Relationships between mortality, visual acuity and microfilarial load in the area of the Onchocerciasis Control Programme

The relationships between onchocercal infection, visual acuity and mortality have been examined using epidemiological data gathered by the Onchocerciasis Control Programme from 66 villages in West Africa. All of these villages were surveyed at least twice. 18,778 persons were registered at the first surveys which were conducted around the time when control activities started. The second surveys were conducted two to five years later. 14,961 persons (79.7%) were alive and registered again, 786 (4.2%) had died, 2776 (14.8%) had moved and 255 (1.4%) could not be traced. The prevalence of blindness and of visual damage other than blindness both increased markedly with age, and the degree of visual damage was strongly associated with level of microfilarial infection. Among adults, the prevalence of blindness was higher for males than for females at all ages. The prevalence and intensity of microfilarial infection were also higher among males but this was not sufficient to explain their excess blindness. Logistic regression analysis showed that males were 1.5 times more likely to be blind than females of the same age and same level of microfilarial infection. The presence of visual damage at the first survey considerably increased the risk of mortality between the first and second surveys for both males and females. Mortality rates were three to four times higher among the blind and about 1.5 times higher among those with visual damage other than blindness compared with those with no visual damage. There was some evidence, for males but not for females, that mortality was also directly related to microfilarial load.(ABSTRACT TRUNCATED AT 250 WORDS)     

Coronary heart disease risk factors in sub-Saharan Africa: studies in Tanzanian adolescents.

STUDY OBJECTIVE--To assess the level of cardiovascular risk factors in young people in sub-Saharan Africa living in rural and urban settings. DESIGN--Cross sectional survey of the population aged 15 to 19 years. SETTING--Eight rural Tanzanian villages in three regions, and two districts in Dar es Salaam. PARTICIPANTS--664 males and 803 females in rural villages and 85 males and 121 females in the city. Response rates for total population were 74% to 94% in the rural areas and 60% in the city. MEASUREMENTS AND RESULTS--Measurements included blood pressure, body mass index, serum lipids, and blood glucose concentrations (fasting and two hours after 75 g glucose). Blood pressure was slightly but significantly higher in young women than in young men (115/67 mmHg versus 113/65 mmHg) and increased significantly with age. Only 0.4% subjects had blood pressure greater than 140 and/or 90 mmHg. There were no urban-rural differences. Body mass index was higher in females (mean (SD) 20.3 (2.8) kg/m2) than males (18.5 (2.1)). Overweight was found in only 0.6% at age 15 years but 5.4% at age 19 years. Serum cholesterol concentrations were low at 3.5 mmol/l in males and 3.7 mmol/l in females. Only 7% had values above 5.2 mmol/l. The highest concentrations were found in the city and in Kilimanjaro, the most prosperous rural region. Serum triglycerides were 1.0 (0.5) mmol/l in males and 1.1 (0.5) mmol/l in females, and were highest in the city dwellers. Diabetes was rare (0.28% males, 0.12% females) but impaired glucose tolerance was present in 4.7% and 4.1% respectively. Drinking alcohol was equally prevalent in males and females, reaching 30% at age 19 years. Only 0.4% of females smoked compared with 7.3% of males. Smoking was commoner in rural areas that in the city. CONCLUSIONS--Several risk factors for cardiovascular disease were found in Tanzanian adolescents, but levels were much lower than in studies reported from developed nations. The challenge is to maintain these low levels as the population becomes more urbanised and more affluent.     

