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Biomedical subjects

H Carabin

Publications and source records attributed to H Carabin.

At least 19 recordsLinked to original sources
PubMed2006

[Measles, pertussis, rubella and mumps completeness of reporting. Literature review of estimates for industrialized countries].

BACKGROUND: Surveillance data for infectious diseases in industrialized countries have been providing useful epidemiological information for several years. However, surveillance is complex and notifications underestimate the true disease incidence. The goal of this paper is to determine the completeness of reporting of measles, pertussis, rubella and mumps through notification in industrialized countries. METHODS: A thorough literature review of papers published (in French or English) on surveillance data of measles, pertussis, rubella and mumps was undertaken with PUBMED. The review was limited to studies conducted in industrialized countries that quantitatively assessed the completeness of the reporting of these diseases. RESULTS: Fourteen studies published from the 1920s met the inclusion criteria. For measles, the studies suggest that 64-85% of symptomatic patients sought medical care, 13-57% of those were diagnosed with measles and 22-81% of the diagnosed cases were reported for a completeness of reporting ranging from 7% to 63% between 1920 and 1980 and 3% to 41% in recent years. For pertussis, it was estimated that 49-59% of symptomatic patients sought medical care, 12% of those were diagnosed and 19-47% of the diagnosed cases were reported for a completeness of reporting ranging from 5% to 25% between 1920 and 1980 and from 3% to 12% in recent years. Very few studies on rubella and mumps were found and none allowed the determination of the global completeness of reporting. CONCLUSION: Reporting has been found to be considerably incomplete. Continued efforts to improve the recognition and reporting of these diseases are needed.

Developed Countries↗
PubMed2006

Estimation of the cost of Taenia solium cysticercosis in Eastern Cape Province, South Africa.

OBJECTIVES: To provide a comprehensive estimate of the societal costs of Taenia solium cysticercosis for the Eastern Cape Province (ECP), South Africa, as an objective measure of its impact in this endemic area. METHODS: Epidemiological data on the prevalence of epilepsy, proportion of epilepsy cases due to neurocysticercosis (NCC) and consequences of cysticercosis were gathered from published and unpublished sources. Economical data were mostly obtained from governmental sources. Three methods were used for estimating productivity losses. Monte Carlo sampling was used to represent the uncertainty of the estimates with 95% Credible Intervals (95% CI). The estimation is for 1 year using a societal approach. All costs are reported in 2004 US Dollars. RESULTS: Overall, there were an estimated 34 662 (95% CI: 17 167-54 068) NCC-associated cases of epilepsy in ECP in 2004. The overall monetary burden (in million of US Dollars) was estimated to vary from US Dollars 18.6 (95% CI: US Dollars 9.0-32.9) to US Dollars 34.2 (95% CI: US Dollars 12.8-70.0) depending on the method used to estimate productivity losses. The agricultural sector contributed an average of Dollars 5.0 million. The prevalence of epilepsy, proportion of productivity reduction and the proportion of epilepsy cases attributable to NCC had the largest impact on the overall estimates. CONCLUSION: This preliminary estimate suggests that T. solium cysticercosis results in considerable monetary costs to a region that is already economically constrained. Because this infection is preventable, these results could guide stakeholders in deciding where to invest scarce health and agricultural resources in their countries.

Agriculture↗
PubMed2006

Concurrent comparison of three water contact measurement tools in four endemic villages of the Philippines. The schistosomiasis transmission ecology in the Philippines project (STEP).

BACKGROUND: Schistosomiasis japonica is a chronic helminthic infection contracted through contact with water infested with Schistosoma japonicum. The infection is associated with severe disease and is an important public health concern in Philippines. OBJECT: To estimate the agreement in the frequency of water contact between bimonthly interviews, self-administered diaries and observations. METHODS: A total of 286 individuals were followed over either a 4 or a 6 months period. Agreement between direct observation and both the bimonthly and diary methods were estimated. RESULTS: The agreement between the observation and the bimonthly interview was 71.8% when days without any water contacts were considered, but decreased to 23.3% when only days with at least some water contact were considered. The agreement between the observation and the diary was 78.7% when days without any water contacts were considered and 40.8% when only days with some water contacts were considered. CONCLUSIONS: Agreement about the degree of water contact is poor between the different measurement tools. This has important implications for future research, since a high degree of measurement error can severely bias any results from studies involving water contact.

