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PubMed1976

Antileprosy measures in Bombay, India: an analysis of 10 years' work.

Leprosy control measures adopted in Bombay consist of health education, case-detection, and treatment, and are carried out mainly by the Acworth Leprosy Hospital and its subsidiary, the Greater Bombay Leprosy Control Scheme. Although the data collected on different aspects of leprosy during the 10-year period 1963-72 are hospital-based and retrospective, their analysis provides a useful indicator of the possible situation in the field. Health education is provided by medical social workers, field staff, and physicians, and the significance of this activity in relation to early detection of leprosy is analysed. It is shown, however, that case-holding is a more urgent priority than case-detection. Trials have confirmed the effectiveness of chemoprophylaxis with dapsone for contacts of infectious index cases in crowded households. Comparison of annual expenditure per outpatient in leprosy clinics with that for inpatients in a leprosy hospital demonstrates greater cost-effectiveness of outpatient treatment. Some practical recommendations are made for leprosy control.

Communicable Disease Control↗
PubMed1978

Epidemic malathion poisoning in Pakistan malaria workers.

In 1976, epidemic organophosphate insecticide poisoning due to malathion occurred among 7500 field workers in the Pakistan malaria control programme. In July, the peak month of the epidemic, it is estimated that there were about 2800 cases. In field studies low red-cell cholinesterase activities were associated with the signs and symptoms of organophosphate insecticide intoxication. Toxicity was seen with 3 different formulations of the insecticide and was greatest with the products containing increased amounts of isomalathion, a toxic malathion degradation product. Poor work practices, which had developed when D.D.T. was the primary insecticide for malaria control, resulted in excessive skin contact with and percutaneous absorption of the pesticide. Airborne malathion concentrations were very low. Implementation of good work practices and proscription of use of the 2 pesticide formulations most contaminated with isomalathion halted the epidemic in September. An extensive training programme and surveillance system for pesticide toxicity preceded 1977 spraying operations.

Cholinesterases↗
PubMed1990

Community participation in the control of onchocerciasis in Cross River State, Nigeria.

Human onchocerciasis is reported to occur in all States of the Federal Republic of Nigeria with serious medical, social and economic impact on affected communities. Attempted control schemes have failed because of reinvasion caused by limited area coverage, short duration of the scheme and non-involvement of the affected communities. As the Nigeria National Onchocerciasis Control Programme (NOCP) takes off with baseline data collection, it is essential to point out the need for community participation in the programme. Information obtained from group interviews in 8 villages in Akamkpa Local Government Area of Cross River State, Nigeria, reveal that ignorance of the cause of onchocerciasis. Location of villages and farms near fast flowing waters and outdoor working habits, have resulted in continued endemicity of the disease in the affected poor farming communities. For successful control of the disease, the communities should be involved in all stages of the control programme. During the preparatory stage, control officials should carry out intensive health education; encourage, and assist in, formation of village health committees (VHC) and selection of village based workers (VBW); and work with the VHC and VBW in developing skeletal control plans and deciding on input from community. During screening for prevalence, communities will, if adequately mobilized, accommodate field workers, act as field guides and interpreters and cooperate despite conflicting religions and traditional beliefs and practices. Before chemical treatment of breeding sites of Simulium, permission will be required from the communities, members of which will, if trained, take part in the exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude to Health↗
PubMed1989

Management information system for leprosy eradication programme--an alternative information system.

For efficient monitoring of multidrug therapy programmes for leprosy both at microlevel (individual patient monitoring) as well as microlevel (programme monitoring), DANIDA decided to develop an alternative, simple and quick information system using a computer. A patient data base system was designed using dBase III Plus package. The field workers of the National Leprosy Eradication Programme were trained in transcribing data on to coded data sheets. The data of 1750 patients of six leprosy control units from the 4 MDT districts were processed and feedback reports were sent to paramedical workers and programme managers. The initial experience in the field over the past year has shown that a computerized management information system is feasible and well accepted by the field staff for the purpose of improving monitoring.

Database Management Systems↗
PubMed1991

On the application of mathematical models of schistosome transmission dynamics. I. Natural transmission.

