates for 1969-2000 were -14.34 and for 1980-2000 -17.26; mortality annual mean variation rates for 1980-2000 was -10.41. Vaccination coverage in infants up to one year of age (3 doses) was 44.4% in 1980; less than 60% until 1982 and higher than 80% after 1990. A highly significant inverse correlation was observed, between (a) vaccine implementation, increase in its coverage, introduction of a fifth vaccine dose, and (b) notification and mortality rates. It was observed during the study, that in our country there is a relatively little knowledge about disease occurrence in adults, and an apparent absence of population-based studies performed on the efficacy of erythromycin chemo prophylaxis in epidemics outbreaks. Based on these data, strategies for a better surveillance and control of pertussis, are exposed.

Adolescent↗
PubMed2005

Every provider counts: effect of a comprehensive public-private mix approach for TB control in a large metropolitan area in India.

SETTING: Mumbai, India. OBJECTIVES: To assess impact on case notification and treatment outcome of a public-private mix approach for tuberculosis (TB) control involving private providers, non-governmental organisations (NGOs), and public providers not previously involved in the Revised National TB Control Programme (RNTCP). METHODS: Under the stewardship of the RNTCP, providers were allocated different roles in referral, diagnosis, treatment initiation, directly observed treatment (DOT) provision, training and supervision. Referral forms were introduced and RNTCP registers were adapted to enable monitoring of case notification by different providers and cohort analysis disaggregated by provider type. RESULTS: A fraction of all non-RNTCP providers had become actively involved by the end of 2003. These providers contributed 2145 new smear-positive cases in 2003, an increment of 40% above the 5397 cases detected in RNTCP facilities. The treatment success rate for new smear-positive cohorts for 2002 was 85% in RNTCP facilities, 81% in private clinics, 88% in medical colleges, 91% in NGOs and 73% in the TB hospital (where the death rate was 16%). CONCLUSION: Active involvement of some key public and private providers can increase case notification substantially while maintaining acceptable treatment outcomes. The impact can be expected to be even larger when all health providers have been involved.

Disease Notification↗
PubMed2005

[Reported infectious diseases within the area of the activity of PSSE Zwoleń between 2000-2004].

The aim of the work was to review and evaluate activity of Primary Health Care Institutions in terms of binding regulations concerning reported infectious diseases and infections. In order to carry out the evaluation, the number of cases diagnosed in Primary Healthcare Institutions PHI (number of cases of infectious diseases registered in daily records according to IC D10 was compared to the number of cases reported to County Sanitary Inspector between 2000-2004. Analyzed figures of morbidity and notification to PSSE reveal that not all the subjected cases, were registered and reported by Health care Institutions. Diseases that have been subjected to legal notification for many years were reported more frequently than those subjected to notification since 2002 (ew Parliamentary Act in force). In order to examine the problem of non-reported infectious diseases further activities of other Sanitary and Epidemiology Stations need to be inspected.

Adolescent↗
PubMed2006

[Surveillance and analysis of the pediatric pulmonary tuberculosis in new smear positive cases from 1992 to 2004 in China].

