Progress toward poliomyelitis eradication--Pakistan, 1994-1998

Since the 1988 World Health Assembly resolution to eradicate poliomyelitis by 2000, polio cases reported globally have decreased by approximately 85%. Despite a strong commitment to polio eradication, polio remains endemic in Pakistan. In 1997, Pakistan reported 1147 polio cases, representing widespread poliovirus circulation nationally and constituting 22% of cases reported worldwide. However, surveillance and laboratory data from 1998 indicate that previous widespread poliovirus circulation was geographically localized for the first time. This report describes polio eradication activities in Pakistan, including the impact of routine and supplementary vaccination on polio incidence.     

A population-based study on the association between parental occupations and some common birth defects in singapore (1994-1998)

We sought to study the association between some common birth defects and parental occupations. The live births and congenital malformation born between January 1994 and December 1998 were obtained from the Singapore National Registry of Births and Deaths (the National Birth Defect Registry). The prevalence of overall birth defects among Singapore live births during the study period is 13.9 per 1,000 live births. The most frequent single coding defects were "bulbus cordis anomalies and anomalies of cardiac septal closure (BCA)," "congenital anomalies of urinary system (CUS)," "cleft palate and cleft lip (CPL)," and "certain congenital musculoskeletal deformities (CMD)." Using the "Legislators, Senior Officers & Managers" as reference and adjusting for possible confounders, there were significant associations for: (1) paternal "clerical workers" (adjusted RR 2.25) with the BCA; (2) maternal "professionals" with CUS (adjusted risk ratio [RR] 3.58); (3) paternal "production craftsmen and related workers" with both the BCA (adjusted RR 2.04), and the CMD (adjusted RR 2.83); (4) paternal "plant and machine operators and assemblers" with the BCA (adjusted RR 2.49), and the CUS (adjusted RR 5.19), and the CMD (adjusted RR 3.01). Paternal rather than maternal exposure might be more important in the causation of some common birth defects in Singapore.     

Trends in use of inhaled corticosteroids for asthma management: 1994-1998

PURPOSE: To evaluate trends in prescribing of inhaled corticosteroids for asthma between 1994 and 1998 and patterns of prescribing in relation to selected physician characteristics. METHODS: Using a HMO database, a physician sample (N = 335) was linked to patient encounter data and pharmacy claims (N = 51,345) for asthma patients ages 5 to 45 years (N = 6,944). Longitudinal and cross-sectional analytic methods were used to examine physician prescribing patterns across the study period. RESULTS: The percent of physicians prescribing an inhaled corticosteroid increased over time with consistently greater prescribing among specialists. Annual comparisons by specialty groups revealed that specialists (allergy and pulmonary) prescribed inhaled steroids to a larger proportion of their patients than generalists (family practice, internal medicine, pediatrics, pediatric emergency department); (range: 0.61-0.69 vs. 0.31-0.39, p < .01). The lowest proportions were found among pediatric emergency department physicians (range: 0.00-0.10) and pediatricians (range: 0.17-0.27). CONCLUSIONS: Significant linear trends in either physician group were not observed during this 5-year period. Differences across physician groups were evident.     

Health behaviour in Estonia,Finland and Lithuania 1994-1998. Standardized comparison

BACKGROUND: The Finbalt Health Monitor project collects standardized information on health and health-related behavioural activity and related trends in Finland and those Baltic countries that have major public health problems with noncommunicable diseases related to lifestyle and behavioural factors. The aims of this study were to compare patterns of and trends in selected health behaviours and their socioeconomic associations in Estonia, Finland and Lithuania in the period 1994-1998. METHODS: Standardized questionnaires were posted to nationally representative samples in 1994, 1996 and 1998. Response rates varied between 62% and 83%. The total number of respondents was 3808 in Estonia, 9608 in Finland and 5716 in Lithuania. Prevalence of smoking, consumption of strong alcoholic beverages, use of vegetable oil in food preparation and leisure-time physical exercise were analysed in this study. RESULTS: No major changes in daily smoking, consumption of strong alcoholic beverages and leisure-time physical exercise emerged. However, the use of vegetable oil increased rapidly in Estonia and particularly in Lithuania (from 41% to 81%). In 1994 the prevalence of daily smoking was 53%, 28% and 44% among men and 24%, 18% and 6% among women in Estonia, Finland and Lithuania, respectively. In Lithuania the prevalence of smoking among women was notably low but increased (from 6% to 13%). The prevalence of strong alcoholic beverage consumption was similar in all countries. Leisure-time physical exercise was most common in Finland. The socioeconomic differences remained similar in all countries, unhealthy behaviours were typical among the less educated groups and men, especially in the age groups 34-49 years. CONCLUSIONS: The sociodemographic pattern of risk-related lifestyles appears to be rather similar and stable in Estonia, Finland and Lithuania. However, from the view point of possible public health implications the rapid changes in the prevalences of some behaviours are notable.     

