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PubMed1990

Cumulative prevalence of prostatism matches the autopsy prevalence of benign prostatic hyperplasia.

The age-specific cumulative prevalence of clinically diagnosed prostatism among 1,057 generally healthy men followed for up to 30 years in the Baltimore Longitudinal Study of Aging was compared with the age-specific autopsy prevalence of pathologically defined benign prostatic hyperplasia (BPH) from a published compilation of five independent autopsy studies involving 1,075 prostates. Clinical prevalences based on medical histories and digital rectal examinations showed excellent agreement with autopsy prevalences at all ages. Despite the well-known lack of correspondence between prostatism and objective urologic evidence of BPH in individual patients, these results suggest that the proportion of the male population with clinically recognizable prostatism by a given age is about the same as the proportion with pathological evidence of BPH.

Adult↗

PubMed1993

Epidemiology of bovine trypanosomiasis in the Ghibe valley, southwest Ethiopia. 2. Factors associated with variations in trypanosome prevalence, incidence of new infections and prevalence of recurrent infections.

An average of 840 East African Zebu cattle from nine herds in the Ghibe valley, southwest Ethiopia were monitored from January 1986 to April 1990. Each month blood samples were collected for analysis of packed red cell volume (PCV) and detection of trypanosomes. Animals found to be parasitaemic and with a PCV less than 26% were treated with diminazene aceturate at a dose of 3.5 mg/kg body weight. The majority of infections were associated with Trypanosoma congolense (84% of infections in adult cattle and 71% in cattle less than 24 months of age), and the mean percentage of adult animals detected parasitaemic 1 month after treatment of an infection with T. congolense was 27%. In order to assess possible existence of drug resistance, a model was applied which allowed monthly incidences of new infections to be distinguished from recurrent infections. This model showed that the monthly incidence of new infections of T. congolense in adult cattle increased significantly from 11% in 1986 to 24% in 1989 following a concomitant increase in the tsetse challenge. The corresponding increase in overall prevalence of T. congolense was from 17% to 38% and the mean prevalence of recurrent infections increased significantly from 6% to 14%. These findings ruled out the possibility that the high prevalence of trypanosome infections in cattle was due only to a high tsetse challenge and pointed to the existence of T. congolense populations which expressed resistance to diminazene. There were variations associated with season, herd, age and sex in the incidence of new infections, prevalence of recurrent infections and relapse to treatment.

Animals↗

PubMed1998

Prevalence of dementia in a rural Netherlands population and the influence of DSM-III-R and CAMDEX criteria for the prevalence of mild and more severe forms.

To obtain estimates of the prevalence of mild and moderate/severe dementia among people age 65 and over, applying criteria for severity of both DSM-III-R and CAMDEX, a two-stage community-based study was conducted in a rural area of the Netherlands. In the first stage, 2191 subjects (out of the target population of 2655) participated in an interview which included the Mini-Mental State Examination (MMSE). Based on MMSE score, a non-proportional random sample (n=496) was drawn for the second stage. A total of 421 subjects responded and were subsequently examined using the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX). In determining the severity of dementia, criteria of both DSM-III-R and CAMDEX were applied. Overall prevalence for both classification systems was 6.5%. There was a large discrepancy between the two classification systems with regard to the criteria for rating severity. The prevalence of moderate/severe dementia using DSM-III-R criteria was twice as high as the prevalence using CAMDEX criteria. These findings reflect the differences between DSM-III-R and CAMDEX in descriptions of dementia severity. Rating according to CAMDEX predicts institutionalization in specialized nursing homes somewhat better than staging according to DSM-III-R. Both content analysis and institutionalization data suggest that the CAMDEX operationalization of rating severity seems preferable.

Aged↗

PubMed2001

Prevalence [correction of prevalance] of functional blindness, visual impairment, and related functional deficits among elderly Mexican Americans.

