Campylobacter infection in urban and rural populations in Scotland

A review of campylobacter infection in Scotland over five years (1978-82), during which 7808 human isolates were recorded (mean annual isolation rate of 30 per 100000), revealed differences in the epidemiology of the disease between rural and urban populations which were not apparent in the national data. The incidence of infection in the two rural areas studied was greatest in the early months of the year, whereas that in the two urban areas showed a third-quarter predominance. In both urban and rural populations, age-specific infection rates were highest in children less than 5 years old, but this trend was more pronounced in rural than urban populations. Conversely, secondary peaks in age-specific infection rates observed in young adults were more pronounced in the urban than rural populations. It is postulated that rural children were being infected by campylobacters at an early age by drinking contaminated raw milk which was not normally available to city residents. The lower incidence in adults in the rural populations is interpreted as indicating more widespread immunity, resulting from greater exposure to infection during childhood. The effect of compulsory heat treatment of milk sold in Scotland, introduced in August 1983, is currently being studied.     

Campylobacter jejuni and Campylobacter coli diarrhoea in rural and urban populations in Yugoslavia

During a 4-month period during the summer of 1985, campylobacters were isolated from 338 (16.3%) of 2080 patients with acute diarrhoea attending the University Hospital of Infectious Diseases in Zagreb. Of these isolates 220 (64.1%) were Campylobacter jejuni and 118 (34.9%) were C. coli. The patients were drawn from three residential zones in and around Zagreb: inner city, peripheral city and rural. Incidences of campylobacter diarrhoea ranged from 71 per 100,000 per year in inner city residents to 99 per 100,000 per year in the rural residents. Most infections were in young children; the incidence in infants ranged from 800 to 2500 per 100,000 per year in the inner city and rural zones respectively. The isolation rate from faecal specimens of infants from the rural zone was 61%. The ratio of isolation rates in males and females (all ages) was 1.1:1, but in infants it was 0.7:1 and in patients over the age of 65 years it was 0.4:1. The incidence of C. coli in the rural zone was four times that in the inner city and twice that in the peripheral zone. This survey shows that campylobacter infection in Zagreb has distinctive epidemiological features. The transmission of infection appears to be midway between that found in industrialized and developing countries, and there is an unexplained excess of C. coli infection.     

The prevalence of hepatitis B infection amongst urban and rural populations in Western Samoa.

A group of 240 urban and 200 rural dwellers in Western Samoa over the age of 20 years was studied for serological evidence of current or past infection with hepatitis B virus (HBV). Overall, 5.5% of subjects were found to be currently infected with HBV and a further 74.5% showed detectable levels of antibody. Antibody to the hepatitis B core antigen was found to be a better marker of past infection than antibody to the surface antigen of the virus. Both the infection rate and carrier rate were higher in males than females and subjects living in rural areas were more likely to be infected than those living in urban areas.     

A comparison of health inequalities in urban and rural Scotland

Previous research suggests that there are significant differences in health between urban and rural areas. Health inequalities between the deprived and affluent in Scotland have been rising over time. The aim of this study was to examine health inequalities between deprived and affluent areas of Scotland for differing ruralities and look at how these have changed over time. Postcode sectors in Scotland were ranked by deprivation and the 20% most affluent and 20% most deprived areas were found using the Carstairs indicator and male unemployment. Scotland was then split into 4 rurality types. Ratios of health status between the most deprived and most affluent areas were investigated using all cause mortality for the Scottish population, 1979-2001. These were calculated over time for 1979-1983, 1989-1993, 1998-2001. Multilevel Poisson modelling was carried out for all of Scotland excluding Grampian to assess inequalities in the population. There was an increase in inequalities between 1981 and 2001, which was greatest in remote rural Scotland for both males and females; however, male health inequalities remained higher in urban areas throughout this period. In 2001 female health inequalities were higher in remote rural areas than urban areas. Health inequalities amongst the elderly (age 65+) in 2001 were greater in remote rural Scotland than urban areas for both males and females.     

The prevalence of obesity and its determinants in urban and rural aging Mexican populations.

