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PubMed1995

Attitude of French general practitioners to the public health surveillance of communicable diseases.

BACKGROUND: The attitude of general practitioners (GPs) to public health surveillance is not well documented, even though they furnish essential information, in particular for sentinel surveillance among the general population. METHODS: The attitude of 560 French GPs to the surveillance of 17 communicable diseases was researched. Half the GPs had previous experience in public health surveillance and the other half did not. Their motivation for belonging to a public health surveillance network and some of their demographic characteristics were also investigated. Their attitude was compared with an objective evaluation of public health surveillance priorities, based on 10 criteria. RESULTS: Primarily, GPs are interested in the surveillance of uncommon and serious diseases (HIV infection, tuberculosis, meningitis), and/or preventable ones (viral hepatitis, flu' syndrome, measles, sexually transmitted diseases), which coincides with the choices made by public health decision makers. The age of the GPs, their type of practice (urban/rural), and their participation (or not) in a surveillance network modify their priorities: in general the GPs' perception of the risks to which their patients may be exposed influences their choice of which diseases should be subject to surveillance in general medicine.

Adult↗
PubMed1999

Prevalence of communicable disease among restaurant workers along a highway in Assam, India.

105 workers of 29 roadside restaurants along a highway in Assam were interviewed for their habits, educational status and were examined for their hygienic status and presence of communicable diseases (STDs,TB etc). Most of them were young, males with 40% literacy; more than half were unmarried. About 30% of them were alcoholic and smokers and 2.9% were addicted to cannabis. The hygienic conditions of the workers were poor. More than one third had sexual contact with multiple sex partners or commercial sex workers and 2% were engaged in homosexual activity. Most of them did not use condom. 25.7% of them had genital lesions suggestive of sexually transmitted disease, 11.8% showed gram negative diplococci in urethral smears and 5.1% were VDRL reactive. Skin infections followed by gastrointestinal disorders and respiratory tract infections were other prevalent problems. 70.6% were positive for intestinal parasites and 22.2% were sputum positive for acid fast bacilli. However all the collected blood samples were negative for HIV.

Adult↗
PubMed2004

Prevention of non-communicable diseases in Pakistan: an integrated partnership-based model.

Development and implementation of non-communicable disease (NCD) prevention polices in the developing countries is a multidimensional challenge. This article highlights the evolution of a strategic approach in Pakistan. The model is evidence-based and encompasses a concerted and integrated approach to NCDs. It has been modelled to impact a set of indicators through the combination of a range of actions capitalizing on the strengths of a public-private partnership. The paper highlights the merits and limitations of this approach. The experience outlines a number of clear imperatives for fostering an enabling environment for integrated NCD prevention public health models, which involve roles played by a range of stakeholders. It also highlights the value that such partnership arrangements bring in facilitating the mission and mandates of ministries of health, international agencies with global health mandates, and the non-profit private sector. The experience is of relevance to developing countries that have NCD programs running and those that need to develop them. It provides an empirical basis for enhancing the performance of the health system by fostering partnerships within integrated evidence-based models and permits an analysis of health systems models built on shared responsibility for the purpose of providing sustainable health outcomes.

Editorial↗
PubMed2006

Changes in the levels of major cardiovascular risk factors in the multi-ethnic population in Singapore after 12 years of a national non-communicable disease intervention programme.

INTRODUCTION: The National Healthy Lifestyle Programme, a population-wide non-communicable disease intervention programme, was started in 1992. A National Health Survey is carried out every six years to evaluate the impact of this programme on the cardiovascular risk factor profile of the resident population of Singapore. METHODS: The 2004 National Health Survey (NHS 04) was a population-based survey carried out over a period of four months from September to December 2004. A combination of disproportionate stratified sampling and systematic sampling was used to select a representative sample (n=7,078) for the survey. The reference population comprised 2.4 million multi-racial Singaporeans aged 18-69 years. Anthropometric and blood pressure measurements were carried out on all subjects and blood samples were taken for biochemical analysis. The results were compared with those of a similar survey conducted in 1998. RESULTS: A total of 4,084 Singapore residents took part in the survey, giving a response rate of 57.7 percent. The age-standardised prevalence of hypertension (greater than or equal to 140/90 mmHg) in Singapore residents aged 30-69 years decreased from 28.0 percent in 1998 to 24.0 percent (p-value is less than 0.001) in 2004. The prevalence of high total cholesterol (greater than or equal to 6.2 mmol/L) among those aged 18-69 years fell from 26.0 percent in 1998 to 18.1 percent (p-value is less than 0.001) in 2004. The prevalence of diabetes mellitus in residents aged 18-69 years in 2004 was 7.8 percent, compared to the 1998 level of 9.5 percent (p-value is less than 0.01). The level of obesity (body mass index is greater than or equal to 30 kg/sqm) increased slightly from 6.2 percent in 1998 to 6.8 percent (p-value equals 0.1627). The prevalence of daily smoking decreased from 15.0 percent in 1998 to 12.5 percent in 2004 (p-value is less than 0.001), while that of regular exercise increased from 17.0 percent to 25.0 percent (p-value is less than 0.001). Ethnic differences in the prevalence of diabetes mellitus, hypertension, hypercholesterolaemia, and exercise were observed. CONCLUSION: The NHS 04 results suggest that the National Healthy Lifestyle Programme significantly decreased daily smoking, high blood cholesterol and hypertension, and increased regular exercise over 1998 levels. The results also suggest that the programme stabilised the prevalence of obesity and diabetes mellitus.

