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PubMed1989

Partner notification in the control of human immunodeficiency virus infection.

Partner notification should be standard public health practice in the control of human immunodeficiency virus (HIV) infection. A universal partner notification program for the United States is affordable, operationally manageable, and can effectively reach high-risk persons. Such a focused approach personalizes the epidemic and probably enhances the efficacy of risk reduction messages. Confidentiality protections are attainable. Voluntary partner notification is acceptable to our constituents; while counseling is "mandatory," testing is optional. Evidence of partner notification's usefulness as a case prevention tool should be a by-product of program outcomes and not a prerequisite for its implementation.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Cost-effectiveness analysis of partner notification program for human immunodeficiency virus infection in Japan.

Successful implementation of partner notification program (PNP) as a part of human immunodeficiency virus (HIV) prevention strategies in some developed countries motivated the execution of cost-effectiveness analysis of this program in Japan. Total number of HIV infected individuals and best estimated number of their partners in 1995 were used to elicit incremental cost-effectiveness ratio over no partner notification program. Index cases and their HIV positive partners world change their sex practice to safer one, thus preventing HIV transmission at a certain rate. This was translated to prevention of certain number of new HIV carriers and finally life years gained were calculated for it. The incremental cost-effectiveness ratio was US$ 4,930 per life year gained. Sensitivity analysis indicated that partner notification program was cost-effective over a wide range of assumptions. These results compare favorably with other medical interventions in Japan. In conclusion, the results of this analysis strongly support the implementation of partner notification program as a part of HIV prevention strategies in Japan.

Adult↗

PubMed1991

Under-reporting in hepatitis B notifications.

Notification and laboratory data for the period January 1985-December 1988 were compared in order to estimate: (i) the minimum level of under-reporting of hepatitis B; and (ii) the consistency of the level of under-reporting, both regionally and nationally. Ratios between hepatitis B notifications and positive hepatitis B laboratory tests (reporting ratios) were calculated to quantify the discrepancy between these parameters. There were at least 7 positive hepatitis B laboratory results for each notified case of hepatitis B during each year studied. The differences between the national reporting ratios for each of the study years were small, indicating that nationally the level of reporting of hepatitis B is fairly consistent. The Cape region had the highest and most constant level of hepatitis B reporting compared with other regions. We conclude that the national incidence of hepatitis B is at least 7 times higher than that calculated from notification data. Further, the inter-year analysis of hepatitis B notification data to identify trends nationally and within the Cape region is valid. However, caution is called for when comparing the incidence rates between regions due to inter-region and region-specific inter-year inconsistencies in reporting levels.

Hepatitis B↗

PubMed1985

Notification of a cohort of workers at risk of bladder cancer.

Surviving members of occupational cohorts studied in retrospective analyses of mortality usually are not notified individually of positive study results. However, concern has arisen that such results may contain risk information pertinent to study subjects. To evaluate the effects and implications of individually notifying survivors of such cohorts, we conducted a pilot notification study. Members of a cohort of 1,385 chemical workers who had handled carcinogenic amines were notified by mail that they were likely to be at increased risk of bladder cancer. Also a bladder cancer screening and follow-up program was established. The study demonstrated that notification is a complex action and that much care needs to be taken when communicating information on risk. Notification requires development of (1) criteria as to what constitutes a notifiable risk and (2) programs to meet the medical and social needs of the various parties involved in notification.

Carcinogens↗

PubMed1982

The geographical distribution of tuberculosis notifications in a national survey of England and Wales (1978-79). Report from the Medical Research Council Tuberculosis and Chest Diseases Unit.