Adult↗
PubMed2005

Estimating sensitivity and specificity of a faecal examination method for Schistosoma japonicum infection in cats, dogs, water buffaloes, pigs, and rats in Western Samar and Sorsogon Provinces, The Philippines.

Schistosoma japonicum causes a chronic parasitic disease, which persists as a major public health concern in The Philippines, the People's Republic of China and Indonesia. This infection is unique among helminthic zoonoses because it can infect humans and more than 40 other mammals. The objective of this study was to estimate the sensitivity and specificity of the Danish Bilharziasis Laboratory technique in cats, dogs, pigs, water buffaloes and rats in the Philippines. Faecal samples from each animal were collected on up to five occasions on five consecutive days in four villages of Sorsogon and Western Samar Provinces between January and July 2003. The faecal samples were analysed with the filtration and sedimentation Danish Bilharziasis Laboratory technique. Sensitivity and specificity of one, two, three, four, and five faecal samples were estimated using a Bayesian latent class approach. A total of 59, 43, 74, and 80% of the censored cats, dogs, pigs, and water buffaloes in the four villages were sampled, respectively. For all species, the sensitivity estimates when using the results of only 1 day of sampling were less than 80%. However, the sensitivity improved to at least 96% in all species when three or more faecal samples were collected on three separate days. The specificity was estimated to be above 92% across all species, even if just a single sample is used. The prevalences and 95% credible intervals of S. japonicum, adjusted for imperfect sensitivity and specificity, in cats, dogs, pigs, rats, and water buffaloes were 11.9% (6.8-18.3%), 19.9% (15.1-25.2%), 2.9% (1.1-5.2%), 31.3% (18.3-45.6%) and 6.3% (2.1-12.6%), respectively. Our results suggest that the Danish Bilharziasis Laboratory technique is valid for the detection of infection with S. japonicum in animals, and that sensitivity estimates are excellent when faecal samples are collected on at least three different days. Monitoring S. japonicum infection in animal reservoirs with a valid test could contribute to more effective public health control programmes.

Animals↗
PubMed2004

Risk factors for the prevalence of porcine cysticercosis in Mbulu District, Tanzania.

To estimate prevalence of and risk factors for the prevalence of porcine cysticercosis in Mbulu District, Tanzania, 770 live pigs were examined by lingual examination in 21 villages. Structured observations and questionnaire interviews were used to assess pig rearing practices and household use of latrines. Associations between factors were analyzed using a Bayesian hierarchical model to obtain prevalence odds ratio (OR) and 95% Bayesian Credible Intervals (95% BCI). Prevalence was 17.4% (village-specific range 3.2-46.7%). Prevalence of porcine cysticercosis was considerably higher in pigs reared in households lacking latrines than in those reared in households that were using latrines (OR = 2.04; 95% BCI = 1.25, 3.45). About 96% of the pigs were kept under free-range conditions. This study suggests the need for further studies in order to design and implement effective prevention and control measures for porcine cysticercosis in Mbulu District, Tanzania.

Animal Husbandry↗
PubMed2003

The cost of measles in industrialised countries.

The aim of this study is to estimate the costs of measles and measles control in 11 industrialised countries with varying levels of measles vaccine coverage. Country-specific annual incidence of measles, measles immunization policy, coverage and costs data were collected. The average societal costs of measles cases and immunisation programme per capita were calculated. These 11 countries spend together over US$ 151 million every year to treat and control measles. Per capita costs of measles control tend to be higher in countries with poorer measles control programmes (for instance, Italy has the highest incidence and highest overall costs), though many other factors, such as the number of antigens given per clinic visit and the local price of MMR also affect the efficiency of the programme. The costs estimates presented here can be used to estimate potential savings that might accrue from changes to measles control programmes.

Costs and Cost Analysis↗
PubMed2002

A review of emergency foot-and-mouth disease (FMD) vaccines.

The primary objectives of this paper are to describe emergency foot-and-mouth disease (FMD) vaccines and review literature on emergency vaccine efficacy to protect animals against (1) clinical signs and (2) infection (local virus replication). The reviewed experiments suggest that in cattle, sheep and pigs, the vaccine could be effective in preventing disease within 4-5 days post-vaccination. These studies also suggest that the risk of spreading infection decreases as the interval between vaccine and challenge increases and that vaccination could reduce the amount of virus excreted compared to non-vaccinated animals. We suggest areas of future research to improve our knowledge of emergency vaccines.