Patterns of cigarette and smokeless tobacco use among children and adolescents

Although cigarette and smokeless tobacco use are recognized as major problems among school-age youth, few nationwide or statewide data exist on the prevalence and patterns of use. To determine the patterns of tobacco use among children and adolescents in Missouri, self-report information was obtained from a representative sample of 5,431 students in grades 5, 8, and 12. Both cigarette smoking and smokeless tobacco use were more common among males than females for each grade level except the 12th, where 30% of females and 28% of males had smoked during the previous week. Smoking prevalence was considerably lower among blacks than whites. Smokeless tobacco use was rare among both blacks and females. Smokeless tobacco use was more common than cigarette smoking in rural areas, where 17% of 8th-grade males and 31% of 12th-grade males had used smokeless tobacco during the previous week. The mean age at first use of cigarettes was slightly lower in the rural than the urban area, whereas the mean age of initial smokeless tobacco use was more than a year earlier in the rural area. Data regarding the perceived difficulty of quitting smoking and quit rates suggested that adolescent females have more difficulty quitting smoking than males. Male smokeless tobacco users appeared to be more addicted than male cigarette smokers. Smokeless tobacco brand preference indicated that users may switch to progressively stronger types of smokeless tobacco as they get older and a nicotine tolerance is developed. The current study emphasizes the urgent need for carefully targeted tobacco prevention and cessation efforts among school-age youth.     

Teenage pregnancy and associated risk behaviors among sexually abused adolescents

CONTEXT: Previous research suggests a link between adolescent pregnancy and sexual abuse history, but most studies have used clinical samples of females only and single measures of abuse. METHODS: Associations between pregnancy involvement, risk behaviors and sexual abuse were examined in sexually experienced teenagers from the Minnesota Student Surveys of 1992 (N=29,187) and 1998 (N=25,002). Chi-square tests assessed differences in pregnancy involvement and related risk behaviors among four groups of adolescents, categorized by type of abuse experienced: none, incest only, nonfamilial only or both. Odds ratios for pregnancy involvement and risk behaviors, adjusted for grade level and race, were calculated for each gender by using logistic regression analysis. RESULTS: Sexual abuse was reported by 6% of males and 27% of females in 1992, and by 9% and 22% in 1998. Reports of pregnancy involvement were significantly more common among abused adolescents (13-26% of females and 22-61% of males, depending on type of abuse) than among nonabused adolescents (8-10%). Abused adolescents were more likely than others to report risk behaviors, and teenagers reporting both abuse types had the highest odds of pregnancy involvement and risk behaviors. The differential in the odds of pregnancy involvement and most behaviors was larger between nonabused and abused males than between nonabused and abused females. CONCLUSIONS: Teenage pregnancy risk is strongly linked to sexual abuse, especially for males and those who have experienced both incest and nonfamilial abuse. To further reduce the U.S. teenage pregnancy rate, the pregnancy prevention needs of these groups must be adequately addressed.     

Sexually Transmitted Diseases and Risk Behaviors Among California Farmworkers: Results From a Population-Based Survey

ABSTRACT:  Context: The prevalence of sexually transmitted diseases and associated risk behaviors among California farmworkers is not well described. Purpose: To estimate the prevalence of sexually transmitted diseases (STDs) and associated risk behaviors among California farmworkers. Methods: Cross-sectional analysis of population-based survey data from 6 California agricultural regions was performed for participants tested for Chlamydia trachomatis (CT), Neisseria gonorrhea (GC), and syphilis, and who completed an interviewer-administered behavioral risk factor survey. Findings: Among the 403 males and 234 females examined and interviewed, males (29.3%) were more likely than females (9.6%) to have had 2 or more sex partners in the past 5 years. Forty-two percent of males ever had sex with a commercial sex worker; unmarried males were more likely than married males to report sex with a commercial sex worker in the past 2 years. Twelve percent of males and 5% of females reported ever having had an STD. Most participants did not report any methods to protect against STDs. Of 192 males and 178 females tested for CT, 3 males and no females were positive. No cases of GC were found. Of 387 males and 194 females tested for syphilis, 4 males and 1 female had positive rapid plasma reagin (RPR) and Treponema pallidum particle agglutination (TPPA) results. Conclusions: In this population-based survey among agricultural workers, there was low STD prevalence but high prevalence of sexual risk behaviors, particularly among males.     

