Booster effect of two-step tuberculin skin testing among hospital employees from areas with a high prevalence of tuberculosis.

During a baseline survey of TST, 236 nurses underwent a two-step TST. Overall, 29 (12%) showed boosting. All age groups showed boosting; the rate was 9.7% in those younger than 35 years. Subjects older than 45 years were more likely to have a booster effect than younger individuals (29% vs 10.1%).     

Efficiency of tuberculin as a tool to determine the prevalence of tuberculosis

Among 1937 first grade primary school children followed, the results of tuberculin test, the prevalence rate of TB infection was 4.49% with an estimated annual infection rate of 0.75%. Household contacts of tuberculin positive pupils gave a prevalence rate of infection of 30.6%. As for the efficiency of tuberculin screening test, data of this work showed a positive predictive value of 13.3%. Out of 10 diagnosed tuberculous patients, 4 cases were diagnosed for the first time during this study.     

Evidence for a high prevalence of spotted fever group rickettsial infections in diverse ecologic zones of Inner Mongolia.

A 3-year study of spotted fever group rickettsial ecology in Inner Mongolia revealed that nearly half of the human population tested had antibodies to Rickettsia sibirica detected by complement fixation test. Infected persons, ticks and a high proportion of seropositive livestock and wild rodents were found in all five vegetation zones (desert, steppe, forest, forest-grassland and grassland).     

The organisation of a national survey for evaluating child psychomotor development in Argentina

A total of 211 selected paediatricians were invited to participate in a national survey designed to evaluate the age of attainment of developmental milestones in children aged 0–5 years. Following a pilot study and a cascade training design, 61.1% of the paediatricians successfully completed the data collection on 139 developmental items. In the pilot study, there were more missing (not performed) items in children over one year of age, thus confirming the impression that paediatricians are more familiar with evaluating development in infants. However, in the age range 1–5 years, there were significantly fewer missing items in the gross motor area than in the other areas. Following a training programme and data editing and cleaning, a final sample of 3573 healthy, normal children was obtained. The impact of the training process was significant, in the sense that 3.5% of the items in children older than one year were not performed by the paediatricians before training, but this percentage was reduced to 1.9% after training ( P < 0.01). The sample formed 0.11% of the national population less than 6 years of age and included a sex ratio of 1.01 compared with a national ratio of 1.02. There were no significant differences in the geographical distribution of the sample in comparison with that of the national population. The social composition, assessed by maternal education level, was biased towards a better education level than the national population. Mean Z-scores for height and weight were not significantly different from zero, when calculated on the basis of the national growth standards. In addition to successfully obtaining a representative sample for the analysis of the age of attainment of developmental milestones in Argentinian children, the survey also accomplished an educational objective in the training of paediatricians in developmental paediatrics.     

Feasibility and benefits of a parent-focused preschool child obesity intervention

OBJECTIVES: This field study tested the feasibility and benefits of a program to promote 6 targeted parental behaviors to prevent obesity in children served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS: Two WIC sites participated in a nonrandomized, controlled 1-year prospective study to assess parents' self-reported behavior changes. RESULTS: Statistical analyses of preintervention and postintervention assessments of parental behavior demonstrated significant changes in 2 behaviors: frequency of offering the child water and frequency of engaging in active play with the child. In both cases, the intervention proved effective in increasing the desired behavior. CONCLUSIONS: The findings demonstrate the feasibility of changing parental behaviors through multidimensional education in a WIC clinic setting.     

A new method for estimating a standardized prevalence of child malnutrition from anthropometric indicators

Although anthropometric indicators are widely used for assessing the nutritional status of children, lack of consensus on the cut-off points for prevalence estimates has precluded the use of standard analytical methods in population surveys. A simple method for estimating a standardized prevalence of child malnutrition from anthropometric indicators is presented. The method is based on comparing the distribution of the indicator with that of the normalized NCHS reference population, the underlying assumption being that both distributions are nearly normal. Standardized prevalence is defined as the proportion of cases in the observed population that is outside the normal distribution of the reference values, which can be estimated from the mean and standard deviation of the standardized Z-scores of the population, by using a formula based on the mathematical properties of the normal probability curve. A reference table is included which provides computer-estimated prevalence rates for different mean Z-scores and standard deviations of normally distributed anthropometric indicators.     

The Duffy blood group and malaria prevalence in Gambian West Africans.