The many mathematical models of the transmission dynamics of schistosomes that have been published since 1965 have had little impact on field studies or on the design of schistosome control programmes. At least in part, this is due to limited interaction between theoretician and field worker, resulting in unrealistic models that are not easily applied to field data. This review aims to make explicit the assumptions and limitations of existing models and their relationships with field data. A basic model is described which considers the mean number of schistosomes per person and the prevalence of patent infections of snails. Various modifications to this model are introduced. These include: prepatent infections of snails; loss of infection of snails; the effects of snail population dynamics; the effects of miracidia and cercariae population dynamics; miracidia searching efficiency; reservoir hosts; heterogeneous patterns of transmission; seasonality; and predisposition to infection. Variation in levels of infection with age and the effects of acquired immunity to infection are also considered. Published models of schistosome transmission dynamics are reviewed within this framework. Approaches to the modelling of schistosome control measures are considered in a companion paper. It is suggested that future theoretical studies give greater attention to the details of snail population dynamics, heterogeneous patterns of transmission and the effects of acquired immunity. There is a need for field studies explicitly designed to provide estimates of transmission parameters and for studies of the epidemiological effects of acquired immunity.

Age Factors↗
PubMed2005

Impact of gender and sex work on sexual and injecting risk behaviors and their association with HIV positivity among injecting drug users in an HIV epidemic in Togliatti City, Russian Federation.

OBJECTIVES: Togliatti City is witness to a large epidemic of human immunodeficiency virus (HIV) associated with injecting drug use (IDU). GOAL: This study sought to examine whether risk behaviors and risk factors associated with HIV differed across a sample IDUs by gender and sex work. STUDY: A sample of IDU (n = 423) comprising female sex workers (SWs) (n = 66), non-sex workers (nonSWs) (n = 89) and men (n = 268) were recruited by field workers in community settings. Behavioral and HIV prevalence data were collected. RESULTS: HIV prevalence did not differ across the groups ( approximately 56%), but gender adversely affected some risk factors. A comparison of risk behaviors indicated that SWs were more likely to engage in risky injecting behaviors than either men or nonSWs. They were also more likely to report a history of sexually transmitted infections. CONCLUSIONS: IDUs involved in sex work and IDU nonSWs require specific and targeted interventions to facilitate safer injecting and sexual behaviors.

Adolescent↗
PubMed1994

Injuries to international petroleum drilling workers, 1988 to 1990.

Nonfatal work-related injury (NFI) rates are 49% higher among oil and gas field workers than among workers in all US industries combined, and these injuries are more severe (the rate of lost workdays in the oil and gas field services industry is 2.8 times that of all US industries combined). We analyzed the 1988 to 1990 incident reports submitted by drilling companies to the International Association of Drilling Contractors, an industry-wide international trade association representing 95% of the world's oil and gas drilling companies. We determined geographic and occupation-specific incidence rates by full-time equivalents, calculated per job category and year. Of the 5,251 reports, 5,218 (99.4%) were of NFI and 33 (0.6%) of fatal work-related injuries (FI). The overall NFI rate was 1.2/100 full-time equivalents and the overall FI rate was 7.5/100,000 full-time equivalents. Reported NFI in US territory was 4 times more common than in non-US territory. Reported FI in US and non-US waters were 4 and 5 times more common than on land, respectively. Three job categories--floormen, roustabouts, and derrickmen--accounted for 74% of the NFI and 64% of FI, with a rate ratio, compared with rates for all other occupations, of 10.5, 8.5, and 7.0 for NFI and 5.0, 9.4, and 4.0 for FI. Among all occupations, the body part most frequently injured was the upper extremity (1,631/5,218 [31%]). The four key NFI types and circumstances identified included the upper extremities "caught in" (857/5,218 [16%]),the back "strained" (592/5,218[11%]), the lower extremities "struck by" (538/5,218 [10%]), and the lower extremities injured while "slipping" (402/5,218 [8%]). Results of these analyses revealed several high-risk occupations in this industry and identified high-risk activities that can be targeted for further study.

Accidents, Occupational↗
PubMed1994

Exposure to magnetic fields among electrical workers in relation to leukemia risk in Los Angeles County.

To address the hypotheses that electrical workers are exposed to higher magnetic fields and are at higher risk of leukemia than nonelectrical workers, we performed a registry-based case-control study among men aged 20-64 years with known occupation who were diagnosed with cancer in Los Angeles County between 1972 and 1990. Controls were men with cancers other than those of the central nervous system or leukemia. Magnetic field measurements on workers in each electrical occupation and in a random sample of occupations presumed to be nonelectrical were used to estimate magnetic field exposures for each occupation. Among men in electrical occupations, 121 leukemias were diagnosed. With the exception of electrical engineers, magnetic field exposures were higher among workers in electrical occupations than in nonelectrical occupations. A weakly positive trend in leukemia risk across average occupational magnetic field exposure was observed (odds ratio [OR] per 10 milligauss increase in average magnetic field = 1.2, 95% confidence interval [CI] 1.0-1.5). A slightly stronger association was observed for chronic myloid leukemia, although only 28 cases occurred among electrical workers (OR 10 milligauss increase = 1.6, 95% CI = 1.2-2.0). The results were not materially altered by adjustment for exposure to several agents known or suspected to cause leukemia. Although not conclusive, these results are consistent with findings from studies based on job title alone that electrical workers may be at slightly increased risk of leukemia.