OBJECTIVE: To analyze the results of surveillance for new smear positive pediatric tuberculosis (TB) cases at the age of 0 to 14 years in China, to understand the trend of prevalence and finding of the new smear positive pediatric cases with TB, to illuminate the significance of surveillance for pediatric TB in TB epidemiology and to explore how to prevent and control pediatric TB with the modern TB control strategy (directly observed treatment, short-course, DOTS). METHODS: According to the register of new smear positive pediatric TB cases at the age of 0 to 14 years in the National Annual Surveillance Reporting from 1992 - 2004, the proportion of new smear positive pediatric TB cases among all the new smear positive TB cases in China, the notification rate of new smear positive pediatric TB, the case detection rate of new smear positive TB in the eastern, central and west parts of China, in Beijing, Tianjin and Shanghai municipalities and 13 provinces where the modern TB control strategies have been implemented in 1992 and 15 provinces where the strategies have not been implemented except Beijing, Tianjin and Shanghai municipalities, were analyzed. RESULTS: From 1992 to 2004, 31,358 new smear positive pediatric cases with TB at the age of 0 to 14 years were registered, among whom 14,727 were males (47%) and 16,631 were females (53%). The proportion of new smear positive pediatric TB cases among all the new smear positive TB cases was 1.26%, while the proportion among males was 0.89% and among females was 2.03%. The proportion among females was higher than that among males (P < 0.01). The notification rate of new smear positive pediatric cases with TB was between 0.42/100,000 and 1.08/100,000. Among the new smear positive pediatric TB cases, 44.9% were from western parts of China, followed by central and eastern parts of China and only 0.9% were from Beijing, Tianjin and Shanghai municipalities. Excluding Beijing, Tianjin and Shanghai municipalities, 13 provinces where DOTS was implemented since 1992 were compared with the other 15 provinces. The notification rate of new smear positive TB was respectively 75% and 25%. Western region of China was listed on the top in the proportion of new smear positive pediatric TB cases among all the new smear positive TB cases in every year. CONCLUSION: Among the registered new smear positive pediatric cases with TB, the number of females was higher than that among females and the proportion among males was also higher than that among males. The number of new smear positive pediatric TB cases in western parts of China was higher than that in central and eastern parts of China and the number in DOTS area was higher than that in non-DOTS area, which meant that the case detection of pediatric TB was associated with TB epidemic and DOTS strategy. Thus, in the implementation of DOTS, strengthening the prevention and control of pediatric TB, tracing the infection source of pediatric TB has certain impact on the TB epidemiological status.

Adolescent↗
PubMed2005

[Incidence of tuberculosis in Poland 2004 and its trends].

UNLABELLED: Tuberculosis has been a major public health problem in Poland for many decades. The aim of this investigation was to evaluate incidence of TB in Poland in 2004 and to examine trends of TB incidence in last decade. In 2004. decrease of tuberculosis notification rates in Poland has continued. In this year 9.493 new tuberculosis cases notified in Poland. Incidence rate was 24.9 per 100.000 population with the large differences in notification rates between voivodships/geographic region/ from 14.5 (The West) to 36.0/100.000 The East). Between 1994-2004 notification rates decreased by 42%. New cases represented 87.8% of all TB cases. Pulmonary cases represented 91.6% of all cases of which 59% were bacteriologically confirmed (smear and/or culture positive). 37% of all TB pulmonary cases were sputum smear positive, which is rather low but similar to previous years. Low proportion--8.4% of extrapulmonary cases which is observed for many years may indicate inadequacies in diagnosis and registration of this TB form. Pediatric TB cases--incidence 1.9--represented 1.3% of all cases notified in Poland. The incidence of tuberculosis increases with age from 1.9 in children up to 51.7 among 65 and older patients. Median age of TB patients is between 50-54 years. The incidence of men 34.1 is two times higher than in woman (16.2) and in rural population it is near the same: 25.5 and in urban 24.5. Among of all the TB pulmonary cases there were 395 cases with resistance to at least one drug. In these cases was about 100 MDR cases. Registered 260 TB cases among prisoners--2.7% of overall cases, and 16 TB cases were among foreigners. CONCLUSIONS: In last decade decrease of TB has continued. The incidence of tuberculosis in Poland was about two times higher than mean incidence for Enlarge European Union. The distance between Poland and EU countries with lowest incidence is estimated for 20-25 years.

Adolescent↗
PubMed1995

[Current situation of human hydatidosis in Chile. 2 proposals for correcting its undernotification].