Adolescent↗
PubMed1985

Utilization of case definitions and laboratory reporting in the surveillance of notifiable communicable diseases in the United States.

In 1984, questionnaires were sent to the chief epidemiologist in all 50 states, Puerto Rico, and Washington, DC, with a 100 per cent response rate. There were substantial variations in case definitions of reportable diseases, criteria for counting as a case, and sources of surveillance. Laboratory reporting of any notifiable condition is mandated by 54 per cent of jurisdictions. These differences in ascertainment and case-counting practices constitute potential sources of error in national surveillance data on communicable diseases.

Attitude of Health Personnel↗
PubMed1978

[Modern methods for surveillance of communicable disease: general introduction (author's transl)].

Epidemiological surveillance has now become a fully developed discipline, to which several technical specialties contribute. All kinds of new problems resulting from present conditions of life have enlarged the field of surveillance beyond the old concept of morbidity-mortality. This has necessitated the application of new methodology--a stimulating challenge for those who are engaged in epidemiological surveillance.

Centers for Disease Control and Prevention, U.S.↗
PubMed2000

Economic evaluation of communicable disease interventions in developing countries: a critical review of the published literature.

Limited health care budgets have emphasized the need for providers to use resources efficiently. Accordingly, there has been a rapid increase in the number of economic evaluations of communicable disease health programmes in developing countries, as there is a need to implement evidence-based policy decisions. However, given the prohibitive cost of many economic evaluations in low-income countries, interest has also been generated in pooling data and results of previously published studies. Yet, our review demonstrated that very few published economic evaluations have been performed during 1984-1997 (n=107). Certain diseases and geographical areas have also been neglected. Of those studies published, appropriate analytic techniques have been inconsistently applied. In particular, there are four immediate concerns: the narrow perspective taken-dominance of the health care provider viewpoint and reliance on intermediate outcomes measures; bias-some costs were excluded from estimates; the lack of transparency-sources of data not identified; and the absence of a critical examination of findings-many papers failed to perform a sensitivity analysis. The usefulness of previously published economic evaluations to help make resource allocation choices on an individual basis and, therefore, for the purpose of international comparisons, pooling or meta-analysis, has to be questioned in light of the results from this study.

Bias↗
PubMed1995

Major chemical incidents--a response, the role of the Consultant in Communicable Disease Control and the case of need for a national surveillance-resource centre.

BACKGROUND: The aim of this study is to discuss the adequacy of current arrangements for dealing with major chemical incidents through the offices of the Consultant in Communicable Disease Control (CCDC). METHOD: This paper describes the public health response to an explosion at a chemical works which was followed by illnesses of unknown aetiology in emergency service workers and other people. An outline of the circumstances as they presented themselves and a description of the lessons learned from the management of this disaster are presented alongside an overview of the prevailing infrastructure of advice, support and training available to CsCDC. Key issues relevant to these areas are discussed. RESULTS: A total of 181 potential cases were notified to the investigating team, of whom 115 had an illness possibly associated with the explosion. Of these, 93 suffered a gastrointestinal illness and 68 had so-called 'toxic' symptoms (eye, skin and bronchopulmonary irritation). Forty-six people had both sets of symptoms at the same time. CONCLUSIONS: Current arrangements dictate that public health physicians have a role in incidents such as this, whether they seek such a position or not. The specialty would do well to consider developing formal disaster training schemes for those likely to have to manage major incidents (usually the CCDC), and would benefit from the setting up of a chemical-environmental incident surveillance-resource centre. Such a centre should have a remit for teaching and training, information support, incident recording, coordination of expert resources, and liaison between interested bodies both nationally and internationally.

Chemical Industry↗