A survey of tuberculosis notifications from 1 October 1978 to 31 March 1979 has provided a special opportunity to estimate annual notification rates in different ethnic groups for the 8 administrative areas of England and the 33 boroughs of Greater London. In addition it has been possible to calculate for each of the 54 counties and 403 local authorities of England and Wales the relative proportions of cases that were of White and non-White ethnic origin. Much of the considerable variation in the rates between the administrative areas of England, ranging from 5.2 per 100 000 in Anglia to 23.7 in the West Midlands, could be accounted for by the varying proportions of persons of Indian subcontinent ethnic origin for whom the notification rates were very high. Nevertheless the White rates also varied widely, from 4.2 per 100 000 in Anglia to 14.5 in the Northern area. The notification rate in Greater London was twice the national average, due in part to the fact that 40% of all non-White patients in the survey were resident there. Within the boroughs of Greater London the rates for all ethnic groups combined ranged from 7.0 in Bromley to 114.3 in Brent, a 16-fold difference. The highest rates occurred in the more densely populated areas. A large number of cases of Indian subcontinent ethnic origin was not necessarily associated with a high rate in the White population, nor vice versa.

Bangladesh↗

PubMed1997

Incompleteness of statutory notification of bacterial gastro-intestinal infection.

A study was made of all potentially statutorily notifiable bacterial infections diagnosed in faecal samples submitted from symptomatic patients to a single microbiology laboratory during a six-month period. Salmonella spp, Campylobacter spp or Shigella spp were isolated from 167 patients and 51% of these were formally notified (54% of general practice patients and 47% of hospital patients). Forty-seven percent of cases of food-poisoning (Salmonella spp. and Campylobacter spp) were notified as were 70% of cases of shigella infections. Notification was made on average 9.4d after sending a specimen to the laboratory. A questionnaire used to ascertain the reasons for non-notification in 80 of 85 cases elicited replies in respect of 78 patients. Four patients infected with Salmonella spp or Campylobacter spp were said not to have been suffering from food-poisoning. A variety of reasons was given for failing to notify the others, the most common were forgetfulness, not receiving the result of the specimen, or believing someone else had made the notification.

Campylobacter Infections↗

PubMed1998

Notification of tuberculosis in patients with AIDS.

BACKGROUND: In the early 1990s cases of tuberculosis in people with HIV infection and AIDS were undernotified. A study to evaluate changes in notification rates in two inner London local authorities was undertaken for the period January 1993-June 1996 inclusive. METHODS: For residents of the two local authorities, tuberculosis notifications were identified using a local database, and cases of AIDS with a recorded diagnosis of tuberculosis were identified from AIDS case reports. RESULTS: During the study period, only 13 (32 per cent) of the 41 AIDS cases with a recorded diagnosis of tuberculosis were also notified as a case of tuberculosis. However, the proportion of notified cases rose from 0 per cent (0 of 11) in 1993 to 50 per cent (5 of 10) in 1995 and 63 per cent (5 of 8) in early 1996. CONCLUSION: The increase in the tuberculosis notification rate for people with AIDS is encouraging, but scope for improvement remains.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

STD partner notification and referral in primary level health centers in Nairobi, Kenya.

BACKGROUND: Controlling sexually transmitted diseases requires that partners of patients with a sexually transmitted disease be notified and treated. However, many countries in the developing world lack the infrastructure and resources for effective partner referral. GOAL OF THIS STUDY: To provide information on rates of partner referral in primary-level health centers in Kenya, to identify characteristics of patients with sexually transmitted diseases who inform their partners about the need for treatment, and to evaluate the impact of a brief counseling intervention on rates of partner notification. STUDY DESIGN: Two-hundred-fifty-four patients presenting for treatment of a sexually transmitted disease were given 5 to 10 minutes of additional counseling on the importance of referring partners for sexually transmitted disease treatment. All patients who returned for follow-up 1 week later were interviewed to determine whether they had notified their sex partners. RESULTS: Sixty-eight percent of patients who returned for follow-up reported they had referred their partners for treatment of a sexually transmitted disease. The highest rates of partner notification occurred among women attending maternal child health/family planning clinics and married men and women attending general outpatient clinics. CONCLUSION: Strengthening and directing counseling toward women in maternal child health/family planning clinics and married men and women in general clinics may be an effective and inexpensive way to increase partner notification in the developing world.