Hydatidosis continues to be a prevalent disease in Chile. Since 1985 and until 1990, the number of notified cases decreased abruptly, probably due to sub-notification. Lethality, not calculated officially, increased since 1985 in a roughly similar proportion to the decrease in communicated incidence. This fact, along with an increase in hospital discharges due to the disease in the country, confirms the hypothesis that sub-notification is true. Two estimation systems for the magnitude of sub-notification are proposed, one based in the expected lethality and the other in the corrected hospital discharges, taking into account the phenomenon of re-admission. Both systems, although differing, disclose much higher incidence of hydatidosis than the communicated figure. A critical analysis of both systems is done.

Adolescent↗
PubMed1996

Surveillance of disease and health with particular reference to infectious disease in Israel.

This paper examines the concept and scope of surveillance in relation to health and disease with special reference to infectious disease in Israel. The methodology of surveillance is reviewed with particular consideration of legal notification. The need for selectivity in relation to notification of infectious disease is outlined and the Canadian approach set out. A brief account is given of infectious disease patterns in Israel and of how this is reflected in notification obligations. A review is strongly suggested. The need to restate the importance of infectious disease control is emphasized, as is that of cooperation with those engaged in surveillance in other fields.

Communicable Diseases↗
PubMed1997

[Documentation problems for occupationally related neoplastic diseases].

The author suggests procedures which can improve the process of identifying an occupational background of neoplastic diseases, bearing in mind a low number of reported cases of occupational cancer in Poland and a concurrent lack of justification (on the basis of data included in a notification from) for some of them. Controversy over diagnosis of neoplasms induced by ionizing radiation is also highlighted. The improved certification of work-related neoplastic diseases must involve each phase of an occupational disease diagnosis: clinical diagnosis with complete and correct medical history, morphological confirmation of the diagnosis, indispensable in the case of cancer, with identification of the primary site of the cancer, identification of causal factor and the exposure size, and occupational disease notification. The author also indicated shortcomings of an occupational disease notification form in regard to neoplastic diseases and suggested its modification.

Disease Notification↗
PubMed1998

A review of sex differences in the epidemiology of tuberculosis.

Globally, the prevalence of infection with Mycobacterium tuberculosis is similar in males and females until adolescence, after which it is higher in males. In industrialized countries in the middle of this century (1930s to 1950s), females aged 15 to 34 years had higher tuberculosis notification rates than males of the same age. However, as notification rates in these countries decreased over time, rates in males became higher than those of females for all ages over 15. Present notification rates of both sexes combined in many developing countries are similar to those of industrialized countries in the middle of the century, although the sex and age pattern is similar to that in industrialized countries at present, with men's disease rates exceeding women's after the age of 15. These findings raise the possibility that cases of tuberculosis among women are being under-reported in developing regions. This is supported by the results of a study comparing active and passive case-finding in which women with tuberculosis were under-notified to public health authorities when relying on passive case-finding. In addition, epidemiological evidence from the pre-human immunodeficiency virus (HIV) era shows that young to early-middle-aged women progress from infection to disease with greater frequency than do men. This elevated frequency of progression among women now coincides with a peak in HIV prevalence among women of the same age. National Tuberculosis Programmes must assess possible sex differences that exist in their countries. In addition, information about the risks of tuberculosis in younger women should be incorporated into maternal and child health, and HIV/AIDS programmes. Further research comparing sex differences in tuberculosis rates, preferably using active as well as passive case-finding, would be necessary to determine whether young women are undernotified in developing countries.

AIDS-Related Opportunistic Infections↗
PubMed1993

Absence of HIV transmission from an infected orthopedic surgeon. A 13-year look-back study.