BACKGROUND: This report describes the prevalence and correlates of functional blindness and visual impairment among older Mexican Americans, using data on 2800 respondents from the Hispanic Established Populations for the Epidemiological Study of the Elderly. METHODS: Bivariate and multivariate logistic regression analyses were used to examine the associations between corrected bilateral distant vision and sociodemographic characteristics, selected health conditions, self-reported health status, health care utilization, and functional dependence on the basis of assistance needed for basic and instrumental activities of daily living (ADLs). RESULTS: Using a modified Snellen test for distance visual acuity, 5% of older Mexican Americans were found to be functionally blind, and 13.5% were found to be visually impaired. Vision loss was significantly associated with older age, lower education, hypertension, diabetes, poor self-rated health, and hospitalization during the year prior to the interview. Over 50% of functionally blind subjects required assistance with at least one basic ADL, compared with 15% of those who were visually impaired and 8% of those who were not visually impaired. CONCLUSIONS: The prevalence of functional blindness in this sample of elderly Mexican Americans was higher than reported for the general elderly population, yet they also have higher rates of adequate vision because of the low prevalence of visual impairment. The results suggest a need for more research on the prevalence and impact of functional blindness and visual impairment on the health of older Mexican Americans.

Age Factors↗

PubMed1998

Association of central obesity and insulin resistance with high prevalence of diabetes and cardiovascular disease in an elderly population with low fat intake and lower than normal prevalence of obesity: the Indian paradox.

OBJECTIVE: To test the hypothesis that high prevalences of cardiovascular disease and diabetes in urban population of India are manifestations of insulin-resistance syndrome. DESIGN AND SETTING: Cross-sectional surveys were conducted in 20 streets in the city of Moradabad and in two villages. SUBJECTS AND METHODS: There were 566 subjects (255 rural and 311 urban) aged 60-84 years. All subjects were divided on the basis of their insensitivity to insulin into groups with mild, moderate and high insensitivity to insulin and data from both sexes were pooled for analysis. RESULTS: Overall increases in the prevalences of coronary disease, diabetes, hypertension, central obesity and associated disturbances were observed with increasing insensitivity to insulin and the trend was more significant among urban than it was among rural subjects. Multivariate logistic regression analysis revealed a significant positive association of level of insulin insensitivity with the age-adjusted prevalences of coronary disease, hypertension, diabetes, hypertriglyceridaemia, intolerance of glucose and central obesity among urban subjects. We observed a significant inverse association between insensitivity to insulin and physical activity both for rural and for urban subjects and between insensitivity to insulin and high-density lipoprotein cholesterol level for urban subjects. For rural subjects, we found significant associations of sensitivity to insulin with coronary artery disease and intolerance of glucose without significant associations with other risk factors. CONCLUSION: Insensitivity to insulin was significantly associated with risks of cardiovascular disease and diabetes, despite there being a low prevalence of obesity (9.0%) among urban subjects. Hypertension, diabetes, hypertriglyceridaemia, intolerance of glucose and central obesity were significantly associated with insensitivity to insulin and coronary disease for urban but not for rural people.

Aged↗

PubMed2005

Prevalence and characteristics of peripheral retinal degeneration in Chinese adults with high myopia: a cross-sectional prevalence survey.