Endemic Lassa fever in Liberia. VI. Village serological surveys for evidence of Lassa virus activity in Lofa County, Liberia

Six villages in Lofa County, north-west Liberia, and one near the coast were surveyed for the presence of indirect fluorescent antibodies (IFA) to Lassa virus (LV). Prevalences were similar among males and females, and among various age groups. The prevalence of IFA positive sera, 6.4%, in two roadside villages was significantly higher than in two matched villages "in the bush", 1.9%. It was also higher in Gbanwei, a roadside village which did not maintain traditional sanitary measures, than in Zuwulo, similarly located but with maintenance of clean-swept areas without shrubbery or rubble between the houses. In another pair of villages, the one adjacent to a Mission Clinic with a very high prevalence of IFA positive staff members had significantly higher prevalence, 14.1%, than did the other, a roadside village with 5.1% seropositives. LV antibodies were also found in 4.3% of the inhabitants of a small coastal village near Robertsfield International Airport. Though LV infections are more common in villages in which traditional practices have been modified, they are present even in villages which are relatively unchanged. In the former they appear to be continuous while sporadic in the latter. The prevalences of IFA in the villages with the highest rates are about one third of what is found in personnel of hospitals near them, suggesting that hospital staff members acquire infections from patients as well as from the communities in which they live.     

Schistosomal periportal fibrosis in Zimbabwe: use of ultrasound in patients with oesophageal varices

Ultrasound (U/S) imaging of liver was used in a prospective study of 62 consecutive patients with oesophageal varices in the central hospitals in Harare; 50 had haematemesis. U/S changes of Symmers's periportal fibrosis (PPF) were graded from mild (grade 1) to gross (grade 4). 46 patients (74%) had U/S features of PPF: 7 were grade 1, 7 grade 2, 29 grade 3, and 3 grade 4. Patients with PPF were more likely to have bled (P less than 0.05) and were less likely to have ascites (P less than 0.05) than those without PPF. Spleen or liver size or grade of varices did not correlate with the U/S grade of PPF. Rectal snips were positive for schistosome ova in 19 of 28 cases with PPF and 2 of 7 cases without PPF. Patients with PPF were more likely than those without PPF (P less than 0.005) or controls (P less than 0.0001) to have spent their childhood in an area of Zimbabwe with a high prevalence of Schistosoma mansoni. Schistosomal PPF appears to be a common cause of portal hypertension in Zimbabwe. It is strongly associated with childhood spent in areas of high S. mansoni prevalence.     

Lung cancer in Israel, 1962–1982 II. Ethnic differences among Jews

Lung cancer incidence rates among Jews in Israel are significantly lower than in most developed countries in the world. A more detailed analysis of the rates among different Jewish ethnic groups also showed low rates. While Jewish males born in Europe-America (EA) had an 11% increase in rates between 1962–66 and 1977–82, Jewish males from Asian-African (AA) origin had a 45% increase resulting in current higher rates among North African than among East European Jews (the two dominant ethnic groups in Israel). In Jewish females, rates have been relatively stable from 1972 to 1982 and were almost twice as high for females born in EA than females born in AA with less prominent differences between countries. While smoking patterns probably explain the increase in rates among Asian-African Jewish males, other possible risk factors as well as the overall smoking prevalence cannot explain the low incidence in the major ethnic Jewish groups. The possibility of differed susceptibility is raised.     

某医学院学生危害健康行为描述性研究

目的 了解医学生危害健康行为的流行病学特征。方法 在某医学院中以无记名方式对1009名一－四年级学生进行最近1年内危害健康行为的问卷调查。结果 危害健康行为在医学生中普遍存在，吸烟率为26．26％，饮酒率为73．34％，7．14％的学生考虑过自杀，5．85％的学生有过性行为，3．77％的学生使用过违禁药品，43．31％的学生缺少体育锻炼，63．63％的学生有过通宵达旦的娱乐行为，16．35％的学生参与赌博。多种行为报告率男生高于女生，并有随年级而升高的趋势。结论 应加强健康教育，降低医学生危害健康行为的发生。     