OBJECTIVE: To determine the risk of human immunodeficiency virus (HIV) transmission from an HIV-infected orthopedic surgeon to patients undergoing invasive procedures. DESIGN: Retrospective epidemiologic follow-up study. PARTICIPANTS: A total of 2317 former patients on whom the orthopedic surgeon performed invasive procedures between January 1, 1978, and June 30, 1991 [corrected]. MAIN OUTCOME MEASURES: HIV infection or death from an acquired immunodeficiency syndrome (AIDS)-defining tumor or opportunistic infection. RESULTS: An orthopedic surgeon voluntarily withdrew from practice after testing positive for HIV. Testing for HIV was performed on 1174 former patients, representing 50.7% of patients on whom the orthopedic surgeon performed invasive procedures during the 13.5-year period. Patients were tested from each year and from each category of invasive procedure. All patients were HIV-negative by enzyme-linked immunosorbent assay. Two former patients reported known HIV infection prior to surgery. Review of AIDS case registries and vital records failed to detect cases of HIV infection among former surgical patients. The estimated cost of the initial patient notification and testing was $158,500. The patient notification and testing were conducted while maintaining the confidentiality of the orthopedic surgeon who was an active participant in the planning and execution of the study. CONCLUSIONS: The risk of HIV transmission from an HIV-infected surgeon who adheres to recommended infection control practices is extremely low. Notification and HIV testing of former patients in this setting is both disruptive and expensive and is not routinely recommended.

AIDS Serodiagnosis↗
PubMed1998

A computer alert system to prevent injury from adverse drug events: development and evaluation in a community teaching hospital.

CONTEXT: Adverse drug events (ADEs) are the most common type of iatrogenic injury occurring in hospitalized patients. Errors leading to ADEs are often due to restricted availability of information at the time of physician order writing. OBJECTIVES: To develop, implement, and evaluate a computer alert system designed to correct errors that might lead to ADEs and to detect ADEs before maximum injury occurs. DESIGN: Prospective case series. SETTING: A 650-bed community teaching hospital in Phoenix, Ariz. PATIENTS: Consecutive sample of 9306 nonobstetrical adult patients admitted during the last 6 months of 1997. INTERVENTIONS: Thirty-seven drug-specific ADEs were targeted. Our hospital information system was programmed to generate alerts in clinical situations with increased risk for ADE-related injury. A clinical system was developed to ensure physician notification of alerts. MAIN OUTCOME MEASURES: A true-positive alert was defined as one in which the physician wrote orders consistent with the alert recommendation after alert notification. RESULTS: During the 6-month study period, the alert system fired 1116 times and 596 were true-positive alerts (positive predictive value of 53%). The alerts identified opportunities to prevent patient injury secondary to ADEs at a rate of 64 per 1000 admissions. A total of 265 (44%) of the 596 true-positive alerts were unrecognized by the physician prior to alert notification. CONCLUSIONS: Clinicians can use hospital information systems to detect opportunities to prevent patient injury secondary to a broad range of ADEs.

Computer Systems↗
PubMed2000

Tracing a syphilis outbreak through cyberspace.

CONTEXT: A recent outbreak of syphilis among users of an Internet chat room challenged traditional methods of partner notification and community education because locating information on sexual partners was limited to screen names and privacy concerns precluded identifying sexual partners through the Internet service provider. OBJECTIVES: To determine the association of Internet use and acquisition of syphilis and to describe innovative methods of partner notification in cyberspace. DESIGN, SETTING, AND PATIENTS: Outbreak investigation conducted at the San Francisco (Calif) Department of Public Health (SFDPH) in June-August 1999 of 7 cases of early syphilis among gay men linked to an online chat room; case-control study of 6 gay men with syphilis reported to SFDPH in July-August 1999 (cases) and 32 gay men without syphilis who presented to a city clinic in April-July 1999 (controls). MAIN OUTCOME MEASURES: Association of syphilis infection with Internet use, Internet use among cases vs controls, and partner notification methods and partner evaluation indexes. RESULTS: During the outbreak, cases were significantly more likely than controls to have met their sexual partners through use of the Internet (67% vs 19%; odds ratio, 8.7; P =.03). We notified and confirmed testing for 42% of named partners; the mean number of sexual partners medically evaluated per index case was 5.9. CONCLUSIONS: In this study, meeting sexual partners through the Internet was associated with acquisition of syphilis among gay men. Public health efforts must continually adapt disease control procedures to new venues, carefully weighing the rights to privacy vs the need to protect public health. JAMA. 2000;284:447-449

Adult↗
PubMed1999

Impact on maternal parenting stress of receipt of genetic information regarding risk of diabetes in newborn infants.