Erythrocytes from 1,168 donors, comprising almost the entire populations of two rural Gambian villages, have been tested for Duffy blood group antigens using antisera to both Fya and Fyb. All tests were negative. Blood film examination of the same samples showed complete absence of Plasmodium vivax parasitaemia, but infections with P. falciparum,P. malariae and P. ovale were observed. The findings are consistent with the view that the Duffy-negative phenotype, FyFy, constitutes the basis of innate resistance towards infection with P. vivax but not towards infection with the other plasmodial species.     

The potential impact of a vaccine on Neisseria gonorrhoeae prevalence among heterosexuals living in a high prevalence setting

BackgroundTreatment of Neisseria gonorrhoeae is under threat with the emergence and spread of antimicrobial resistance. Thus, there is a growing interest in the development of a gonorrhoea vaccine. We used mathematical modelling to assess the impact of a hypothetical vaccine in controlling gonorrhoea among heterosexuals living in a setting of relatively high N. gonorrhoeae prevalence (∼3 %).MethodsWe developed a mathematical model of N. gonorrhoeae transmission among 15–49-year-old heterosexuals, stratified by age and sex, and calibrated to prevalence and sexual behaviour data from South Africa as an example of a high prevalence setting for which we have data available. Using this model, we assessed the potential impact of a vaccine on N. gonorrhoeae prevalence in the entire population. We considered gonorrhoea vaccines having differing impacts on N. gonorrhoeae infection and transmission and offered to different age-groups.ResultsThe model predicts that N. gonorrhoeae prevalence can be reduced by ∼50 % in 10 years following introduction of a vaccine if annual vaccination uptake is 10 %, vaccine efficacy against acquisition of infection is 25 % and duration of protection is 5 years, with vaccination available to the entire population of 15–49-year-olds. If only 15–24-year-olds are vaccinated, the predicted reduction in prevalence in the entire population is 25 % with equivalent vaccine characteristics and uptake. Although predicted reductions in prevalence for vaccination programmes targeting only high-activity individuals and the entire population are similar over the same period, vaccinating only high-activity individuals is more efficient as the cumulative number of vaccinations needed to reduce prevalence in the entire population by 50 % is ∼3 times lower for this programme.ConclusionProvision of a gonorrhoea vaccine could lead to substantial reductions in N. gonorrhoeae prevalence in a high prevalence heterosexual setting, even with moderate annual vaccination uptake of a vaccine with partial efficacy.     

The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis

Objectives

Systematic reviews on prevalence estimates of child sexual abuse (CSA) worldwide included studies with adult participants referring on a period of abuse of about 50 years. Therefore we aimed to describe the current prevalence of CSA, taking into account geographical region, type of abuse, level of country development and research methods.

Methods

We included studies published between 2002 and 2009 that reported CSA in children below 18 years. We performed a random effects meta-analysis and analyzed moderator variables by meta-regression.

Results

Fifty-five studies from 24 countries were included. According to four predefined types of sexual abuse, prevalence estimates ranged from 8 to 31 % for girls and 3 to 17 % for boys. Nine girls and 3 boys out of 100 are victims of forced intercourse. Heterogeneity between primary studies was high in all analyses.

Conclusions

Our results based on most recent data confirm results from previous reviews with adults. Surveys in children offer most recent estimates of CSA. Reducing heterogeneity between studies might be possible by standardized measures to make data more meaningful in international comparisons.     

The infant health effects of starting universal child benefits in pregnancy: Evidence from England and Wales

Child benefits are typically paid from birth. This paper asks whether starting universal child benefits in pregnancy leads to improvements in infant health. Leveraging administrative birth registry and hospital microdata from England and Wales, I study the effects of the Health in Pregnancy Grant, a universal conditional cash transfer equivalent to three months of child benefit (190 GBP) as a lump sum to pregnant mothers from 2009 to 2011. I exploit quasi-experimental variation in eligibility with a regression discontinuity design in the date of birth of the baby. I find that the policy increased birth weight by 8–12 grams on average, reduced low birth weight ($<$2500 g) by 3-6 percent and decreased prematurity by 9–11 percent. Younger mothers, particularly those living in deprived areas, benefit the most. I present evidence that the mechanisms are unlikely to be antenatal care, nutrition or smoking, with reductions in stress remaining a possible explanation.     

Interpretation of tuberculin reactions in populations with a high proportion of BCG-vaccinated persons

In recent years there has been an apparent increase in the frequency with which inconsistent results are obtained in the routine tuberculin-testing carried out at the Central Tuberculosis Dispensary in Copenhagen. The author describes an investigation which was undertaken to find out the cause of these conflicting results. In this study, about a thousand non-tuberculous people, many of whom had previously been vaccinated with BCG, were tested by one of two different techniques. In another similar group of people, 300 tuberculin reactions were each read independently by three nurses.