Adult↗
PubMed2006

Cell-phone based assistance for waterworks/sewage plant maintenance.

Cell-phones are now incorporating the functions necessary for them to be used as mobile IT devices. In this paper, we present our results of the evaluation of cell-phones as the mobile IT device to assist workers in industrial plants. We use waterworks and sewage plants as examples. By employing techniques to squeeze the SCADA screen on CRT into a small cell-phone LCD, we have made it easier for a plant's field workers to access the information needed for effective maintenance, regardless of location. An idea to link SCADA information and the plant facility information on the cell-phone is also presented. Should an accident or emergency situation arise, these cell-phone-based IT systems can efficiently deliver the latest plant information, thus the worker out in the field can respond to and resolve the emergency.

Cell Phone↗
PubMed1983

The reliability of the microscopic diagnosis of malaria in the field and in the laboratory.

Four hundred and seventy thick and thin blood films were prepared from 129 villagers in the Solomon Islands. After staining with Giemsa, Leishman's, and Field's stains, they were randomized and examined in the field, using a miniature McArthur microscope. The specimens were then examined in the local central laboratory and by a microbiologist at a hospital in England. Films over which there was disagreement were examined by an expert at the Liverpool School of Tropical Medicine. The rate of false negative diagnoses (for thick films) was 3% for the field worker, 9% for the malaria laboratory, and 27% for the English hospital. Field diagnosis was no less reliable than laboratory diagnosis (P less than 0.001). Field's stain was the most reliable stain for both thick films (P less than 0.001) and thin films (P less than 0.05), for which a new staining technique is described.

Azure Stains↗
PubMed2005

Advances in field-based studies of primate behavioral endocrinology.

The papers in this issue were inspired by a symposium we organized for the 27th Annual Meeting of the American Society of Primatologists, held in June 2004. The purpose of the symposium was to highlight some of the new ways in which noninvasive techniques for measuring steroids are being employed to investigate the relationships between hormones and behavior in wild primates. Endocrinological data from the field provide new insights and more precise interpretations of behavioral data on topics ranging from social and reproductive strategies to seasonality, reproductive suppression, concealed ovulation, and development. Advances in the development of methods for extracting steroids from urine and feces have increased the options available to field workers, who can now select the most appropriate methodology for their study subjects, field conditions, and specific research questions. Field-based studies of behavioral endocrinology have spread to include a wide diversity of primate species. As the scope of these studies continues to grow, we anticipate the emergence of a dynamic new field in which comparative models of primate behavioral endocrinology contribute new perspectives on primates.

Animals↗
PubMed1986

NACA overview on assessment of mixer-loader-applicator exposure to pesticides. National Agricultural Chemical Association.

An overview is given of the involvement of the National Agricultural Chemical Association (NACA) in the research of field worker exposure and in the drafting of a protocol for performing exposure studies. Specific field methods are discussed and criteria for the utilization of biological monitoring are given. A generic exposure data base is being developed together with the Environmental Protection Agency (EPA).

Absorption↗
PubMedDate not supplied

Implementation of tests for monitoring drug compliance of leprosy out-patients under multi-drug therapy.

The field workers of two MDT districts (Srikakulam in Andhra Pradesh and Ganjam in Orissa) were trained for implementation of 'Paper Spot Test together with Pill/Capsule count methods' of monitoring the treatment compliance of leprosy out-patients receiving MDT. All the workers recognized the importance of implementing these methods and found them operationally feasible, in field. Of the 672 Paucibacillary and 749 multibacillary cases monitored for drug compliance, 85-88% cases showed regular compliance (more than 75% drug intake) to dapsone. The compliance to Clofazimine among Multibacillary cases was better (94% regular) than dapsone compliance. Both these monitoring methods are advocated to be used on larger scale under our National Leprosy Eradication Programme.

Clofazimine↗
PubMed2001

Rabies and canine distemper in an arctic fox population in Alaska.