Our objective was to investigate whether notification of high-risk status for type 1 diabetes in newborn infants results in an increased maternal-parenting stress level when compared with notification of low-risk status for type 1 diabetes. Maternal parenting stress level was assessed at 5-7 weeks postpartum (baseline) and was reassessed 4-5 months after parents were informed of their newborn infants' genetic screening results (follow-up). Parenting stress level was measured using the total stress score (TSS) of the Parenting Stress Index/Short Form. The outcome variable, change in TSS, was calculated by subtracting the baseline TSS from the follow-up TSS. Demographic variables such as maternal race, maternal age, maternal education level, maternal marital status, child's birth order, and total family income were assessed through a structured phone interview at the time of baseline assessment. The risk factor of interest was the child's human leukocyte antigen (HLA) status for type 1 diabetes, i.e., whether child was at a high or moderate (combined into "high") genetic risk or at a low genetic risk for type 1 diabetes. A sample of 88 mothers (23 with a high-risk child and 65 with a low-risk child) was evaluated. Baseline median TSSs were 65 and 74 for mothers of low-risk infants and mothers of high-risk infants, respectively. Both groups' median TSS decreased between baseline and follow-up. No significant differences were found between change in TSS and maternal age, race, education level, marital status, total family income, or child's birth order. Although the median decrease in TSS was smaller in mothers with a high-risk child when compared with mothers of a low-risk child, this difference was not statistically significant. We did not find an association between newborn's HLA status and change in maternal TSS. The results of this study suggest that notification of high-risk status for type 1 diabetes in newborn infants may not result in an increased level of parenting stress among mothers.

Adult↗
PubMed1998

Linkage of AIDS and cancer registries in Italy.

We report the first results of a comparison between the Italian Registry on AIDS (RAIDS) and 13 population-based cancer registries (about 8 million population in 1991) with respect to the notification of Kaposi's sarcoma and non-Hodgkin's lymphoma. Routine indicators of data quality and completeness have been found in both types of registry, consistent with the best international standards. A linkage process was carried out on about 339,000 cancer notifications and 3,134 AIDS notifications and was herein restricted to individuals under the age of 50. Out of 243 Kaposi's sarcomas at either type of registry, 90 (37%) were reported as such by both; 68% of individuals with Kaposi's sarcoma at cancer registries could be identified at the AIDS registry, including AIDS-defining illnesses other than Kaposi's sarcoma; 62% of individuals with Kaposi's sarcoma at RAIDS could be found at cancer registries. Of 2,104 non-Hodgkin's lymphomas at either type of registry, 55 were reported as such by both; 65% of individuals reported as having non-Hodgkin's lymphoma at the AIDS registry were found at cancer registries. Our present results indicate the scope for improving cancer assessment in individuals with HIV infection and AIDS and the potential of AIDS and cancer registries for such a purpose.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Lead poisoning in precious metals refinery assayers: a failure to notify workers at high risk.

Lead poisoning in a precious metals refinery fire assayer and a routine OSHA inspection prompted an investigation of the index facility, a survey of the industry, and efforts to notify assayers of this previously unrecognized hazard. Air and blood samples were obtained at the index facility. Management personnel from all fire assay laboratories in Rhode Island and southern Massachusetts were interviewed. The industry's trade association, OSHA, NIOSH, trade unions, and the media were asked to assist in a nationwide notification effort. Assayers at the index facility had excessive exposures to lead due to an age-old, lead-based assaying method that remains the industry gold standard. Blood lead levels of the three assayers (mean 61.3 micrograms/dl, range 48-86 micrograms/dl) were considerably higher than those of 16 other refinery workers (mean 27.4 micrograms/dl, range 13-49 micrograms/dl). The industry survey revealed inadequate knowledge of both the lead hazard and the applicability of the OSHA lead standard. Notification efforts failed in large part due to economic obstacles. The notification of workers at high risk of lead exposure and the eradication of occupational lead poisoning will require greater attention to economic forces.

