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PubMed1994

[Leprosy in New Caledonia from 1983 to 1992. Histopathological and epidemiological data].

New Caledonia is a South Pacific Island inhabited by more than 170,000 people: most of them are melanesians or europeans. Multidrug therapy for Hansen disease has been employed since 1983; so we made an epidemiologic and histopathologic study of the new cases diagnosed for 10 years, from 1983 to 1992. Local (clinical, histological, microbiological and immunological) means of diagnosis are described. In New Caledonia, the endemic level is lower than in the small neighbouring Pacific islands but there is still a native reservoir of Mycobacterium leprae with 40% multibacillary types. Nearly half of the new cases are less than 25 years old. They are often male melanesians. The diagnosis of indeterminate forms is debated when there is no acid-fast bacillus. Border-line forms are rare. Tuberculoid leprosy poses many differential diagnosis problems. Despite available multidrug therapy, one cannot yet consider that the incidence is decreasing significantly.

Adult↗
PubMed1996

Epidemiological data on drug use during pregnancy in Thuringia, East Germany, 1993.

An international collaborative WHO-study on drug use in pregnancy of 1987 involving 300 puerperae from Thuringia, East Germany (the former GDR), has partly shown great differences in drug use habits between the countries which had participated on the study. In 1993--after the radical change on the socioeconomic situation in East Germany by the reunification of Germany leading also to changes in health service--an update of the East German data was carried out by repeating the investigation in the same Thuringian region as in 1987. Whereas drug therapy of chronic diseases in pregnancy and drug administration under delivery were widely similar in both investigations, we found a marked increase in drug use in case of illness in the course of pregnancy before admission to hospital for delivery but also in the treatment of nursing women. The differences can be partly put down to socioeconomic development. Because of the continuously enlarging drug market on the one hand and a small data basis on drug risks and side-effects for unborn life on the other hand, a large screening on drug exposition in pregnancy including recording of newborns' data ought to be performed.

Adult↗
PubMed1998

The Côte d'Ivoire national HIV counseling and testing program for tuberculosis patients: implementation and analysis of epidemiologic data.

OBJECTIVES: To describe the implementation of a free, voluntary and confidential HIV counseling and testing program for patients with newly diagnosed tuberculosis at the eight large outpatient tuberculosis centers in Côte d'Ivoire, and to present epidemiologic findings on participating patients. DESIGN: HIV counseling and testing program with ongoing HIV serosurveillance. METHODS: HIV counseling and testing services were established at the two tuberculosis centers in Abidjan in 1989 and were extended to six centers in the Côte d'Ivoire interior in the first half of 1994. Characteristics of counseled patients, acceptance rates of HIV testing, and HIV serologic results were analyzed for all eight centers from 1994 to 1996. Temporal trends in HIV seropositivity rates were examined for the two centers of Abidjan from 1989 to 1996. RESULTS: From July 1994 through December 1996, 17 946 (91.8%) out of 19 594 patients who were counseled at the eight centers in Côte d'Ivoire consented to HIV testing, of whom 7749 (43.2%) were HIV-seropositive. The highest rates of 47.0 and 45.6% were found in the two centers in Abidjan, with rates ranging from 32.9 to 42.4% in the six centers in the interior. HIV-seropositive tuberculosis patients from each of the 50 districts in Côte d'Ivoire were identified. In Abidjan, the HIV seropositivity rate remained relatively stable among men (46.7% in 1989, 48.5% in 1991, 43.6% in 1996), but rose sharply among women from 32.7% in 1989 to 50.1% in 1996. CONCLUSIONS: The high HIV seropositivity rates among tuberculosis patients in all geographic regions of Côte d'Ivoire indicate that the HIV epidemic has now spread throughout the country. However, the successful implementation of an extensive HIV counseling and testing program for more than 37000 tuberculosis patients to date demonstrates the commitment of the Côte d'Ivoire Ministry of Health to integrating HIV/AIDS prevention activities with tuberculosis control efforts. When logistically and economically feasible, the extension of HIV-related social and clinical services to HIV-seropositive tuberculosis patients should be considered by other national tuberculosis control programs in Africa.