A long-term follow-up of asymptomatic amicrofilaraemic individuals living in a filaria-endemic region of Orissa, India: infection and disease status

A group of asymptomatic amicrofilaraemic individuals (endemic normals) aged > 12 years was identified in 2 filaria-endemic villages of Orissa, India in 1990 (Bajapur village, n = 40) and in 1994 (Olosingh village, n = 47). They were re-examined for microfilaraemia and disease status in the year 2000 after a 10-year and a 6-year period. Studies conducted at both villages yielded a similar pattern in the development of disease. Above 85% of the females remained normal, compared to 54% of males. Remaining individuals had acquired hydrocoele (males) and adenolymphangitis (both males and females). Only 1 individual converted to having asymptomatic microfilariae. No case of elephantiasis was observed. Results indicate that most females remained normal and males faced considerable risk of developing hydrocoele in these Wuchereria bancrofti-endemic areas.     

Impact of vaccination on the risk factors for acute rotavirus diarrhea: An analysis of the data of a cluster randomized trial conducted in a rural area of Bangladesh

BackgroundRotavirus is one of the causes of severe diarrhea and death in young children. To control the disease, safe and effective vaccines are being used in several countries. We assessed the impact of vaccination on the risk factors for acute rotavirus diarrhea (ARD) in Bangladesh.MethodsWe used the data of a cluster-randomized trial. The clusters were 142 villages, 71 in each of the two arms of study. The infants were offered human rotavirus vaccine (HRV), Rotarix, over three-year period. We divided the time period into two equal periods (T1 and T2). A generalized estimating equation with logit-link function was used to evaluate the risk factors by arm and by period.ResultsAmong 10,917 children, 5,759 (53%) were in the HRV villages. We had 359 cases; 44% in the HRV villages. Mean age of attack was similar between the arms of study in T1, but significantly higher in HRV villages than that in the non-HRV villages in T2. In HRV villages, males were at a higher risk of having ARD than females in T1, but not in T2. In contrast, males were at a higher risk of having ARD in both the time periods in non-HRV villages. In HRV-villages, children having literate mother were at significantly higher risk of having ARD in T1 but not in T2; whereas children in the non-HRV villages had a higher risk of having ARD in T2. Children living in an area with higher phone users had more cases than their counterpart in non-HRV villages, but not in HRV villages.ConclusionOur study illustrates that several risk factors for ARD varied between the two arms of study as well as between the two periods of study. Assessing post-vaccination risk factors is, therefore, important for understanding the impact of vaccination and undertaking post-vaccination control measures.     

Lung cancer in Israel, 1962–1982 I. Jews and Arabs

The magnitude and dynamics of lung cancer incidence in Jews and Arabs in Israel between the years 1962 and 1982 were studied. In general, age-standardized incidence rates increased consistently between the years 1962 and 1976 among Jewish (24% increase) and Arab (39%) males, and to a lesser degree among Jewish females (15%). Arab females had the highest (77%) increase. From 1977 to 1982 a general decrease in incidence rates, which was largest among Arab males (19%) and females (15%), was noted. Rates among Jewish males are currently 26% higher than among Arab males, and are 162% higher among Jewish females than in Arab females. Lung cancer rates in both males and females in Istrael (Jews and Arabs) are lower than in most developed countries in the world. Among the possible reasons are differences in the population risk factors profile, availability of health care and the level of diagnosis and ascertainment of cases.     