PURPOSE: The purpose of this study was to study the prevalence of peripheral retinal findings in adult Chinese patients with high myopia (refraction < or = -6.00 D) and to investigate the correlation between the retinal lesions and the severity of myopia or axial length. METHODS: A cross-sectional prevalence survey screening was conducted in high ethnic Chinese myopes with refractions equal to or less than -6.00 D. The examinations included cycloplegic refraction, A and B scan ultrasonography, and retinal examinations by indirect ophthalmoscopy with scleral indentation and Goldmann three-mirror contact lens examination. RESULTS: Two hundred thirteen eyes in 213 patients with a mean refraction of -10.10 +/- 4.23 D (range = -6.00 to -27.00 D) were examined. The mean axial length was 26.69 +/- 1.68 mm (range = 25.18-33.62 mm) and the mean age was 33.5 +/- 10.6 years (range = 18-73 years). The most common peripheral retinal finding was pigmentary degeneration (51.2%), followed by lattice degeneration in 12.2% and retinal holes in 7.5% of eyes. A positive correlation was noted between axial length and the lesions of pigmentary degeneration and pavingstone degeneration. The prevalence of retinal holes was 6.4% and 30.0% in eyes with axial length of < 30 mm and > or = 30 mm, respectively (chi-squared test, p = 0.006). CONCLUSION: A high prevalence of peripheral retinal degenerations was found in adult Chinese high myopes. The presence of retinal holes was positively correlated with very high myopia of an axial length of > or = 30 mm.

Adult↗

PubMed2006

Does the prevalence of gsp mutations in GH-secreting pituitary adenomas differ geographically or racially? Prevalence of gsp mutations in Japanese patients revisited.

OBJECTIVE: The prevalence of gsp mutations in GH-secreting pituitary adenomas was thought to differ geographically or racially, given its exceptionally lower incidence among Japanese patients (4.4-9.3%) compared to other regions (30-50%). However, this notion is now being challenged after a recent paper reported a 53.3% incidence among Japanese with acromegaly. We have since re-evaluated the prevalence of gsp mutations on a larger scale. PATIENTS: One hundred Japanese acromegaly patients with surgically confirmed GH-secreting pituitary adenomas were enrolled. METHODS: mRNAs from primary cultured adenomas were used for reverse transcriptase-polymerase chain reaction and direct sequencing of the Gsalpha subunit. Patient data were reviewed from medical charts. RESULTS: There were 53 gsp mutations (53%), consisting of 42 Arg201Cys, one Arg201His, one Arg201Ser, 8 Gln227Leu, and one Gln227Arg mutation. Age at operation, sex ratio, basal serum GH and IGF-I levels were no different with or without the mutations. In contrast, patients responded differently to most dynamic tests with statistical significance: serum GH levels in gsp-positive patients had blunted response to GHRH, were well suppressed by bromocriptine, and had higher rates of paradoxical response to TRH. Notably, paradoxical response to LHRH was observed exclusively in gsp-negative patients. Octreotide suppressed GH levels strongly regardless of gsp status. These clinical characteristics are similar to those of Caucasian patients. CONCLUSION: We conclude that the prevalence of gsp mutations in Japanese acromegaly patients is comparable to those of other reports from various regions. Therefore, Japanese patients do not stand as an example for geographical or racial difference in the prevalence of gsp mutations in GH-secreting pituitary adenomas.

Acromegaly↗

PubMed2003

Changes in blindness prevalence over 16 years in Malawi: reduced prevalence but increased numbers of blind.

BACKGROUND/AIMS: In the coming two decades significant increases in the burden of blindness are anticipated unless concerted efforts are made to improve eye care in developing countries. Evidence of changing prevalence rates or numbers of blind people are few. The change in blindness prevalence and the number of blind people in an adult population of Malawi was measured over a 16 year period. METHODS: In 1999 a population based survey of blindness in adults (age 50+) was conducted in Chikwawa district of Malawi. Visual acuity and cause of vision loss were recorded for each eye independently. Blindness was defined as presenting better eye vision of <6/60. Findings from a 1983 survey of blindness in the same district (using similar methods) were re-analysed to be comparable with the survey conducted in 1999. RESULTS: Among 1630 enumerated adults 89% were examined. The age adjusted prevalence of blindness in the adult population was 5.4% and more common in women than men. In each age group the prevalence of blindness was lower in 1999 than in 1983; the overall reduction in blindness was 31%. During this period the 50+ population in Malawi increased almost twofold. Extrapolating the Chikwawa district data to the Malawi population reveals that the number of blind people has increased by 24%; the increase is primarily because of the large increase in the size of the most elderly group, aged 70 and above. CONCLUSION: The majority of blind people in Chikwawa (1983 and 1999) are in the age group 70 and over. This group has had the largest proportional increase in population size in this time. Services in this population have improved in the intervening 16 years and yet there was still an increase in the number of blind people. There was little change in excess blindness in women, suggesting that the same barriers that prevented utilisation of services in 1983 probably persist in 1999. Efforts to reach the most elderly and to reach women are needed to lead to a reduction in blind people in settings such as rural Malawi.