Animals↗
PubMed2002

Assessment of the factors associated with flavivirus seroprevalence in a population in Southern Vietnam.

Dengue and Japanese encephalitis flaviviruses cause severe disease and are hyperendemic in southern Vietnam. This study assesses associations between sociodemographic factors and flavivirus seroprevalence in this region. Sera were collected from 308 community and hospital-based subjects between April 1996 and August 1997 and tested with an indirect ELISA. The factors associated with seroprevalence were assessed using multivariate logistic regression. In this first report of adjusted prevalence odds ratios (POR) for flavivirus infection in Vietnam, seropositivity was associated with increasing age in children (multiple regression coefficients for a child compared to an adult = -4.975 and for age in children = 0.354) and residence in the city compared to surrounding rural districts. The association with age indicates that subjects were most likely to have acquired infection in early childhood. This is key to the design of Vietnamese health education and immunization programmes.

Adolescent↗
PubMed2002

The potential role of suppressive therapy for sex partners in the prevention of neonatal herpes: a health economic analysis.

BACKGROUND: The development of suppressive therapy and type specific tests for herpes infections allow for screening to reduce the risk of neonatal herpes. OBJECTIVES: To assess the potential effectiveness, cost effectiveness, and benefit of suppressive therapy among herpes simplex virus serodiscordant sex partners during pregnancy. METHODS: Decision and economic analyses are used to compare the incidence and costs of neonatal herpes in California (2000) for three interventions: (1) no management; (2) current guidelines (caesarean delivery for women with lesions); (3) screening for women at risk and use of suppressive treatment in sex partners. RESULTS: Screening and suppressive therapy are the most effective interventions, while current guidelines have limited effectiveness, but the latter provide the most cost effective results. CONCLUSIONS: While current guidelines are cost saving, they forgo a potential 82% decrease in neonatal herpes incidence that would be possible with screening and suppressive therapy if society were willing to pay the necessary US$363 000 per case prevented. To evaluate HSV screening and drug therapy completely, clinical trials and an economic assessment of infant mortality "value" to society are required.

Acyclovir↗
PubMed2001

Comparison of methods to analyse imprecise faecal coliform count data from environmental samples.

Imprecise values arise when bacterial colonies are too numerous to be counted or when no colonies grow at a specific dilution. Our objective was to show the usefulness of multiple imputation in analysing data containing imprecise values. We also indicate that interval censored regression, which is faster computationally in situations where it applies, can be used, providing similar estimates to imputation. We used bacteriological data from a large epidemiological study in daycare centres to illustrate this method and compared it to a standard method which uses single exact values for the imprecise data. The data consisted of numbers of FC on children's and educators' hands, from sandboxes and from playareas. In general, we found that multiple imputation and interval censored regression provided more conservative intervals than the standard method. The discrepancy in the results highlights both the importance of using a method that best captures the uncertainty in the data and how different conclusions might be drawn. This can be crucial for both researchers and those who are involved in formulating and regulating standards for bacteriological contamination.

Child Day Care Centers↗
PubMed2000

A population dynamic approach to evaluating the impact of school attendance on the unit cost and effectiveness of school-based schistosomiasis chemotherapy programmes.

This paper presents a first attempt at modelling the possible cost and effectiveness of reaching non-enrolled children through school-based programmes using empirical data from Egypt. A sex/school-attendance/age-structured population dynamic model was used to predict trends in infection and early disease. Four treatment delivery strategies were compared: school-based (coverage of 85 %) and school-aged targeted (coverage of 25, 50 and 85 %). The school-aged targeted strategies also included the school-based programme. For each alternative strategy, the maximum unit cost was calculated to obtain a cost-effectiveness ratio equal or smaller to the one obtained with the school-based programme (unit cost of US$ 0.60). The analysis showed that, for S. mansoni in Lower Egypt, a programme where only 85% of children attending school were treated would still prevent 77 % of the early disease cases prevented with a programme where 85 % of all school-age children were treated. However, using the school-aged targeted strategy, from US $ 0.06 to US $ 1.03 extra unit costs could be spent to reach non-enrolled children and still be more cost-effective. Treating non-enrolled children is an important consideration in maximizing the effectiveness of treatment programmes while maintaining a cost-effectiveness comparable to school-based delivery.