Cancer mortality among American Indians and Alaska Natives--United States, 1994-1998

In the United States, public health interventions to control infectious diseases, lower infant and maternal mortality, and improve basic sanitation have led to a substantial increase in life expectancy for American Indians and Alaska Natives (AI/ANs). During 1940-1995, average life expectancy among AI/ANs increased 39%, from 51 years in 1940 to 71 years in 1995; however, AI/ANs experienced a parallel increase in mortality rates for chronic diseases, including cancer, which is the second leading cause of death for AI/ANs nationally and the leading cause of death among Alaska Natives. A previous study examining cancer mortality rates during 1989-1993 documented lower cancer mortality rates for AI/ANs than for the overall U.S. population, with regional variation. To understand cancer mortality among AI/ANs subsequent to that period, the Indian Health Service (IHS) and CDC analyzed death certificate data provided by CDC's National Center for Health Statistics for deaths among AI/ANs in five U.S. geographic regions during 1994-1998. This report summarizes the results of that analysis, which indicate that cancer mortality rates among AI/ANs nationally were lower than cancer mortality rates for all U.S. racial/ethnic populations combined. Rates for AI/ANs varied by region, with the highest rates found in the Alaska and the Northern Plains regions. Plans or modifications for cancer prevention and treatment programs should account for regional variation, and programs to discourage smoking initiation, encourage tobacco cessation, and promote colorectal cancer screening among AI/ANs in the Alaska and the Northern Plains regions should be expanded.     

Fatal injuries caused by logs rolling off trucks: Kentucky 1994-1998

BACKGROUND: Logging is one of the most hazardous occupations and fatality rates are consistently among the highest of all industries. A review of fatalities caused by logs rolling off trucks is presented. METHODS: The Kentucky Fatality Assessment and Control Evaluation Project is a statewide surveillance system for occupational fatalities. Investigations are conducted on selected injuries with an emphasis on prevention strategy development. Logging was an area of high priority for case investigation. RESULTS: During 1994-1998, we identified seven incidents in which a worker was killed by a log rolling off a truck at a sawmill, accounting for 15% of the 45 deaths related to logging activities. These cases were reviewed to identify similar characteristics and risk factors. CONCLUSIONS: Investigations led to recommendations for behavioral, administrative, and engineering controls. Potential interventions include limiting load height on trucks, installing unloading cages at sawmills and prohibiting overloaded trucks on public roadways.     

湖北省1998～2007年麻疹流行病学分析

目的分析湖北省1998～2007年麻疹流行状况,为加速控制和消除麻疹提供科学依据。方法对湖北省1998～2007年法定传染病疫情报告资料和麻疹监测资料进行流行病学分析。结果湖北省1998～2007年共报告麻疹29000例,发病率波动在2．17／10万-8．20／10万之间,年均发病率为4．93／10万。近10年来麻疹疫情报告资料显示,每年3～6月为发病高峰,病例数占全年总数的62．89％。男女比为1：0．69。发病以小年龄组为主,15岁以下儿童发病居多,占发病总数的81．81％。全省各市（州、林区）均有麻疹病例报告,发病主要集中在武汉市、黄石市、黄冈市、荆州市、荆门市、恩施州。近4年麻疹监测系统报告的11458例个案中,有麻疹疫苗免疫史的仅占16．29％,其中麻疹疫苗免疫1次者占11．66％,免疫2次者占4．63％,无免疫史的占39．54％,免疫史不详占44．18％。1999～2007年全省共报告83起麻疹暴发疫情,均经过实验室确认。结论湖北省麻疹发病率已大幅下降。     

Trends in adrenaline (EpiPen) dispensing in Israel in 1997-2004

BACKGROUND: The prevalence of allergic diseases has increased over the last 20 years in the Western world. Reports on the growing use of adrenaline auto-injectors (EpiPen and EpiPen Jr) in several countries may point to increased rates of anaphylactic reactions, increased awareness of the risk of anaphylaxis or both. OBJECTIVES: To evaluate the dispensing rate of EpiPen units in Israel from 1997 to 2004. METHODS: The database of the General Health Services (Clalit) was searched to determine the number of EpiPen units dispensed each year from 1997 to 2004. Data on mortality from anaphylaxis were derived from the Central Bureau of Statistics using International Classification of Diseases, 10th revision codes. RESULTS: The dispensing rate of EpiPen units rose gradually from 1689 in 1997 to 2981 in 2004; an overall increase of 76%. No case of death from anaphylaxis was reported from 1998 to 2000. CONCLUSIONS: The dispensing rate of adrenaline auto-injectors has increased considerably over the last 8 years in Israel, although to a lesser degree than in other countries. This is probably a reflection of updated medical policies, in accordance with the clinical guidelines for the management of anaphylaxis and improved public education. Further studies are needed to determine the prevalence of anaphylactic reactions in Israel.     