大学生危害健康行为的流行病学研究

目的：了解大学生危害健康行为的流行病学特征。方法：在4所省属大学中以无记名的方式,对884名1－4年级学生进行了危害健康行为的问卷调查,结果：危害健康行为在我省大学生中普遍存在,吸烟率为73．9％,饮酒率为95．9％,有15．7％的学生考虑过自杀,6．1％的学生承认有过性行为,各种危害健康行为均为男生高于女生,并有随年级而升高趋势。等级相关分析表明：多种不良行为之间存在相关关系。结论：大学生的危害健康行为干预应引起关注。     

Assessment of the nutritional status of children with special needs in Alexandria. Part II: Anthropometric measures

The present study was undertaken to evaluate the nutritional status of children with special needs in Alexandria city, on the basis of anthropometric measures. The following variables were determined in a sample of 278 disabled children (171 males, 107 females) aged 6 to 24 years, recruited from five specialized day care centers for retarded children in Alexandria: birth order, type of disability, socioeconomic status, body weight, height, body mass index (BMI) and hemoglobin level. Mentally retarded children represent the highest proportion of subjects followed by Down's syndrome and autism. There is an increase in the mean body weight of males with the increase in age among the three type of disability except at age from 14 to 18 years, while there is a fluctuation in the mean body weight between ages and disability among females. Down syndrome groups at all ages are shorter than the other groups, while disabled males are taller than females at all ages. Based on BMI for age, the incidence of obesity was higher among Down's syndrome and mentally retarded females and among autistic males (19.8%, 16.1% of males versus 15.8%, 6.7% of females with mental retardation and autism were underweight). Majority of subjects have mild degree anemia. Hemoglobin levels below the cut-off levels issued by WHO were found higher among autistic and mentally retarded females. The levels were comparable among males with autism and mental retardation and among Down's syndrome males and females. The results also revealed that underweight, overweight and obesity were more common in subjects who showed an evidence of anemia.     

广州地区1087名大学生咳嗽的流行病学调查

目的调查广州地区大学生咳嗽的患病率及危险因素。方法采用统一的流行病学调查表,以整群随机抽样的方法对广州市某高校1091名大学生进行面访式问卷调查,咳嗽超过8周者进行胸部X线检查。结果调查资料完整的大学生有1087人,男生648人,女生439人,平均年龄为21.16岁±1.25岁。咳嗽的总患病率为10.9%,其中,男生患病率为10.3%,女生患病率为11.9%;急性咳嗽总患病率为7.6%,其中,男生患病率为6.9%,女生患病率为8.7%;慢性咳嗽总患病率为3.3%,男生患病率为3.4%,女生患病率为3.2%。无论在咳嗽总患病率,还是急性咳嗽或慢性咳嗽患病率,男女间差异均无统计学意义(P值均>0.05)。77.8%的慢性咳嗽患者以咳嗽为惟一或主要症状,与急性咳嗽患者(44.6%)相比,差异有统计学意义(χ2=11.166,P<0.01)。患鼻部疾病是慢性咳嗽患者的危险因素,33.3%的慢性咳嗽患者患有慢性鼻部疾病。结论咳嗽是广州地区青年大学生常见的症候,其患病率无性别差异。鼻部疾病是慢性咳嗽重要的危险因素。     

广东省成年居民体重认知偏移及其影响因素分析

目的 了解广东省居民体重认知偏移的情况及其影响因素,为开展与体重相关健康问题的预防控制提供科学依据.方法 通过多阶段分层随机整群抽样抽取广东省21个县区168居委/村的6717个家庭,对每个家庭用Kish Grid抽样方法(KISH法)确定1名15 ～ 69岁的家庭成员进行问卷调查,获得体重、体重认知及相关的影响因素....     

Epidemiological features and clinical manifestations in 469 adult patients with brucellosis in Babol, Northern Iran