Adolescent↗
PubMed2000

Comparison between two common methods for reporting cold and diarrhoea symptoms of children in daycare centre research.

BACKGROUND: The increasing number of children attending day care centres (DCCs) in industrialized countries has refocused attention on the occurrence of infections and infectious diseases in these settings. OBJECTIVE: To evaluate the agreement between two methods (parent method vs. educator method) for reporting the occurrence of respiratory and diarrhoeal infections. METHODS: Fifty-two DCCs in Quebec, Canada, participated. Both educators and parents were invited to fill in calendars on which they would indicate the occurrence of colds and diarrhoea. For the parents' method, parents were telephoned biweekly to record their calendar information. For the educators' method, educators returned their calendar pages monthly (following prompting by phone, when necessary). RESULTS: Three hundred and thirty-three parents of toddlers participated in the 15-month reporting period between September 1996 and November 1997. The average agreement between the two methods was low (13.5% for colds and 9.8% for diarrhoea). Overall estimates of the incidence rates of respiratory and diarrhoeal infections based on parents' method were higher than those based on educators' method. CONCLUSIONS: Parents' data lead to larger estimations of incidence rates and are probably more valid than educators' data.

Child Day Care Centers↗
PubMed2000

A comparative analysis of the cost-effectiveness of treatment based on parasitological and symptomatic screening for Schistosoma mansoni in Burundi.

OBJECTIVES: To assess the cost-effectiveness of three alternative screening strategies in delivering treatment to patients presenting with symptoms suggestive of S. mansoni, using data collected from 17 PHCCs in the Rusizi Plain, Burundi. The three strategies were: (1) screening all symptomatic patients using a Kato-Katz smear and treating only the ones found positive; (2) treating all symptomatic patients or (3) treating only those presenting with symptoms of severe diarrhoea (blood in stool). METHODS: The database consisted of 41 051 visits of symptomatic patients to the 17 PHCCs during 1990. Effectiveness was measured as the number of infected patients treated (gold standard: 25-mg Kato-Katz smear). Cost-effectiveness ratios (CERs) (cost in US$ per infected patient treated) were used to compare the control strategies. Sensitivity analysis was performed to assess the effect of drug price and prevalence of infection on the CERs. RESULTS: The overall prevalence of S. mansoni infection was 9.5% (95% CI = 9.1%, 9.9%). Treating only those with severe symptoms of infection would have left 92% of infected patients untreated. Performing a Kato-Katz smear to confirm the diagnosis was more cost-effective than treating all symptomatic patients on a presumptive basis, with CERs of 4.2 US$ and 12.43 US$ per infected person treated, respectively. Sensitivity analysis showed that, for a cost of 0.99 US$ per dose of praziquantel, the Kato-Katz option remained the most cost-effective approach for prevalences under 76%. For a drug price of 0.21 US$ per dose, both strategies would have become equivalent. The latter value varied extensively per PHCC (range 0.17 US$ to 0.51 US$), due to the different prevalences of infection (range 0.5% to 34.3%). CONCLUSION: We found that using severe diarrhoea as an indicator for infection was not appropriate, and that screening symptomatic patients with the Kato-Katz method remained the most cost-effective approach in the given setting. The CER of treating all symptomatic patients on a presumptive basis depended very much on the drug price and the endemic level.

Adolescent↗
PubMed1999

Estimation of direct and indirect costs because of common infections in toddlers attending day care centers.

OBJECTIVE: To describe both the direct and the indirect costs of illness in a closely followed cohort of toddlers attending day care centers (DCCs) in Québec, Canada. METHODS: Fifty-two DCCs participated in the study. Parents were invited to fill in a calendar on which they would indicate the occurrence of colds, diarrhea, and vomiting, in addition to any actions taken with respect to this occurrence. The participating parents were called biweekly to report the information. The costs reported in this article are based on a period of 6 months of follow-up. The direct costs included medication and visits to a physician whereas indirect costs included alternative care provided by a family member, a babysitter, or an employed parent who missed work. RESULTS: Two hundred seventy-three toddlers were followed from 35 to 182 days during the study period. During a 6-month period, the adjusted average costs per child for medication and consultation were $47.47 (standard deviation [SD] = 52.76) and $49.10 (SD = 51.34), respectively, whereas they amount to $11.51 (SD = 51.19) for care by a babysitter, $35.68 (SD = 94.74) for care by a family member, and $117.12 (SD = 210.29) for a parent missing work (when using opportunity cost). The overall adjusted average total costs per child incurred to the parents and society was $260.70 (SD = 301.25). CONCLUSIONS: The originality of this study was to comprehensively include all costs associated with the care of an ill child attending DCCs. Future research should aim at finding economical ways to decrease illness frequency in toddlers attending day care centers and subsequently the costs they incur.

