PubMed · 15148699
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Susan Williams. 2004. Making every vote count.. https://pubmed.ncbi.nlm.nih.gov/15148699/
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INTRODUCTION: Serotyping of pneumococci has become increasingly important as new pneumococcal vaccines are introduced and place emphasis on knowledge of national serotype-distributions and their development over time. AIM: The aim of this study was to evaluate the quality of serotyping of pneumococci in Europe, and to focus on possible problems with methods, procedures, etc. that may lead to wrong serotypings. METHODS: This study was part of a larger EU-project. Eleven reference laboratories in Europe participated in the validation of pneumococcal serotyping. The Streptococcus Unit at SSI functioned as the gold standard for use of the Neufeld test. Each laboratory was asked to type 70 blinded pneumococcal strains by use of their normal serotyping procedure and to answer to a questionnaire regarding their experience and serotyping procedure for pneumococci. The 70 strains were chosen to represent all the 23 pneumococcal types included in the 23-valent pneumococcal vaccine plus a number of other less common types. RESULTS: A total of 735 serotypings was performed. Five laboratories performed complete serotyping whereas the remaining six laboratories performed partial or variable serotyping into groups or types that did not belong to groups. In general, a high degree of consensus appeared between the 11 European reference laboratories. Of 735 serotypings, 39 erroneous serotypings were made (5% of all). Most serotyping errors included a wrong serotype within the correct serogroup, where especially types 9N, 18C and 19F were mistyped. Furthermore, misidentification of noncapsular pneumococci like S. mitis and S. oralis was also a frequent error. For 22 strains (30%) of pneumococci, serotyping mistakes were made. The erroneous serotypings were neither correlated to the use of other methods than the Neufeld test, nor to the serotyping routine of the laboratories. A number of errors may be due to a serotyping result based on a negative reaction with a specific factor serum, instead of a positive reaction with another factor serum. This may be chosen in order to simplify the serotyping procedure. Thus, all the necessary factor sera must be used in order to assure correct serotyping. CONCLUSIONS: Overall, the quality of serotyping of pneumococci was high, and a high degree of consensus was found between the eleven laboratories. It is important to use all the necessary factor sera for serotyping, to perform all the necessary tests and to base a serotyping result always on one or more positive reactions and not on a negative reaction alone. More focus on serotyping of serotypes within groups seems to be warranted.
This study assesses whether stroke mortality trends have been less favorable among lower than among higher socioeconomic groups. Longitudinal data on mortality by socioeconomic status were obtained for Finland, Norway, Denmark, Sweden, England/Wales, and Turin, Italy. Data covered the entire population or a representative sample. Stroke mortality rates were calculated for the period 1981-1995. Changes in stroke mortality rate ratios were analyzed using Poisson regression and compared with rate ratios in ischemic heat disease mortality. Trends in stroke mortality were generally as favorable among lower as among higher socioeconomic groups, such that socioeconomic disparities in stroke mortality persisted and remained of a similar magnitude in the 1990s as in the 1980s. In Norway, however, occupational disparities in stroke mortality significantly widened, and a nonsignificant increase was observed in some countries. In contrast, disparities in ischemic heart disease mortality widened throughout this period in most populations. Improvements in hypertension prevalence and treatment may have contributed to similar stroke mortality declines in all socioeconomic groups in most countries. Socioeconomic disparities in stroke mortality generally persisted and may have widened in some populations, which fact underlines the need to improve preventive and secondary care for stroke among the lower socioeconomic groups.
BACKGROUND: Up to 20 million persons are infected with the human retroviruses human T-lymphotropic virus (HTLV)-I and HTLV-II globally. Most data on the seroprevalence of HTLV-I and HTLV-II in Europe are from studies of low-risk blood donors or high-risk injection drug users (IDUs). Little is known about the general population. METHODS: A prospective anonymous study of HTLV-I and HTLV-II seroprevalence among 234,078 pregnant women in Belgium, France, Germany, Italy, Portugal, Spain, and the United Kingdom was conducted. Maternal antibody status was determined by standard methods using sera obtained for routine antenatal infection screens or eluted from infant heel prick dried blood spots obtained for routine neonatal metabolic screens. RESULTS: Anti-HTLV-I/II antibodies were detected and confirmed in 96 pregnant women (4.4 per 10,000, 95% confidence interval [CI]: 3.5-5.2). Of these, 73 were anti-HTLV-I, 17 were anti-HTLV-II, and 6 were specifically anti-HTLV but untyped. The seroprevalence ranged from 0.7 per 10,000 in Germany to 11.5 per 10,000 in France. CONCLUSIONS: Pregnant women better reflect the general population than blood donors or IDUs. The seroprevalence of HTLV-I and HTLV-II in Western Europe is 6-fold higher among pregnant women (4.4 per 10,000) than among blood donors (0.07 per 10,000). These data provide a robust baseline against which changes in HTLV-I and HTLV-II seroprevalence in Europe can be measured.