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At least 19 recordsLinked to original sources
PubMed1984

Cost effectiveness of epidemiological monitoring.

Epidemiological monitoring (EPM) is emerging as a frequent counterpart to environmental monitoring (ENM). EPM and ENM are not alternatives to each other but rather complement each other. Each cannot be evaluated on its own merit but rather on its contributory effects in conjunction with the other. The effectiveness of EPM depends primarily on the types of action which it is designed to trigger. The benefits may be evaluated in terms of the prevention of adverse health outcomes on the one hand, and from costs saved due to avoidance of unnecessary controls on the other. Nothing definitive can be said about the cost-effectiveness of EPM in general. Every context and setting require a separate analysis. The attractiveness of introducing EPM, perhaps in conjunction with ENM, is its more immediate linkage to action and protective measures.

Carcinogens, Environmental↗
PubMed1984

Epidemiological monitoring in environmental health: introduction and overview.

Epidemiological monitoring as used here is the repeated standardized evaluation of the health status of a population for the purpose of protecting this population from environmental health hazards. It is contrasted with epidemiological studies and environmental monitoring. Non-specificity of environmental monitoring is an important justification for epidemiological monitoring. In considering why epidemiological monitoring has not been more extensively used, historical, conceptual, and technical reasons are suggested. A modest increase in resources in this field is likely to be relatively cost-effective.

Environmental Health↗
PubMed1998

[Epidemiologic monitoring of tuberculosis in Omsk].

The paper presents an epidemiological monitoring of tuberculosis infection with personal computers. The procedure may standardize different epidemiological characteristics, objectively evaluate the level of antituberculosis work in various areas, promptly process a great deal of data. The tuberculosis epidemiological situation in Omsk is analyzed in comparison with the indices of epidemiological well-being.

Adolescent↗
PubMed1984

Epidemiological monitoring in the vicinity of a coal-fired power plant.

An epidemiological monitoring program has been designed and put into operation in response to a health monitoring requirement of a permit to build a coal-fired power plant. It will consist of four 350 megawatt units and is being built on the Mediterranean coast about halfway between Tel-Aviv and Haifa; the first unit became operational in 1981. The resident population within a 10 km. radius consists of about 69,000 persons. The permit to build this power plant required the installation of a comprehensive monitoring network including environmental, health and agricultural monitoring. Four types of studies are included in the epidemiological monitoring program: mortality analyses, monitoring of requests for health services, studies of pulmonary symptoms and lung function in school children, and panel studies of children and adults with chronic pulmonary conditions. Areas of maximal expected exposure risk and two other comparable areas of lesser risk were chosen, based on expected emissions, meterological and topographical considerations; baseline data were gathered for a year prior to the operation of the first unit of the power plant. Subsequent data are planned to be collected for another 10 years. The program permits detection of short-term effects based on increases in health service requests, medium-term effects by repeat examination of panelists, and long-term effects based on pulmonary conditions among school children. The initial survey, before plant operations showed, among other things, lower flow rates for children in the area expected to have medium levels of exposure.

Adult↗
PubMed2003

Epidemiologic monitoring of prenatal screening for neural tube defects and Down syndrome.

Achieving and maintaining the proper balance between detecting fetuses with open spina bifida or Down syndrome while maintaining an acceptably low screen-positive rate requires careful, ongoing monitoring of screening performance indicators along with specific procedures aimed at taking rapid and effective corrective actions when warranted. The process of epidemiologic monitoring, which uses data generated from the screened population, has been developed as an extended quality assurance measure for this purpose. The primary indicators used include the percentage of women with a screen-positive result and the grand multiple of the median. These indicators are sensitive to inaccurate and imprecise assay values and help to ensure that gestational age-specific median values are appropriate. Epidemiologic monitoring also provides useful information for physicians, public health authorities, and regulatory bodies.

Adult↗
PubMed1984

Feasibility of epidemiological monitoring for a proposed coal-fired power plant, Ivanpah, California.