Child Day Care Centers↗
PubMed1999

Effectiveness of a training program in reducing infections in toddlers attending day care centers.

The objective of this study was to assess the effectiveness of a hygiene program in reducing the incidence of respiratory and diarrheal diseases in toddlers attending day care centers. A randomized field trial was conducted in 52 day care centers in Quebec, Canada, between September 1, 1996 and November 30, 1997. Absences for any reasons and the daily occurrence of colds and/or diarrhea in toddlers were recorded on calendars by the educators. The number of fecal coliforms on children's hands and on educators' hands was measured during three unannounced visits. Overall, 1,729 children were followed in 47 day care centers for a total of 153,643 child-days. The incidence rate of diarrhea was considerably reduced by the effect of monitoring (IRR = 0.73, 95% CI = 0.54,0.97), and the intervention reduced the incidence rate of upper respiratory tract infections (IRR = 0.80, 95% CI = 0.68,0.93). Monitoring alone also had an important effect in reducing the level of bacterial contamination on children's and educators' hands. The results indicate that both an intervention program and monitoring alone play a role in reducing infections in children attending day care centers.

Child Day Care Centers↗
PubMed1997

Determination of gestational age in sheep and goats using transrectal ultrasonographic measurement of placentomes.

Three experiments were conducted to determine gestational age in the ewe and doe by measuring placentomes with a B-mode ultrasonograph and a 5 MHz transducer. Transrectal measurements were obtained by placing the female over a bale of hay. In Experiment 1, ewes (n = 12) and does (n = 15) were examined by transrectal ultrasonography every week from breeding to parturition to determine the growth pattern of placentomes during pregnancy. In Experiment 2, placentomes from 132 ewes and 169 does were measured between 30 and 90 d of gestation. A linear regression relationship between fetal age in days and placentome size in mm was calculated and adjusted for does (gestational age = 28.74 + 1.80PL + e, r(2) = 70.34) and for ewes (age = 47.98 + 0.62PL + e, r(2) = 15.59). In Experiment 3, the placentomes of 63 does were measured to validate this relationship by using linear regression. Gestational age was determined correctly in 66% of the does, with a range of +/- 7 d and in 96% with a margin of +/- 14 d. In conclusion, transrectal ultrasonography allowed for the measurement of placentome size, which increased rapidly during the first 70 to 90 d of gestation in ewes and does. In ewes, however, there was a poor correlation of placentome size with gestational age, while in goats, measurement of placentomes could be used along with pregnancy diagnosis by transrectal ultrasonography as an indication of gestation age.

Journal Article↗
PubMed1996

Detection of cervical bacterial contamination in swine by two methods of swabbing in relation to artificial insemination.

Factors associated with uterine contamination during artificial insemination (AI) are not well defined. A frequently imputed risk factor is vulvar hygiene, although its role has never been assessed objectively. The aim of this study was to identify an objective marker of hygiene during AI and to assess the impact of vulvar hygiene on cervical contamination. In a herd in a depopulation-repopulation process, 68 paired sows of each parity were divided into 2 treatment groups. Before 2 sham AIs, with a 24 hour interval, control sows (CTR) had their vulva cleaned and treatment sows (TRT) had theirs soiled with feces. After the 2nd sham AI, swabbings were taken from the spirette and from the cervix. Bacterial growth was assessed by a semiquantitative method, and aerobic bacterial species identified. The discordance between the paired data was assessed by a McNemar chi-square test. No difference in gram-positive bacterial counts between the 2 groups was found using the cervical swab (P > 0.05). The presence of trace colonies of Escherichia coli were, however, more frequent in TRT (P < 0.05). The spirette showed a greater contamination for mixed flora of bacterial species such as E. coli (P < 0.001) and non-S. suis streptococci (P < 0.05) in TRT sows. A light cervical E. coli growth was more frequent when the vulva had been soiled. Bacterial flora on the spirette following AI may be used as an objective and practical indicator of vulvar hygiene during AI in sows.

Animals↗