Disaster preparedness and response.
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Biomedical subjects
Publications and source records attributed to O Elo.
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Since 1982 over 2 million Afghan refugees have settled in the North West Frontier Province (NWFP) of Pakistan. Socio-economical factors, sudden urbanisation and psychological stress may influence the pattern of tuberculosis morbidity and infection among refugees as compared with the original population. In order to study the prevalence of tuberculous infection among Afghan children a tuberculin survey was carried out in April and May 1985 on a cluster sample of male children attending the first two grades of primary schools in refugee camps in the NWFP. The sample size was 4108 male children with an average age of 8 years. 1358 of them, average age of 7.8 years, had not been vaccinated with BCG. An infection prevalence of 13.8% was found when using a transverse diameter of 10 mm induration or more for the tuberculin test as the criterion for infection. The findings were compared with the results of a national sample survey carried out in Afghanistan in 1978: a downward trend of the annual risk of infection (ARI) of 7.8% per year was found in children of the same age group. Thus, Afghan children living in refugee camps in NWFP showed a lower ARI than was observed in their homeland 7 years earlier.
Serial blood specimens for various serological examinations were taken from the crew of a passenger ship which sailed on winter cruises. The study covered 3 successive seasons totalling about 150 years of observation. The figures on the rates of infection were compared with data available from the general population. The study revealed no clear evidence of an increased infection risk among the crew.
The benefits of vaccination are, in general, recognized. For some diseases these benefits are obvious. When starting or evaluating new vaccination programmes, a more critical approach is needed. Before starting vaccination against measles and rubella in Finland a cost-benefit study was performed. According to those studies the net benefits of each vaccination would be ca. 100 million Finnish marks in 25-30 years. Those benefits not measurable in money value of human life, decrease of suffering, etc., were not included. For the purpose of formulating the national influenza vaccination policy a similar study was performed on influenza. The method used before seemed to be less suitable, however, with certain assumptions the vaccinations against influenza proved to be profitable.
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The act which outlined measures for restricting tobacco smoking in Finland took effect on 1 March 1977. This act is presented and its background described. The main regulations provided by the law are: 1) Health authorities administer all tobacco regulation, except taxation; 2) 5% of tobacco taxes are alloted annually to health education research and evaluation; 3) advertising and promotion of tobacco are prohibited; 4) limits on tar, nicotine and carbon monoxide are set by the government; these must be met for a permit to be granted; 5) tobacco products are quality controlled; 6) cigarette packets must bear health warnings; 7) no tobacco products may be sold to persons under sixteen years; 8) they may be sold only from supervised dispensing machines; 9) smoking is prohibited in all public areas, including transport; 10) the Board of Health administers nation-wide education measures. With regard to the latter regulation, some past and projected programmes are described. Initial results of the campaign were limited; further support from taxation and a pricing policy is necessary.
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Measles vaccination is fairly beneficial. During the third year after launching of the vaccination programme, cumulative benefits accuring from vaccination outweigh the cumulative costs of vaccination. This conclusion is based on a study of the vaccination programme in Finland. According to the vaccination programme, all 1-year-old infants in Finland are vaccinated. The duration of the period under survey has been set at 25 years, the measuring unit is the Finnish mark and the price level is that of the year 1975. When comparing costs and benefits, these are converted to present day monetary values. Vaccination costs per vaccinated infant amount to 32 marks, and in total during the period 1975--1999 they will amount to about 34 million marks according to an interest rate of 9% and to about 41 million marks according to an interest rate of 6% in current monetary value. Benefits gained by vaccination, compared with costs, are manifold. The benefits of one vaccination have been estimated at 230 marks. In total, benefits during the period 1975--99 constitute ca 117 million marks at an interest rate of 9%, and ca 159 million marks at an interest rate of 6% in current monetary value, without any deduction for vaccination costs. The net gain of vaccination--with a deduction of vaccination costs--is ca 84 million marks at an interest rate of 9%, and ca 118 million marks at an interest rate of 6% in current monetary value.
The proportion of cases with fresh syphilis in males contracted by homosexual contacts in Helsinki before and after the change of the criminal law in 1971 was studied. Since 1971, homosexuality is by law no longer a crime in Finland. In 1964, only 2% of males with fresh syphilis admitted a homosexual contact. The same figure was 8% in 1970, and increased to about 50% in 1974 and 1975. It was concluded that a change of legislation concerning homosexuality, probably by several different routes, changed the proportion of cases of detected homosexually transmitted early syphilis. This was thought to be of special importance for case finding and controlling of the spread of syphilis.
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