PubMed Health⌕ Search

Biomedical subjects

A Moren

Publications and source records attributed to A Moren.

At least 19 recordsLinked to original sources
PubMed2003

An outbreak of Norwalk-like viral gastroenteritis in holidaymakers travelling to Andorra, January-February 2002.

A retrospective cohort study was conducted to investigate an outbreak of Norwalk-like viral gastroenteritidis that occurred in Irish holidaymakers visiting Andorra, in January-February 2002. Preliminary results showed the risk exposure was higher for tourists who stayed in Soldeu and consumed ice cubes in their drinks (OR = 2.5, 95% CI [1.3-4.6)], after logistic regression and adjusting for sex and water consumption).

Adolescent↗
PubMed2001

Intervention epidemiology training: a European perspective.

Within the widening European Union, large-scale movements of people, animals and food-products increasingly contribute to the potential for spread of communicable diseases. The EU was given a mandate for public health action only in 1992, under the Treaty of European Union ("Maastricht Treaty"), which was broadened in the 1997 with the Treaty of Amsterdam. While all EU countries have statutory requirements for notifying communicable diseases, national and regional communicable disease surveillance practices vary considerably. The Network Committee (NC) for the Epidemiological Surveillance and Control of Communicable Diseases in the EU was established in 1998 to harmonise these activities.

Academies and Institutes↗
PubMed1998

Measles vaccine effectiveness in standard and early immunization strategies, Niger, 1995.

BACKGROUND: An Expanded Programme on Immunization was started in late 1987 in Niger, including vaccination against measles with one dose of standard titer Schwarz vaccine given to infants after 9 months of age. During epidemics an early two-dose strategy was implemented (one dose between 6 and 8 months and one dose after 9 months). From January 1, 1995, until May 7, 1995, 13 892 measles cases were reported in Niamey, Niger. METHODS: A retrospective cohort study was conducted in a crowded area of Niamey at the end of the outbreak to assess the effectiveness of measles vaccine in standard (after 9 months) and early (before 9 months) immunization strategies under field conditions. RESULTS: Highest measles incidence rates were observed among children <1 year of age. Vaccine effectiveness estimates increased with age at vaccination from 78% with a single dose administered at 6 months of age to 95% at 9 months. Vaccine effectiveness with the early two dose strategy was 93%. CONCLUSIONS: Immunization with a single dose of standard titer Schwarz vaccine before 9 months of age provided higher clinical protection than expected from seropositivity studies. The early two dose strategy is justified in contexts where measles incidence is high before 9 months of age. Our results raise the issue of lowering the recommended age for measles vaccination in developing countries.

Child, Preschool↗
PubMed1998

A multifocal outbreak of trichinellosis linked to horse meat imported from North America to France in 1993.

An outbreak of 538 cases of trichinellosis occurred in France in December 1993. Seven cases developed neurotrichinosis and 23 had cardiologic complications. No deaths were recorded. Two patients had a positive muscle biopsy showing living Trichinella larvae. One of them was typed as Trichinella spiralis. A case-control study showed that horse meat was the only meat associated with illness (odds ratio = 80.7). The risk of illness increased with the amount of horse meat eaten and when it was consumed raw. The cases, which were spread out in five foci, bought horse meat from five butchers who had received parts of a single horse carcass imported in November 1993 from Canada. The Trichinella International Screening Program, implemented since 1985 after two similar episodes involving a thousand cases, failed to detect the incriminated horse carcass. This new horse meat-related outbreak led to modifications of the internationally recommended screening methods whereby the weight of meat samples tested was increased.

Animals↗
PubMed1998

[European Program for Intervention Epidemiology Training (EPIET): a training epidemiologic intervention in Europe].