OBJECTIVE: To determine the prevalence of obesity and its association to different variables in urban and rural older Mexican populations. METHODS AND PROCEDURES: A cross-sectional study of three different Mexican communities. A total of 121 men and 223 women 60 years and older and 93 men and 180 women aged 35 to 59 years old were selected randomly for inclusion in the survey. A personal interview assessed demographic information, personal medical history and functional status and a 24-hour diet recall was obtained. The physical examination included anthropometric and blood pressure measurements. A fasting blood sample was obtained for measurements of lipids, insulin and glucose. RESULTS: Obesity was highly prevalent in women, in individuals from the urban communities and diminished with advancing age. A BMI > or =30 kg/m2 was observed in 23.6% younger vs. 15.6% older adult men (p=0.21) and 28.4% younger vs. 19.7% older adult women (p = 0.06). The association of obesity with other variables was estimated using a stepwise multivariate logistic regression, increased insulin levels [Odds Ratio (OR) 1.68, p=0.006] and living in an urban area (OR 5.90, p<0.007) were variables independently associated to obesity in adult older individuals. In the younger adults, obesity was associated with hypertension (OR 2.74, p<0.0009), higher insulin levels (OR 1.31, p<0.03) and central adiposity (OR 2.97, p = 0.05), these relationship were not observed with gender, distribution of food or alcohol intake or other coronary risk factors. CONCLUSIONS: The present survey confirms the high prevalence of obesity in the Mexican urban population that declines with advanced age. Studies in elderly population must consider the bias produced by increased early mortality in those individuals with a more unfavorable risk profile.     

Opisthorchis viverrini infection in rural and urban communities in northeast Thailand

The prevalence and intensity of liver-fluke (Opisthorchis viverrini) infection were investigated among 559 patients who were born in, and had lived all their lives in, either the rural or urban northeastern Thailand. 344 (79.4%) of 433 rural dwellers were infected compared with only 69 (54.8%) of 126 urban dwellers (P less than 0.005). The intensity of infection, and the reported level of consumption of koi-pla, a favourite dish of local inhabitants prepared from uncooked freshwater fish which often contains viable metacercariae, were greater among rural dwellers than their urban counterparts (P less than 0.05 to P less than 0.005). Infection due to O. viverrini appears to be mainly a rural problem strongly associated with the habit and frequency of eating koi-pla.     

Health and poverty in rural Scotland

This paper presents findings from a study on rural disadvantage to explore the implications of disadvantage for the health of rural communities and the organisation and delivery of health care services in rural areas. Rural health research has been a neglected topic. Yet previous research has reported the importance local people and practitioners place on the provision and organisation of health services in rural areas.' The research reported in this paper further emphasises this point and, in addition, provides empirical data on local people and practitioners perceptions of health issues and health services in four areas of rural Scotland.     

Data-based planning for educational interventions through hypertension control programs for urban and rural populations in Maryland.

As part of a statewide effort to coordinate existing resources for high blood pressure (HBP) control, a public health HPB control program was planned and implemented in two high-risk communities in Maryland. The selection of the two communities was based on epidemiologic data. The planning of the educational intervention program in these communities (urban and rural) was guided by organizational theory and health education principles. The framework for development, implementation, and evaluation of the program utilizes an educational assessment model which identified factors that predispose, reinforce, and enable individual persons to practice positive health behavior. Multiple data sources were used in assessing the extent of the problem and relevant approaches in the development of the coordinated HPB control program. These include statewide vital statistics and a random statewide household survey to assess the prevalence rates of awareness, treatment, and control of HPB. To supplement these data, telephone surveys were carried out in the two communities to assess knowledge, beliefs, and practices related to HPB control. Medical record reviews provided baseline information on appointment keeping behavior and BP correlates of hypertensive patients. The planning and implementation of the program was carried out under the direction of representatives of the health care systems, community leaders, and residents, and representatives of communitywide organizations involved in HPB control.     

Pathogenicity and convalescent excretion of Campylobacter in rural Egyptian children.