Humans↗
PubMed2002

Very high compliance in an expanded MS-MS-based newborn screening program despite written parental consent.

OBJECTIVES: In Bavaria, Germany, an expanded MS-MS-based newborn screening program was implemented in 1999. The coverage of new additional conditions and novelty of technology required introduction of written parental consent. Here we evaluated the influence of the consent procedure on compliance by systematic demographic tracking. METHODS: Comprehensive information was provided for parents, professionals, and the public. Screening notifications were matched with all birth notifications on name and date of birth. Parents of children without screening notification were contacted and counseled. RESULTS: Between August 1, 1999, and July 31, 2000, 123,284 children eligible for screening were born. Of these, 116,652 were matched successfully. Among 6,632 parents contacted, 2,516 (2%) did not respond. Three thousand thirty-four children were screened but the parents initially refused to participate in tracking. Five hundred ninety-four were screened outside the program. Four hundred eighty-eight untested newborns were identified. Three hundred twenty-five screening failures due to logistic problems were tested subsequently. Screening was definitely refused by the parents of 163 children (0.1% of target population). CONCLUSIONS: With appropriate information provided and surveillance by tracking, high compliance with newborn screening can be achieved despite a written consent requirement.

Adult↗
PubMed1982

The EEC policy in the hazard assessment of new chemicals.

The sheer number of new chemicals produced each year poses problems to ensure that no dangerous products are brought in to use in the Community. Therefore the Council of Ministers of the European Communities has adopted on September 18, 1979 a Community legislation with respect to the notification of new chemicals. This is the so called sixth amendment of the Council directive of 27 June 1967 relating to the classification, packaging and labelling of dangerous substances. The purpose of this directive is to approximate the laws, regulations and administrative provisions of the ten Member States on: a) the notification of new chemical substances and b) the classification, packaging and labelling of substances dangerous to man and the environment which are placed on the market (including imported products) in the Member States of the Community. When giving this pre-marketing notification, the technical dossier requires, amongst others, the results of tests, of physico-chemical properties and toxicological and ecotoxicological parameters, following a three level hierarchical or step-sequence test system based on the quantities of the substances marketed. The first level concerns a mandatory base-set or level 0, the so called Annex VII, followed by a level 1 and level 2 testsystem (Annex VIII).

Animals↗
PubMed1988

Survey on tuberculosis reports in a major Italian region.

A survey was carried out on all cases of pulmonary and extrapulmonary tuberculosis reported in the Latium region of Italy during 1986, in order to characterize them from bacteriological and epidemiological points of view. A total of 497 TB notifications were investigated; reliable medical records were traced and consulted for 458 of these. Seventy-six percent of cases was classified as respiratory tb, 21.8% non-respiratory tb and 2% both. Ninety-two percent of all cases had been hospitalized for long periods (mean: 69 days/median: 63 days for cases of respiratory TB and mean: 40/median 29 days for non-respiratory patients). Contrary to the definition of a reportable case in Italy, evidence of Mycobacteria on direct or cultural examination was present in only half of all reported patients. Twenty-seven percent of respiratory cases and 33.3% of non-respiratory had a previous diagnosis of TB mentioned on the clinical record. High daily alcohol intake is reported more frequently among TB patients with respect to the general population, while drug abusers, immigrants and HIV seropositives represent a very low proportion. Delays in notification have been observed and current notification system is evaluated.

Adolescent↗