The European programme for interventional epidemiology training (EPIET) offers a two year practical training in European national institutes mandated for the surveillance and control of communicable diseases. The training, closely supervised by senior epidemiologists, allows each EPIET fellow to learn while serving and conducting tasks devoted to intervention epidemiologists (surveillance, investigation, research, aid to decision making, and communication with the public, the media, the health authorities and the scientific community). The programme is equally funded by the European Commission, the 15 member states, Norway and the World Health Organisation. This training, derived from the North American and British experiences offers a practical complement to knowledge acquired from European universities. EPIET fellows, their supervisors and colleagues from training institutes have rapidly formed a network of intervention epidemiologists necessary for conducting and coordinating the surveillance of communicable diseases in Europe.

Communicable Diseases↗
PubMed1995

[Trypanosomiasis from Trypanosoma brucei gambiense in the center of north-west Uganda. Evaluation of 5 years of control (1987-1991)].

In Uganda, a case-finding and treatment programme has been implemented by Médecine Sans Frontières (MSF) and the Ministry of Health in the North of West-Nile province. Data collected in the hospital of Moyo from January 1987 to June 1991 were analyzed. Forty eight hundred and twenty two cases of trypanosomiasis due to T. B. gambiense has been recorded. Cumulative incidence rate for this period was 5.6%. Passive and active case-finding strategies were used, both based on Card Agglutination Test (CATT) as screening tool, followed by parasitological examinations. The mobile teams identified 1906 of the 4,822 cases (39.5%). Case fatality rate was 2.6%. This study confirmed the association between social and political disruptions, large movements of population and extension of trypanosomiasis. Active case-finding seems to quickly reduce disease prevalence in hyper-endemic areas. An integrated programme is then necessary to control sleeping sickness transmission.

Adolescent↗
PubMed1994

Measles epidemic in the urban community of Niamey: transmission patterns, vaccine efficacy and immunization strategies, Niger, 1990 to 1991.

From October 1, 1990, until April 28, 1991, 13,578 cases of measles were reported in the urban community of Niamey, Niger. Vaccine coverages (one dose of Schwarz vaccine given after 9 months) in urban community of Niamey were, respectively, 63% at the age of 12 months and 73% at 24 months before the epidemic. Incidence rates were the highest among children ages 6 to 8 months and 9 to 11 months and 22% of the cases were less than 1 year old. Vaccine efficacy estimates ranged from 86 to 94% according to age groups and the method used (screening method, case control study, retrospective cohort study). The risk of transmission of illness increased with the intensity of contact with a case. Contact with a health facility 7 to 22 days before onset of rash was not a risk factor. Seasonal migrants in Niamey were more likely to develop measles. Recommendations included implementation of an early two dose schedule of measles immunization during the outbreak, vaccination offered at each contact with a health facility, radio and television advertising for measles immunization and distribution of vitamin A to all measles cases.

Adolescent↗
PubMed1994

[2 epidemics of arsenical encephalopathy in the treatment of trypanosomiasis, Uganda, 1992-1993].

Since 1988, the french non-governmental organisation Médecins Sans Frontières is running a control program of human african trypanosomiasis in the district of Moyo, North-Uganda. Between 1988 and 1993, more than 7,000 patients were diagnosed and treated. Since 1988, it has been noted that incidence of melarsoprol reaction had increased systematically between June and October of each year, indicating strong seasonal variation. In 1992 and 1993, two outbreaks of arsenical reactive encephalopathy (ARE) occurred in the sleeping sickness center of Adjumani. The incidence of ARE suddenly exceeded 10% of the patients treated by melarsoprol during August 1992 and September 1993. The onset of 80% of those "epidemic" cases, occurred between the 5th and the 11th day of treatment. Two retrospective studies were conducted in 1992 (75 cases) and in 1993 (51 cases). Among the risk factors studied, two appear to increase the risk of ARE: the prescription of thiabendazole to treat strongyloidiasis during the melarsoprol cure and the bad general clinical conditions of patients. These observations suggest that exogenous co-factors could be involved in the occurrence of ARE. Recommendations were to avoid administration of diffusible anti-helminthic treatment during the cure, and to improve the general conditions of patients before the cure of melarsoprol.

Adolescent↗
PubMed1993

An outbreak of pellagra related to changes in dietary niacin among Mozambican refugees in Malawi.