Adult↗

PubMed1987

The impact of a parental notification law on adolescent abortion decision-making.

In 1984, we investigated the impact of a parental notification statue with judicial bypass procedures in Minnesota. Subjects were interviewed on the day of their abortion at four Minnesota and two Wisconsin clinics. Relatively few were aware of the statute in Minnesota. Parental notification rates were similar in Minnesota and Wisconsin, which has no parental notification statute.

Abortion, Legal↗

PubMed1995

Assessing the completeness of tuberculosis notification in a health district.

We have estimated the completeness of tuberculosis notification in Bolton health district by combining notification data with information from prescriptions issued by general practitioners and hospital admission data. From 1 January 1991 to 31 December 1993, 307 cases of tuberculosis were notified in Bolton. Thirty-four cases were identified using general practitioners' prescriptions: 27 of these had been notified between January 1991 and December 1993, and seven had not been notified during this period. Although prescriptions may be used as a marker for tuberculosis, they would not be an adequate alternative to notification of cases. One hundred and forty-eight cases of tuberculosis were identified between 1 October 1992 and 30 September 1993 by combining data from the three sources: 138 cases had been notified (93.2%), 28 identified from prescriptions (23.0%), and 54 identified from hospital data (36.5%).

Antitubercular Agents↗

PubMed1994

Behaviour, knowledge and reactions concerning sexually transmitted diseases: implications for partner notification in Lusaka.

Available data show that STDs and their consequences are a major health problem in Zambia. This study focuses on factors which could have implications for partner notification, as a tool for prevention. Fifty women and fifty men with STD were interviewed at two outpatient clinics in Lusaka, where partner notification is not functioning optimally. A majority of the sexual partners during the last three months were known by the patients who also stated a willingness to bring more partners than they were asked to do. Women had symptoms for a longer period than men before they came for treatment. They were less aware of symptoms connected with STD and a majority of them did not know that they were receiving treatment for STD. The communication between the health care provider and the patients about disease, treatment and partner notification needs to be improved especially for women.

Adolescent↗

PubMedDate not supplied

Notification of meningococcal disease and Haemophilus influenzae meningitis: a requirement for public health action.

------------------------------------------------------------------------ ------------------------------------------------------------------------ ------------------------------------------------------------------------ ---------------------------meningitis was ascertained for the years 1987-1991. Laboratory record review identified positive blood culture and cerebro-spinal fluid isolates for 4 Dublin hospitals serving the paediatric population of the Eastern Health Board. Infectious disease registers, inspected for evidence of notification, revealed than only 44% of culture positive cases had been notified. The notification rate for Haemophilus meningitis (33%) was significantly lower than that for meningococcal disease (53%). All laboratory identified cases should have been notified. Public health assessment is required for each condition as rifampicin prophylaxis can prevent secondary cases in close contacts of both diseases. Improved notification is essential, not just to comply with the law but more importantly, for better management of these diseases.

Child↗

PubMed1993

Is the medical community ready for worker notification?

Although the potential for early detection of disease has been of central importance in the evolution of worker notification policy and practice, it is not the only positive outcome of medical intervention. The provider-patient encounter also creates an important opportunity for patient-centered risk communication that may result in workplace modifications as well as lifestyle changes to reduce the likelihood of subsequent illness and injury--both work and nonwork related. At the same time, it may signal the beginning of a series of social, legal, and political actions that may have positive or negative consequences for notified workers. This article identifies several important roles for members of the medical community relating to worker and community notification programs and explores the readiness of health care professionals in assuming these roles. It is suggested that health care providers lack both the training and sociopolitical sensitivity needed for meaningful participation in the notification process. This article addresses possible short-term and long-term approaches to enhancing the readiness of health care providers and suggests that effective intervention with notified workers requires a willingness to step beyond the confines of the medical model.

Communication↗

PubMed1993

Content of notification: exposure to the pesticide chlordimeform.