AIDS Serodiagnosis↗
PubMed2004

Review of STI and HIV epidemiological data from 1990 to 2001 in urban Burkina Faso: implications for STI and HIV control.

OBJECTIVES: To better understand the sexually transmitted infection (STI)/HIV dynamics in an urban west African setting in order to adapt STI/HIV control efforts accordingly. METHODS: Review of STI and HIV epidemiological studies performed over the past decade in Bobo-Dioulasso, the second city of Burkina Faso. Trends in STI prevalence among commercial sex workers and the general population were assessed over time through studies that used the same recruitment and laboratory diagnostic procedures. Variations in aetiologies of vaginal discharge, urethral discharge, and genital ulcers were also evaluated among patients consulting for genital infection complaints. Antenatal clinic based surveys provided data to assess HIV trend among the general population. RESULTS: We observed an important decline of classic bacterial STI such as syphilis, Neisseria gonorrhoea, Chlamydia trachomatis, and Haemophilus ducrey infections in all study groups. Trichomoniasis also declined but to a lesser extent. HIV infection followed the same trend at the same time, with a significant decline in the 15-19 year age group of pregnant women, suggesting a possible decrease of HIV incidence. Although no evidence of a causal relation can be drawn from this review, adoption of safer sex behaviour, introduction of the syndromic management (SM) approach, or higher antibiotic use may have contributed to these changes. CONCLUSIONS: Classic bacterial STI declined over the past decade in parallel with a stabilisation of HIV infection. Variations in syndromes aetiology and sexual behaviours should be monitored as part of STI surveillance in order to improve STI syndromic management algorithms and to adapt HIV/STI prevention efforts.

Burkina Faso↗
PubMedDate not supplied

The association between lack of male circumcision and risk for HIV infection: a review of the epidemiological data.

BACKGROUND AND OBJECTIVES: Whether male circumcision reduces the risk of acquiring human immunodeficiency virus (HIV) infection remains controversial. STUDY DESIGN: As there have now been a number of studies conducted that have examined this issue, we undertook to review their findings. Thirty epidemiological studies identified in the literature that investigated the association between male circumcision status and risk for HIV infection were reviewed. RESULTS: Eighteen cross-sectional studies from six countries reported a statistically significant association, four studies from four countries found a trend toward an association. Four studies from two countries found no association. Two prospective studies reported significant associations, as did two ecological studies. In studies in which significant associations were demonstrated, measures of increased risk ranged from 1.5 to 8.4. The groups in which positive associations were found included sexually transmitted disease (STD) clinic and hospital patients, outpatient clinic and HIV screening clinic attenders, long-distance truck drivers, and general community members. CONCLUSION: Potential sources of error, assessment of causality, implications of the findings, and future research needs are discussed. Because a substantial body of evidence links noncircumcision in men with risk for HIV infection, consideration should be given to male circumcision as an intervention to reduce HIV transmission.

Bias↗
PubMed1997

[Urban atmospheric pollution and public health: epidemiologic data].

Air pollution which is generated by car traffic of by various industries is susceptible to alter several functions of the respiratory cells. This has been demonstrated in several studies in vivo, in animal models or in human volunteers. However, the results of epidemiological studies in which the impact of air pollution on human health and particularly on the respiratory system (e.g asthma or respiratory infections), are unclear. Short term epidemiological studies have shown that air pollution can be responsible for some asthma symptoms such as cough and shortness of breath in known asthmatics, particularly in patients with mild rather than severe asthma. Moreover, these studies do not demonstrate than air pollution is responsible for the increase prevalence of asthma which has been reported these last 20 years. Concerning the relationships between air pollution and respiratory infections, the epidemiological studies are also contradictory.

Air Pollution↗