Age Distribution↗

PubMed1998

Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done?

OBJECTIVES: To review the appropriateness of the prevalence odds ratio (POR) and the prevalence ratio (PR) as effect measures in the analysis of cross sectional data and to evaluate different models for the multivariate estimation of the PR. METHODS: A system of linear differential equations corresponding to a dynamic model of a cohort with a chronic disease was developed. At any point in time, a cross sectional analysis of the people then in the cohort provided a prevalence based measure of the effect of exposure on disease. This formed the basis for exploring the relations between the POR, the PR, and the incidence rate ratio (IRR). Examples illustrate relations for various IRRs, prevalences, and differential exodus rates. Multivariate point and interval estimation of the PR by logistic regression is illustrated and compared with the results from proportional hazards regression (PH) and generalised linear modelling (GLM). RESULTS: The POR is difficult to interpret without making restrictive assumptions and the POR and PR may lead to different conclusions with regard to confounding and effect modification. The PR is always conservative relative to the IRR and, if PR > 1, the POR is always > PR. In a fixed cohort and with an adverse exposure, the POR is always > or = IRR, but in a dynamic cohort with sufficient underlying follow up the POR may overestimate or underestimate the IRR, depending on the duration of follow up. Logistic regression models provide point and interval estimates of the PR (and POR) but may be intractable in the presence of many covariates. Proportional hazards and generalised linear models provide statistical methods directed specifically at the PR, but the interval estimation in the case of PH is conservative and the GLM procedure may require constrained estimation. CONCLUSIONS: The PR is conservative, consistent, and interpretable relative to the IRR and should be used in preference to the POR. Multivariate estimation of the PR should be executed by means of generalised linear models or, conservatively, by proportional hazards regression.

Chronic Disease↗

PubMedDate not supplied

A Bayesian approach to estimate the prevalence of low height-for-age from the prevalence of low weight-for-age.

Victora et al. (1998) proposed the use of low weight-for-age prevalence to estimate the prevalence of height-for-age deficit in Brazilian children. This procedure was justified by the need to simplify methods used in the context of community health programs. From the same perspective, the present article broadens this proposal by using a Bayesian approach (based on Markov Chain Monte Carlo (MCMC) methods) to deal with the imprecision resulting from Victora et al.'s model. In order to avoid invalid estimated prevalence values which can occur with the original linear model, truncation or a logit transformation of the prevalences are suggested. The Bayesian approach is illustrated using a community study as an example. Imprecision arising from methodological complexities in the community study design, such as multi-stage sampling and clustering, is easily handled within the Bayesian framework by introducing a hierarchical or multilevel model structure. Since growth deficit was also evaluated in the community study, the article may also serve to validate the procedure proposed by Victora et al.

Age Factors↗

PubMed1996

The prevalence of diabetes in Rio de Janeiro, Brazil. The Cooperative Group for the Study of Diabetes Prevalence in Rio De Janeiro.