A notification about exposure requires a detailed search of records and interviews with personnel to properly identify potentially exposed groups. Next, these potentially exposed groups must be examined to determine which groups had the potential for highest exposures. The notification should address three key questions: Why am I receiving this notification? What problems are associated with exposure to the chemical? What am I supposed to do? Consideration should be given to notifying lesser-exposed groups, as to why they are not considered to be at increased risk.

Chlorphenamidine↗

PubMed1993

Experiences of a state-sponsored notification and screening program for asbestos workers.

Worker notification can involve a broad range of activities including medical screening, personal and mass communications, cohort identification and tracing, and even litigation. The inclusion or exclusion of various supporting activities in a worker notification program may pose significant medical, public health, financial, logistical, and even legal implications for targeted individuals as well as for the agencies involved. This report describes some experiences in a state-sponsored notification and screening program of approximately 4,500 asbestos workers in Minnesota. In this program, a variety of factors led to the decision to provide medical screening to 1,101 workers and 451 spouses. It is anticipated that another 3,400 workers will be notified but not screened. A follow-up survey of notified workers showed overwhelming support for this program. It is estimated that this program will cost more than $650,000 by its completion. The decision to institute medical screening and other support activities should be made with careful consideration of the diverse implications of these activities to the individuals, communities, and agencies involved.

Asbestos↗

PubMed1990

Exercise intervention attenuates emotional distress and natural killer cell decrements following notification of positive serologic status for HIV-1.

The impact of aerobic exercise training as a buffer of the affective distress and immune decrements which accompany the notification of HIV-1 antibody status in an AIDS risk group was studied. Fifty asymptomatic gay males with a pretraining fitness level of average or below (determined by predicted VO2 max) were randomly assigned to either an aerobic exercise training program or a no-contact control condition. After five weeks of training, at a point 72 hours before serostatus notification, psychometric, fitness and immunologic data were collected on all subjects. Psychometric and immunologic measures were again collected one-week postnotification. Seropositive controls showed significant increases in anxiety and depression, as well as decrements in natural killer cell number following notification whereas, seropositive exercisers showed no similar changes and in fact, resembled both seronegative groups. These findings suggest that concurrent changes in some affective and immunologic measures in response to an acute stressor might be attenuated by an experimentally manipulated aerobic exercise training intervention.

Adult↗

PubMed1993

Surveillance of measles in Scotland 1983-1991; a comparison of statutory notification and laboratory reporting.

The epidemiology of measles in Scotland for the period 1983-1991, based on statutory notification and laboratory reporting, is described. There were 34,823 notifications compared to only 690 laboratory reports. This suggests that for less than 1 in 50 notifications of measles was the clinical diagnosis confirmed by laboratory testing. Both sets of data show a declining incidence of measles (in keeping with rising rates of immunisation) but a statistically significant shift in the age distribution of cases towards the over 15 years age group. There were differences, however, between the two sets of data in the sex ratio within various age groups. In particular, among notified cases, there was a highly significant but unexplained preponderance of males in the over 15 years age group (59.7% vs. 40.3%, P < 0.001). Discrepancies between the two sets of data were also evident from comparisons among Health Boards. Possible sources of bias are suggested for each set of data. The relevance of this surveillance to the current debate about the need for a two stage Measles/Mumps/Rubella (MMR) immunisation policy is briefly discussed. In order that this debate be reliably informed, it is highly desirable that the clinical diagnosis in each case of apparent vaccine failure is confirmed by laboratory testing.

Adolescent↗

PubMed1992

Limitations of the OPCS congenital malformation notification system illustrated by examination of congenital malformations of the cardiovascular system in districts within the Trent Region.

Data are presented from OPCS notification statistics and other sources on rates of congenital cardiovascular malformations in the Trent Health Region and in its constituent Districts. While Trent in general, and some of its districts in particular, show high notification rates, other data sources suggest that the underlying malformation rate may not be raised compared with that seen nationally. Reasons for this discrepancy are discussed and the OPCS notification system is compared with that in Scotland.

Heart Defects, Congenital↗