The authors were asked to determine the feasibility of conducting epidemiologic monitoring for adverse health impact of emissions from the proposed Ivanpah Coal-Fired Power Plant. The study was required by the licensing agency, and specifically concerned health effects on the surrounding community. No potential occupational effects were considered. The area of concern was limited by the licensing agency to a circle of 50 mile radius around the Ivanpah site. The proposed power plant will be capable of generating 1500 megawatts of electricity utilizing low sulfur western coal. It is designed with stack heights of 500 feet for good dispersion and is planned to be outfitted with the best available stack emission control equipment. To establish whether an epidemiologic study is feasible, one must determine: (1) the size of the population which potentially would be exposed; (2) the pollutants to which that population might be exposed and the expected level of exposure and (3) the known or expected health effects of these pollutants and the frequency of such health outcomes. In addition, as in any epidemiologic study, the choice of a proper comparison group, the acceptability of a study to the population to be monitored and costs of the study in relation to available resources must also be taken into account. The population residing within 20 miles of the site consists of approximately 1,500 people at the present time. This population is not expected to increase significantly, although there is the possibility of growth of a "company town" surrounding the plant. Such an event would clearly alter the feasibility of conducting an epidemiologic study. Air quality modeling was used to predict the exposures to the population from various emissions from the proposed generating station. It was based on worst-case assumptions of wind speed, direction, atmospheric stability and percent sulfur-content coal. While a great many pollutants may result from coal burning, the levels of all pollutants, with the possible exception of ozone, are expected to be much lower than existing standards allow and therefore of little practical concern in the communities near Ivanpah. Since ozone is not a primary pollutant but is of secondary origin, its concentration, given the appropriate conditions, could increase with distance from the plant. None of the expected health outcomes occurs with sufficient frequency to allow the detection, with a reasonable degree of statistical certainty, of any reasonably expected increase in frequency in an epidemiologic study of a population as small as that which is associated with the Ivanpah site.(ABSTRACT TRUNCATED AT 400 WORDS)

Air Pollutants↗
PubMed1995

Characterisation of penA and tetM resistance genes of Neisseria gonorrhoeae isolated in southern Africa--epidemiological monitoring and resistance development.

OBJECTIVE: To investigate penA and tetM resistance gene variation of Neisseria gonorrhoeae in order to define gene types for epidemiological monitoring and resistance development. DESIGN: Isolates of N. gonorrhoeae which were susceptible and resistant to penicillin and/or tetracycline were selected. Strains comprised South African isolates (22 from Bloemfontein, 13 from Transvaal, 20 from the Cape) and 15 Botswana and 4 Namibia isolates. The penA genes (2 kb) of all strains and tetM genes (765 bp) of 11 high-level tetracycline-resistant strains were amplified and restricted with HpaII. RESULTS AND CONCLUSIONS: Twelve different HpaII fingerprint patterns were obtained from the 74 isolates analysed for penicillin-binding protein (PBP) 2 gene (penA) alterations. Focusing on the transpeptidase domain, 25 isolates (3 whole gene patterns, minimal inhibitory concentrations (MICs) < or = 0.03-0.125 micrograms/ml) had restriction sites equivalent to those previously described for a susceptible strain. Of the remaining 9 PBP 2 gene groups, 25 strains fell into a designated group E. Penicillin/ penicillin + clavulanic acid MICs determined on these group E isolates gave a range of 0.125-2.0 micrograms/ml, although MICs against 4 strains were < or = 0.03 micrograms/ml. MICs of penicillin/penicillin + clavulanic acid for the 24 isolates that contained altered PBP 2 transpeptidase gene regions not designated group E were only < or = 0.03-0.125 micrograms/ml. The lack of a HpaII restriction site at nucleotide 1934 in the PBP 2 gene of group E strains was indicative of a small terminal region of N. cinerea DNA. This gene block, which was found in all the southern African areas studied, appears to predispose isolates to increased penicillin resistance. The 25.2 MDa conjugative plasmid carrying the tetM resistance determinant was readily demonstrated in 11 Botswana/Namibia isolates exhibiting high-level resistance to tetracycline (MICs > or = 16 micrograms/ml). The tetM gene was shown to be of the American type.

Drug Resistance, Microbial↗
PubMed2002

Molecular markers in epidemiological monitoring of the spread of resistance to antimalarials: a review.