OBJECTIVE: To assess the prevalence of diabetes and impaired glucose tolerance (IGT) in the adult population of Rio de Janeiro, a two-stage cross-sectional survey was carried out in a random sample of 2,051 individuals aged 30-69 years from Rio de Janeiro city in Brazil. RESEARCH DESIGN AND METHODS: Subjects were first screened by fasting capillary glycemia (FCG). All individuals who screened positive (FCG > 5.6 mmol/l) and every sixth consecutive person who screened negative (FCG < 5.6 mmol/l) were subjected to a 75-g glucose load. Diagnoses of diabetes and IGT were based on World Health Organization criteria. RESULTS: Results from every sixth individual who screened negative were extrapolated to all individuals who screened negative after adjustment for some potential bias in the subsample. Age-adjusted prevalence rates for diabetes and IGT were 7.1 and 9.0%, respectively. The rates were higher (P < 0.01) among women than among men (8.7 vs. 5.2% for diabetes and 11.7 vs. 5.8% for IGT), among obese individuals than among nonobese individuals (7.9 vs. 6.2% for diabetes and 11.4 vs. 7.3% for IGT), and among those with family history of diabetes than among those without family history of diabetes (12.4 vs. 4.8% for diabetes and 13.8 vs. 6.7% for IGT). The rates for diabetes and IGT increased with age, being 1.7 and 4.5%, respectively, for the age-group of 30-39 years, 3.9 and 8.5% for the age-group of 40-49 years, 13.6 and 13% for the age-group of 50-59 years, and 17.3 and 15.3% for the age-group of 60-69 years (P < 0.01). The prevalence of diabetes was higher among individuals with low educational levels than among those with high educational levels (7.3 vs 4.2%). For IGT, the rates increased from the group with intermediate level of education (8.3%) to the low- (11.3%) and high-education group (12.6%). Differences in the rates for whites and non-whites (6.9 vs. 7.1% for diabetes and 8.8 vs. 9.6% for IGT) were not statistically significant. Among those with confirmed diabetes in the survey, 27.6% did not know of their diabetic condition. Among previously diagnosed diabetes (self-reported diabetes), 19.5% were not being treated, 31.8% were on diet only, 40.7% were on oral hypoglycemic drugs, and 8.0% were on insulin. Self-reported prevalence of diabetes was 0.1% for the population < 30 years of age, 4.3% for the 30-69 year old age-group, and 16.6% for those > 70 years of age. CONCLUSIONS: The numbers found for Rio de Janeiro are similar to those for more developed countries and lead us to conclude that the impact of diabetes on public health is the same as in those countries where this disease is considered an important health problem.

Adult↗

PubMed2000

Reduced prevalence of impaired glucose tolerance and no change in prevalence of diabetes despite increasing BMI among Aboriginal people from a group of remote homeland communities.

OBJECTIVE: To examine trends in glucose tolerance and coronary risk among Aboriginal people from a group of homeland communities in central Australia during a 7-year follow-up period. RESEARCH DESIGN AND METHODS: Community-based screenings of adult volunteers were performed in 1988 (n = 437; 93% response rate) and in 1995 (n = 424; 85% response rate). A health promotion intervention program commenced after the 1988 survey that focused on the benefits of exercise and appropriate diet. RESULTS: Mean (95% CI) BMI increased significantly from 22.8 kg/m2 (22.3-23.2) to 24.2 kg/m2 (23.8-24.7) during the follow-up period (P < 0.001). This increase was similar for men and women and across all age-groups. The increase in BMI was greater among subjects residing adjacent to a store compared with those residing in communities located far from a store (P < 0.001). Decreases were evident in the prevalence of impaired glucose tolerance (IGT) (from 22.5 to 10.1% among women, P < 0.001; from 12.2 to 6.5% among men, P = 0.074) and hypercholesterolemia (from 36.7 to 25.8% among women, P < 0.01; from 52.4 to 44.0% among men, P = 0.147), but no change was evident in the prevalence of diabetes. Smoking remained rare among women (<4%) and decreased among men (from 52.9 to 40.8%, P < 0.05). CONCLUSIONS: The trends in glucose intolerance were clearly better than have been observed in other Aboriginal communities. The institution of an intervention program corresponded with reductions in the prevalence of IGT, hypercholesterolemia, and smoking. The prevalence of diabetes remained unaltered despite a significant increase in mean BMI, possibly because of the promotion of increased physical activity levels.