Two oil field workers were attacked by a rabid arctic fox (Alopex lagopus) in the Prudhoe Bay oil field (Alaska, USA) prompting officials to reduce the local fox population. Ninety-nine foxes were killed during winter 1994. We tested foxes for prevalence of rabies and canine distemper. Exposure to rabies was detected in five of 99 foxes. Of the five, only one fox had rabies virus in neural tissue as determined by the direct fluorescent antibody test. The other four foxes had been exposed to rabies, but had apparently produced antibodies and did not have an active infection. No evidence of canine distemper was detected as determined by the absence of distemper antibodies in serum and distemper virus in neural tissue.

Alaska↗
PubMed1986

Biological monitoring of agricultural workers exposed to pesticides: I. Cholinesterase activity determinations.

An estimated 4 to 5 million persons work in agriculture; within this sector, mixers, loaders, applicators, and other workers who directly handle agricultural chemicals are at highest risk for pesticide-related illnesses. Among field workers, seasonal workers engaged in certain cultivation and harvesting operations are also at risk of exposure to pesticide residues. Biological screening for agricultural workers is limited at present to pesticide mixers, loaders, and applicators, and consists almost exclusively of measurements of cholinesterase activity to estimate inhibition by organophosphate and carbamate compounds. We review here the measurement and interpretation of cholinesterase activity in occupationally exposed populations and the correlation between cholinesterase activity and symptoms of acute and chronic illness among agricultural workers. The only state to mandate medical surveillance for agricultural workers is California: criteria for surveillance, baseline cholinesterase determination, periodicity of testing, and criteria for removal from and return to work are described, and alternative approaches for screening and clinical evaluations are discussed.

Adult↗
PubMed2002

Support required for antiretroviral uptake in developing countries.

It is evident from the current global debate on improving care and treatment for people living with HIV that antiretroviral therapy will become increasingly available in resource-poor countries. As this happens, there is an imperative to determine which factors will promote optimal use of these complex therapies to minimise the potentially serious consequences of poor adherence and the development of a worse epidemic of multidrug-resistant HIV (MDRHIV). In parallel with the process of allocating funds to purchase drugs, there needs to be a pro-active scaling up of healthcare worker training and infrastructure support systems and development of continuity of care from healthcare services into the community. The engagement of healthcare workers in the HIV epidemic has been largely ignored in favour of a focus on prevention which, understandably, works through the non-government sector as the vehicle for implementation. This upscaling and recruitment of healthcare workers needs involvement not only from our more eminent clinicians as spokespeople but also from experienced field workers, who will be caring for the majority of patients as they become ill. This article identifies the multidimensional approach necessary to implement a broad initiative for care and treatment and discusses the possible strategies and consequences of each factor.

AIDS-Related Opportunistic Infections↗
PubMed1976

Classification of leprosy from the clinical point of view.

While, according to some, classification of leprosy is primarily clinical, there should be no objection to the application of the advances made in the last decade in understanding the immunological and histopathological aspects of the disease, provided thereby the clinical classification can be made with more accuracy. Unlike most other diseases, the bulk of the process of attempts at diagnosis and classification of this disease is still in the hands of para-medical personnel in the field, and hence it is important that at the same time, an easily understood, uniformly accepted clinical classification should be recommended for field workers. While tuberculoid and lepromatous leprosy of the polar types can be diagnosed with accuracy even under field conditions, confusion generally arises with reference to the diagnosis or indeterminate maculoanaesthetic and borderline forms, and to identify some reacting lesions. Certain terminologies in vogue add further to the confusion. Reacting lesions are confused with active lesions. The importance of recognition of varieties of reacting lesions is stressed since the therapeutic management in such cases is entirely different. It is suggested that the early forms of leprosy characterised by paucity of cardinal features of the disease should be separated from the more established types and grouped under the term indeterminate leprosy. The diagnostic points to be taken into consideration in these lesions are discussed. The importance of investigating thoroughly before classifying patients who report rarely with neuritic symptoms without any evidence of skin lesion is stressed.

Adult↗
PubMed2001

Family-planning services in a low-performing rural area of Bangladesh: insights from field observations.

This paper mainly reports the results of an observational study carried out during 1994-1995 in five rural unions of Bangladesh to identify the barriers to adoption of family-planning methods. At the time of the survey, one-fifth of 1,889 mothers with a living child, aged less than five years, were practising modern family-planning methods. Of the methods used, oral pill was the most common (50%), followed by injectables (20%), female sterilization (13%), IUD (11%), and condom (4%). Various factors that were responsible for the low performance of the family-planning programme included: inadequacy of motivational work by the field workers, poor counselling on the management of contraceptive-related side-effects, inadequate response to the needs of clients, irregular field visits, and poor supervision and monitoring. The efficiency of the programme needs to be improved to meet the demand for family-planning methods in Chakaria, Bangladesh.

Adult↗