OBJECTIVE: To review the prevalence and distribution of resistance to chloroquine and pyrimethamine-sulphadoxine combination and the use of molecular markers for monitoring the spread of the resistance. DATA SOURCES: Literature search on compact disk-read only memory (CD-ROM), Medline and Internet, using the key words: Malaria and epidemiology, malaria and resistance, sulphadoxine-pyrimethamine resistance and chloroquine resistance. Some articles were manually reviewed. STUDY SELECTION: Relevant studies or articles on resistance to chloroquine, sulphadoxine pyrimethamine combination and other antimalarials and molecular resistance markers from various sources are included in the review. DATA EXTRACTION: From individual study or articles. DATA SYNTHESIS: Information on antimalarial resistance is harmonised under the headings; Introduction, Prevalence and distribution of resistance to antimalarials, Use of molecular markers for epidemiological monitoring of antimalarial resistance. CONCLUSION: The spread and status of resistance to sulphadoxine-pyrimethamine (SP) and chloroquine should be monitored constantly in major health facilities. This will not only detect the emergence of resistance to these drugs but also generate information on the extent of resistance to these antimalarials. Mutations in the dhfr and dhps genes can be used as markers in SP resistance surveilance while the presence of pfcrt mutations thought to confer resistance should also be analysed to ascertain whether they truly correlate to the resistance patterns that have been observed in various malarious regions. Little is known on the interaction and exact role(s) of PfCRT protein in conferring the resistance trait.

Animals↗
PubMed2006

Antimicrobial resistance in non-typhoidal salmonellas from humans in Northern Ireland, 2001-2003: standardization needed for better epidemiological monitoring.

This study investigated the identification and antimicrobial susceptibility testing of Salmonella isolates in Northern Ireland during 2001-2003. All six participating hospital laboratories used similar methods. Identification and antimicrobial resistance of human enteric (n=897) Salmonella isolates were analysed by retrospective collation of laboratory records. Resistance of human Salmonella isolates to nalidixic acid was 16% but resistance to ciprofloxacin or cefotaxime was rare (<1%). Minor inter-laboratory variations in sensitivity testing practices make it difficult to compare antimicrobial sensitivity results reliably and also to monitor for epidemic clones such as S. Typhimurium DT104 with the ACSSuT resistance pattern. The outcome of this study was the adoption of a standardized regional approach to the isolation of salmonella antimicrobial resistance. This should improve epidemiological monitoring of epidemic clones and assure optimum treatment options are available. In cases of treatment failure, MICs to third-generation cephalosporins and ciprofloxacin should be determined.

Anti-Infective Agents↗
PubMed1983

Immunofluorescence test for the epidemiological monitoring of acute haemorrhagic conjunctivitis cases.

An epidemic of acute haemorrhagic conjunctivitis (AHC) occurred in and around Chandigarh, north India, during June, July and August 1981. Considering the difficulty of virus isolation, the indirect immunofluorescence test was used for the demonstration of virus-specific antigen in the cytoplasm of exfoliated conjunctival cells, using reference antisera. The epidemic appeared to be primarily due to enterovirus type 70. The method was found suitable for the rapid diagnosis of AHC cases and for detecting subclinical infection among healthy subjects and convalescent carriers. During follow-up, it was observed that some of the AHC cases were shedding virus-infected conjunctival cells for a prolonged period, even after clinical recovery and during convalescence, before they became free from virus. In the absence of virus isolation, this method can be considered as suitable for the epidemiological monitoring of AHC.

Acute Disease↗
PubMed1984

Epidemiological monitoring of environmental lead exposures in California State Hospitals.