山东省丁型肝炎病毒感染调查研究

为了解山东省丁型肝炎病毒感染状况 ,并探讨丁型肝炎病毒 ( HDV)感染与乙型肝炎病毒 ( HBV)感染的关系 ,应用酶联免疫吸附试验 ( EL ISA)对山东省 2 681例乙型肝炎病毒感染者进行了血清丁型肝炎病毒抗体 (抗 - HDV)检测 ,共检出抗 - HDV阳性者 2 0 7例 ,阳性率 7.72 %。HBs Ag携带者组抗 - HDV阳性率 3.16% ,乙肝患者组抗 - HDV阳性率 13.15% ,两组之间的差异有非常显著性 ( P<0 .0 0 1)。在乙肝患者组中 ,慢性活动性肝炎患者和重症肝炎患者抗 - HDV阳性率高于急性肝炎患者和慢性迁延性肝炎患者 ,差异有非常显著性 ( P<0 .0 0 1) ,表明乙肝病史越长、病情越重 ,其抗 - HDV阳性率越高。提示乙肝患者联合或重叠感染 HDV与乙肝慢性化和病情加重的形成有关。     

National surveillance of methicillin-sensitive and methicillin-resistant Staphylococcus aureus in Austrian hospitals: 1994-1998

In 1994, the Austrian Federal Ministry for Labour, Health and Social Affairs initiated a nationwide survey of the prevalence of methicillin-sensitive (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) in Austrian hospitals. A questionnaire had to be filled out by the medical directors of participating hospitals. During the five years of surveillance (1994-1998), a total of 9385 MRSA and 71510 MSSA episodes of infection/colonization were reported. The rate of MRSA decreased from 15.8% in 1994 to 8.2% in 1998. However, the frequency per 1000 hospital admissions increased from 0.85 to 1.29 with a maximum of 2.42 MRSA episodes per 1000 admissions in 1997. Overall, in 53.6% of 5020 S. aureus episodes, signs and symptoms of an infection were reported, of these 9.3% (251/2692) were due to MRSA. For large hospitals with more than 1000 beds, 20.9% of reported MRSA episodes were associated with infection, 54.9% of MRSA episodes from hospitals with 301-1000 beds, 60.1% from hospitals with 101-300 beds, and 80.0% from small hospitals with less than 100 beds. Our data do not support the hypothesis of higher virulence of MRSA compared with MSSA. Indeed, in this survey, MSSA episodes were more frequently associated with signs and symptoms of infection (OR=1.35, 95% CI: 1.12-1.62, P<0.001).     

Enterobacterial susceptibility to antibiotics in northern Lebanon (1998-2001)

The purpose of this study was to assess the epidemiology of local enterobacterial susceptibility to antibiotics. Between 1 January, 1998, and 31 December, 2001, we studied the sensitivity of 2,238 Enterobacteria to 26 different antibiotic agents in northern Lebanon, in the Microbiology department and Laboratory of the Islami Hospital, Tripoli, Lebanon. We used the diffusion disk method and complied with the guidelines of the French Microbiology Society antibiogram committee. Urinary samples were the most frequent source (67.5%), followed by blood cultures (12.7%). The dominant species in blood cultures was S. typhi (44.7%). We found 194 strains that produced extended-spectrum beta lactamases (ESBL), with the highest prevalence in Serratia spp. (44.3%), followed by Klebsiella pneumoniae (23.7%), Escherichia coli (20.7%) and Klebsiella oxytoca (11.3%). The global susceptibility of these strains to aminopenicillin was 15%; it reached 30% when combined with clavulanic acid. Susceptibility of the ESBL strains to these agents was 0%. The global susceptibility (and that of the ESBL strains, when greater than 0%) to other antibiotics was as follows: ticarcillin 38.5%, piperacillin 38.5%, piperacillin-tazobactam 88% (64%), imipenem 99.4%, (100%), cefalexin 41%, cefoxitin 65% (40.3%), cefuroxime 75%, amikacin 89%, chloramphenicol 30%, gentamicin 78% (42%), tetracycline 28% (16%), minocycline 30% (18.4%), colistin 67% (75%), nitrofuran 40% (45%), cotrimoxazol 40% (13%), nalidixic acid 53% (5.6%), pefloxacin 63% (23%), ciprofloxacin 71% (39%), and levofloxacin 72% (47%).     

Trends in the number of Arabs with intellectual disability in residential care in Israel 1998-2006

Life expectancy for persons with intellectual disability has increased over the past 100 years, and today is closer to the life expectancy of the general population (except for Down syndrome). In this study, we looked at trends in the numbers of Arab persons with intellectual disability living in residential care centers in Israel. Analysis of annual questionnaires to the medical clinics in all residential care centers for the period 1998-2006 revealed that the Arab population had increased from 749 to 921 persons in 13 residential care centers (13.5% of the total residential care population). Of the 921 persons in 2006, 58 were children aged 0-9 years and 260 were aged 10-19 years, with the majority having severe or profound intellectual disability. The increase in the number over time can been seen as a longer life expectancy in this population; the lower than expected numbers in residential care can be seen as a result of children staying at home with their families for a longer time than in the Jewish population.