Campylobacter infection in developing countries has not received much public health attention because of the observation that infections are not associated with disease beyond the first 6 months of life. A cohort of 397 Egyptian children aged less than 3 years, who were observed twice weekly during 1995--1998, experienced an incidence of 0.6 episodes of Campylobacter diarrhea per child-year. A total of 13% of the Campylobacter diarrheal episodes were characterized by severe dehydration. Age-specific incidence rates (episodes per year) were 0.9 in infants aged less than 6 months, 1.5 in those 6--12 months, and 0.4 and 0.2 in the second and third years of life, respectively. Convalescent excretion of Campylobacter after a diarrheal episode might be enhancing transmission and contributing to this high incidence. Observed risk factors for Campylobacter diarrhea were poor hygienic conditions and the presence of animals in the house. Regardless of the child's age, a first infection by Campylobacter was associated with diarrhea (odds ratio = 2.45; 95% confidence interval: 1.61, 3.71); however, subsequent infections were associated with diarrhea only in children aged less than 6 months. This observation that natural infection did not confer protection during the first 6 months of life poses a challenge to vaccine development.     

Primary health-care teams as adaptive organizations: exploring and explaining work variation using case studies in rural and urban Scotland.

It is acknowledged, internationally, that health-care practitioners' work differs between and urban areas. While several factors affect individual teams' activities, there is little understanding about how patterns of work evolve. Consideration of work in relation to local circumstances is important for training, devising contracts and redesigning services. Six case studies centred on Scottish rural and urban general practices were used to examine, in-depth, the activity of primary health-care teams. Quantitative workload data about patient contacts were collected over 24 months. Interviews and diaries revealed insightful qualitative data. Findings revealed that rural general practitioners and district nurses tended to conduct more consultations per practice patient compared with their urban counterparts. Conditions seen and work tasks varied between case study teams. Qualitative data suggested that the key reasons for variation were: local needs and circumstances; choices made about deployment of available time, team composition and the extent of access to other services. Primary care teams might be viewed as adaptive organization, with co-evolution of services produced by health professionals and local people. The study highlights limitations in the application of workload data and suggests that understanding the nature of work in relation to local circumstances is important in service redesign.     

三亚市小学生肠道寄生虫感染状况

了解三亚市小学生肠道寄生虫感染情况,为今后更好地开展防治工作提供依据.方法 分层整群随机抽取三亚市10所市区小学和4所乡镇小学的2 790名小学生,采用改良加藤法检验粪便中的蛔虫卵、鞭虫卵、钩虫卵.结果 三亚市小学生肠道寄生虫总感染率为6.99%,其中蛔虫感染占53.79%,鞭虫感染占42.06%,钩虫感染占4.15%.乡镇小学生感染率明显高于城市小学生(x2=114.20,P<0.01),城市及乡镇小学生感染率均随年龄的增长而下降(x2值分别为11.62,36.47,P值均<0.05),乡镇小学男生感染率明显高于女生(x2 =4.23,P<0.05).结论 三亚市乡镇小学生肠道寄生虫感染率仍较高.应加强健康教育,改善卫生条件,整治环境卫生,将防治重点放在农村.     

Geohelminth infection of children from rural plantations and urban slums in Malaysia

This study compares levels of geohelminth infection in children living in rural estates and urban slum areas of Malaysia. The statistical characteristics of geohelminth infection in 1499 children from birth up to 15 years of age, living in rural estates, were analysed according to age, sex and ethnic origin and compared with the same statistics for 1574 slum-dwelling children of similar age groups and ethnic origins. The prevalence and intensity of ascariasis and trichuriasis were significantly higher among children from the urban slums. Slum-dwelling ethnic Indians and Malays had higher levels of infection with Ascaris lumbricoides and Trichuris trichiura than their rural counterparts, but the infection status of the ethnic Chinese in the 2 areas was similar. Hookworm infection was similar in both areas, indicating that hookworm infection is neither necessarily nor solely a rural disease. These results suggest that urban slum children are at greater risk of ascariasis and trichuriasis than their rural counterparts.     

Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey

Background  

Measuring health status in a population is important for the evaluation of interventions and the prediction of health and social care needs. Quality of life (QoL) studies are an essential complement to medical evaluation but most of the tools available in this area are in English. In order to evaluated QoL in rural and urban areas in Lebanon, the short form 36 health survey (SF-36) was adapted into Arabic.