Blood lead screening of 8062 state hospital residents in California revealed 143 residents with excessive lead levels (greater than or equal to 30 micrograms/dL). This screening was part of the Childhood Lead Project and was performed in 1978. The purpose of this study was to identify "critical" lead sources in California State Hospitals. Accurate identification is crucial if subsequent abatement programs are to be effective. The strategy involved the following sequence of steps: 1) Selection of cases based on blood lead and erythrocyte protoporphyrin screening. 2) Determination of pica habits and environmental exposures through interviews with ward's staff and/or parents. 3) Measurement of lead levels in environmental samples reflecting exposures. 4) Interpreting these data in order to identify critical lead sources. 5) Reducing exposure to critical lead sources. 6) Following up of cases and controls to validate the effects of this strategy. A group of 36 lead-burdened cases with pica (30-60 micrograms Pb/dL blood) and 36 matched controls (PbB less than 20 micrograms/dL) were selected from among the developmentally disabled residents of two California State Hospitals. These subjects were studied in order to identify the lead sources to which they were exposed and to abate the major ones. Three major lead sources were found in the state hospitals: wall and furniture paints (100-45,400 micrograms Pb/g paint); surface soil (33-570 micrograms Pb/g soil); educational format was presented to all involved staff. The results have indicated a trend towards lower lead intake by the lead-burdened cases. In one of the two hospitals a "lead-free unit" had been established. All the lead-burdened cases were transferred to this unit in August 1981. A few months later the blood lead levels of all the cases dropped below 30 micrograms/dL. Initial epidemiological monitoring indicated where there were preventable hazards, which abatement efforts succeeded in reducing. Further monitoring of such problems is indicated in this and other developmentally-disabled populations.

Adolescent↗
PubMedDate not supplied

[Epidemiologic monitoring system for the diabetic patient; use of computerized technology in the quality of medical care].

OBJECTIVE: To describe an instrument for epidemiologic surveillance of diabetes mellitus and evaluating the quality of care in primary health care. MATERIAL AND METHODS: The study was conducted from January 1, 1998, to June 30, 1999, at the Epidemiology and Health Services Research Unit of the Mexican Institute for Social Security (IMSS), in Hermosillo, Sonora. A single data collection form was designed, which contains items included in the diabetes care clinic of the Unit of Family Medicine of the Mexican Institute of Social Security. RESULTS: We developed and implemented a software program to enter data from the paper format and to generate individual and group reports on attendance to scheduled medical visits, medical history, evolution of signs and symptoms, laboratory tests, and medication. CONCLUSIONS: Electronic data systems allow the availability of reliable and continuing information for surveillance of the comprehensive care of the diabetic patient.

Computers↗
PubMed1986

Intracranial pressure monitors. Epidemiologic study of risk factors and infections.

An increase in the number of cases of gram-negative ventriculomeningitis in patients followed with intracranial pressure monitors when compared with patients with craniotomy alone was revealed by routine surveillance data. A study was undertaken at four area institutions to describe the infections, risk factors, and management. Two hundred fifty-five patients with diagnoses of intracerebral hemorrhage (n = 86), closed trauma (n = 66), open trauma (n = 21), tumor (n = 66), and miscellaneous other conditions were compared with their nonmonitored counterparts for type of intracranial pressure monitor used, use of drains, prophylactic antibiotics, and steroids, and remote presence of infection. The presence of intracranial pressure monitor with craniotomy was associated with an 11 percent infection rate whereas craniotomy alone demonstrated a 6 percent rate. Of the intracranial pressure monitors used, the subarachnoid screw was associated with the lowest infection rate (7.5 percent) followed by the subdural cup catheter (14.9 percent) and the ventriculostomy catheter (21.9 percent). Regardless of the monitor used, infection was twice as likely to develop in patients with open trauma or hemorrhage. The use of bacitracin flush solutions for maintenance of lumen patency was more often associated with infections. Use of prophylactic antibiotics did not significantly influence outcome.

Adolescent↗
PubMed1999

Monitoring epidemiologic surveillance data using hidden Markov models.

The analysis of routinely collected surveillance data is an important challenge in public health practice. We present a method based on a hidden Markov model for monitoring such time series. The model characterizes the sequence of measurements by assuming that its probability density function depends on the state of an underlying Markov chain. The parameter vector includes distribution parameters and transition probabilities between the states. Maximum likelihood estimates are obtained with a modified EM algorithm. Extensions are provided to take into account trend and seasonality in the data. The method is demonstrated on two examples: the first seeks to characterize influenza-like illness incidence rates with a mixture of Gaussian distributions, and the other, poliomyelitis counts with mixture of Poisson distributions. The results justify a wider use of this method for analysing surveillance data.

Disease Outbreaks↗