The epidemiological features and clinical manifestations of adult cases of brucellosis admitted to the Department of Infectious Diseases, Babol Medical University, Iran from 1997 to 2002 were investigated. Of 469 cases, 267 (56.9%) were males. The mean age of cases was 36.9 +/- 15 years. Most (60.8%) were from rural areas. Two thirds of cases (306, 66.3%) presented during spring or summer. Fresh cheese (22.4%), animal husbandry (11.3%), laboratory worker (8.1%) and veterinary profession (1.5%) were the main risk factors. Forty-five families (9.6%) had two cases. Sweating, fever, and arthralgia were the most frequent clinical symptoms. Complications were documented in 105 males (39.5%) and 41 females (20.3%, P=0.0001). Peripheral arthritis was seen in 24 (9%) males and 19 (9.4%) females, with knees and hips being the most common sites of infection. Sacroiliitis and spondylitis were seen in 28 (6%) and 32 (6.8%) cases respectively with spondylitis more common in males (P=0.023). Epididymo-orchitis was seen in 29 (10.9%) males. There were three cases each of endocarditis (0.6%) and neurological complications (0.6%). Most patients with brucellosis did not have any of the known risk factors for brucellosis. Thus consumption of unsafe dairy products could be the main route of infection. The disease manifested with a diversity of clinical manifestations and complications. Complications were more frequent in males than females.     

Differences between blacks and whites in the epidemiology of insulin-dependent diabetes mellitus in Allegheny County, Pennsylvania

Racial differences in the incidence and natural history of insulin-dependent diabetes mellitus were evaluated in Allegheny County, Pennsylvania. The yearly incidence rate for whites was approximately 1.5 times that for blacks. The cumulative risk of developing insulin-dependent diabetes prior to age 20 was greater for whites (3.1/1,000, males; 2.8/1,000, females) than for blacks (1.7/1,000, males; 2.0/1,000, females). There was a slight excess risk for white males versus white females (relative risk = 1.09, p = 0.04), while no sex differential in risk was noted for blacks. The temporal trends and seasonal patterns were similar. Blacks more frequently possessed human lymphocyte antigen (HLA)-DR3/X and whites DR4/X; however, the risks associated with these antigens were similar by race. At onset, blacks had evidence of greater immunologic disturbance and less frequently reported infection than whites, although blacks more often had evidence of previous coxsackie viral infections. Evaluation of mortality patterns by race revealed that blacks had a higher mortality rate than whites. By 20 years duration of diabetes, blacks had a 2.4-fold increase in the risk of mortality compared with whites.     

Pilot study of risk behaviour, voluntary HIV counselling and HIV antibody testing from saliva among inmates of prisons in Slovakia

OBJECTIVE: To implement a pilot study of risk behaviour and HIV infection using HIV antibody testing from saliva to improve the situation as regards HIV/AIDS infection in prison institutions in the Slovak Republic. MATERIAL AND METHODS: The study comprised adult and juvenile males of grade one correction categories and prisoners from the prison for juveniles in Martin, as well as females prisoners in Nitra. Preventive activities were implemented in May 1998 in the form of discussions concerning topics related to HIV/AIDS infection. Saliva was collected for the presence of HIV antibodies and a questionnaire regarding sexual practice was completed. RESULTS: 32 persons [8 adult males (25%), 6 juvenile males (18.7%) and 18 females (56%)] were voluntarily tested for the presence of HIV antibodies in saliva. Nobody was HIV-positive. 75 persons (20 adult males, 30 juvenile males and 25 females) were involved in the study of risk behaviour. 40.8% participants had primary education, 28.2% secondary education, 2.8% were students of universities and 28.2% were apprenticies. 60% inmates (mostly females) were religious. Juvenile males reported the highest number of partners while females the smallest (p < 0.001). The more partners were reported by respondents, the lower was condom usage (p < 0.07). 47.6% females relied on credibility of partners, while 75% adult males and 50% adolescent males did not use protection. 0% females, 5% adult males and 10.3% juvenile males reported to have homosexual contacts outside prison while 19%, 5.6% and 8.3% in the prison, respectively. Paid sexual services were offered by 9.1% females, 15.8% adult males and 25% juvenile males. Outside prison adult and juvenile males used non-sterile used syringes as well as tattooing more often than females (p < 0.07 and p < 0.04, respectively). CONCLUSION: The present study provides information on the results of HIV-antibody testing in saliva. The results are based on a study of risk behaviour and difficulties linked with HIV/AIDS prevention among prisoners.