Age- and sex-related blood cell values in healthy black Americans

Hemoglobin, mean corpuscular volume, erythrocyte count, and leukocyte count were measured, and hematocrit, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration were computed electronically for 7,739 healthy black persons. The study population comprised 3,393 males and 4,346 females 1-84 years of age, all from the Washington, DC, metropolitan area. Persons with sickle cell disease and elevated hemoglobin F were excluded from analysis, but those with traits for hemoglobin S, C, and thalassemia were not. Mean and percentile values are presented in tabular form. Hemoglobin, hematocrit, and mean corpuscular volumes were lower than those reported in surveys of white populations. Beginning with the 11-15-year age groups, black males had higher red cell values than black females. After age 30, mean hemoglobin levels for men gradually declined, while those in women rose, so that the sex difference diminished after 60 years of age. Leukocyte counts were higher in young children and in women, compared with men ages 21-50 years. After 60 years of age, the sex difference disappeared. Further large surveys that exclude data on persons with iron deficiency are needed in black populations.     

A method for adjusting gender bias in neonatal tetanus reports in Egypt 1991

Reports of neonatal tetanus (NT) disease, common in developing countries, often suffers from gender bias because male infants are brought to health facilities while females are attended at home. Using existing health data we applied reasonable assumptions to estimate the true incidence of NT economically. To adjust for gender disparities in national reporting, we ignored the number of female NT cases and doubled the number for males. Governorates with similar demographic risk profiles for NT were assigned to one of six groups. The highest incidence rate within the group was determined and applied to the number of live births represented by the group. Other internal data comparisons were done to support our estimate that the male:female ratio of NT incidence was far less than the reported 412:1. In 1991, the male: female ratio of NT cases was 4.12:1. Decreasing the male: female ratio to 1:1 decreased sensitivity to a 62% estimate. Further adjusting for assumed under-reporting by governorates based on population profiles yielded a reporting sensitivity of 40%. Estimated male and female age-specific NT mortality rates from available data supported the assumption that NT mortality ratios are less than 4.12:1. This report, therefore, describes a unique, economical method to estimate the incidence of a disease assumed to be affected by gender biases in the reporting system. The method relies on two assumptions: that the true NT male:female ratio is close to 1:1 and that populations with similar demographics within a country should have similar incidence rates of NT.     

Multiclonal outbreak of methicillin-resistant Staphylococcus aureus infections on a collegiate football team

An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) occurred in a college football team in August 2006. Of 109 players on the team roster, 88 (81%) were interviewed during a cohort investigation. Twenty-five cases were identified, six of which were culture-confirmed. Available culture isolates were typed by pulsed-field gel electrophoresis (PFGE), which identified two different MRSA strains associated with the outbreak. Playing positions with the most physical contact (offensive linemen, defensive linemen, and tight ends) had the greatest risk of infection [risk ratio (RR) 5.1, 95% confidence interval (CI) 2.3-11.5. Other risk factors included recent skin trauma (RR 1.9, 95% CI 0.95-3.7), use of therapeutic hydrocollator packs (RR 2.5, 95% CI 1.1-5.7), and miscellaneous training equipment use (RR 2.1, 95% CI 1.1-4.1). The outbreak was successfully controlled through team education and implementation of improved infection-control practices and hygiene policies.