Between February and October 1990, 18,276 cases of pellagra dermatitis (due to niacin deficiency) were reported among 285,942 Mozambican refugees in Malawi. Overall, 6.3% of the refugee population developed pellagra and the attack rate was 7.8 times higher among women than men. This outbreak followed a 5-month cessation of groundnut distribution (the major source of niacin) to refugees. A matched-pair case-control study confirmed the protective role of the daily consumption of groundnuts (Odds Ratio [OR] = 0.08), as well as the independent role of garden ownership (OR = 0.34), and home maize milling (OR = 0.3). Recommended corrective action included early case finding and treatment, distribution of niacin tablets, prompt identification of groundnut supply on the world market, fortification with niacin of the food ration and diversification of the food basket through access to local markets.

Adolescent↗
PubMed1991

Monitoring and evaluation of relief programmes.

Information is power. Every major relief programme of the past 15 years has shown that facts and figures are an indispensable tool for health staff. A simple graph of daily mortality rates can work miracles: mobilize human and material resources, focus the attention of decision-makers, guide and refine the assistance programme that is being put in place. If you want useful data, look at these five areas: (i) mortality; (ii) incidence of the most important diseases; (iii) nutritional status; (iv) 'activities data', such as immunizations performed; and (v) the 'vital sectors', namely food, water, sanitation, shelter, etc. The most effective way of presenting information is graphically, so that anyone can see at a glance the trend from month to month. Finally, there are two golden rules. Always give feedback to the workers out in the field who are the primary source of information. And secondly, always act upon information: if your statistics do not lead to concrete action, you are probably better off not collecting them at all.

Epidemiologic Methods↗
PubMed1991

Practical field epidemiology to investigate a cholera outbreak in a Mozambican refugee camp in Malawi, 1988.

Of all populations affected by cholera, refugees are at particular risk of infection due to overcrowding and poor sanitation. Between 15 March and 17 May 1988, 951 cases of cholera were registered at the cholera treatment centre in a Mozambican refugee camp in Malawi. The epidemic duration was 65 days. Vibrio cholerae biotype E1 Tor serotype Inaba was isolated. To identify high-risk groups and potential risk of acquiring the disease, an epidemiologic investigation was conducted. The attack rate of recorded cases was 2.6% with a range from 0.9 to 5.1% for different sections of the camp. The case fatality rate was 3.3% and decreased from week 1 to week 6. The epidemic started in the section near the market place and radiated out. A matched-pair case-control study of food and water consumption was performed early in the outbreak. It showed that cases were more likely to use shallow wells (surface wells) instead of boreholes compared to controls (OR = 4.5, CI = 1.0-20.8, P = 0.04) and that cases were more likely to have had contact with the market than controls (OR = 3.5, CI = 0.7-16.8, P = 0.09). None of the food items available at the market was more likely to be preferred by cases than controls. Recommendations included early case finding and treatment, temporary closure of the market, tetracycline prophylaxis of contacts, and water chlorination.

Case-Control Studies↗
PubMed1990

Measles outbreaks in the Mozambican refugee camps in Malawi: the continued need for an effective vaccine.

Between November 1988 and January 1989, measles outbreaks occurred in 11 Mozambican refugee camps in Malawi with five camps principally affected. A total of 1214 cases were reported. Despite the reduction of the age of measles vaccination to six months in 1987, attack rates were highest in children aged 6-9 months (10-26%); rates were also high in the 0-5 month age group (3-21%). The case-fatality rate was high among children less than five years old (15-21%). Children were being inappropriately vaccinated, either being vaccinated at less than six months of age (2-29%) or failing to receive a second dose if vaccinated at six months (0-25%). With vaccine coverage between 66-87%, vaccine efficacy in children less than five years old was estimated to be more than 90% in the camps principally affected. Reduction of the age of vaccination leads to logistical problems in vaccine delivery in refugee situations. These outbreaks again indicate the need to improve vaccine coverage with the existing Schwarz vaccine, and also highlight the urgent need for an effective single dose measles vaccine for children less than nine months of age.

Age Factors↗