Adolescent↗

PubMed2005

Estimates of prevalence of hip dysplasia in Golden Retrievers and Rottweilers and the influence of bias on published prevalence figures.

OBJECTIVE: To estimate prevalence of canine hip dysplasia (CHD) in Golden Retrievers and Rottweilers and identify sources of bias in published reports. DESIGN: Prospective study. ANIMALS: 200 clinically normal Golden Retrievers and 140 clinically normal Rottweilers between 24 and 60 months of age referred for hip evaluation (group 1) and 93 clinically normal dogs evaluated for Orthopedic Foundation for Animals (OFA) hip certification (group 2). PROCEDURE: Hip-extended pelvic radiographs from group 1 dogs were screened for CHD. Radiographs were evaluated twice; the first interpretation used an OFA-type subjective 7-point scoring system, and the second included the caudolateral curvilinear osteophyte as an additional sign of degenerative joint disease. The OFA submission rate of group 2 dogs was determined from the number of official reports returned from the OFA. RESULTS: Prevalence of CHD in Golden Retrievers ranged from 53% to 73% and in Rottweilers ranged from 41% to 69%. Among dogs referred for OFA evaluation, radiographs from 49 (53%) were submitted to OFA. Of submitted radiographs, 45 (92%) were normal; of radiographs not submitted, 22 (50%) were normal. Radiographs with normal-appearing hips were 8.2 times as likely to be submitted to the OFA. Compared with Golden Retrievers, Rottweiler radiographs were significantly more likely to be submitted for OFA certification. CONCLUSIONS AND CLINICAL RELEVANCE: Prevalence of CHD in these 2 breeds may be much higher than previously reported in the United States. Results suggest substantial bias in the OFA database, which causes lower estimates of prevalence of CHD.

Animals↗

PubMed2005

Prevalence of dental caries among school children in Kulasekharam village: a correlated prevalence survey.

The prevalence of the most common dental disease, dental caries has been a subject of intense debate due to its importance in statistical measurement and for the clinical control of this disease. Kulasekharam, a small village, situated in Kanyakumari District has a large number of hospitals and a dental college; yet the people seem to have a very poor knowledge about dental health. This prompted us to do a study among school children in the age group of 6-12 years to assess the prevalence of dental caries and to increase their awareness toward oral health. This paper further strives to find any correlation between patient awareness and prevalence of dental decay. The dental caries prevalence was noted to be low compared to the WHO-recommended values. The fluoride level was also tested and was found to be far below the optimal level.

Attitude to Health↗

PubMedDate not supplied

[Prevalence of tuberculosis infection prevalence in a provincial prison].

BACKGROUND: Tuberculosis in prisons is a serious public health problem. In those penitentiaries with a high prevalence of co-infection by M. tuberculosis and HIV infection, the treatment of the tubercular infection can be an important tool for prevention and control. Ascertaining the prevalence of tubercular infection, the access and adherence to the treatment of tubercular infection in a prison population without a history of treatment of tubercular disease or infection could be of great interest in order to assess the efficacy of this measure. METHODS: A cross study was made of the population confined at 28 June 1999 in a Penitentiary with a programme of prevention and control of tuberculosis, based on the directly observed therapy (DOT) of the patients, on early diagnosis and the treatment of the tubercular infection. The treatment of the tubercular infection was prescribed following individualised counselling, reaching an agreement with the patient as to the modality of treatment (DOT, daily or twice-weekly check-up). The clinical histories of the patients were reviewed in order to determine the prevalence of patients infected by M. tuberculosis, of those who had completed treatment and of those who were still undergoing treatment of tubercular infection. The Eidus-Hamilton test was performed in the case of patients under treatment for tubercular infection in order to evaluate compliance. RESULTS: Of the 219 inmates, 127 (58%) presented criteria of tubercular infection. Treatment of the tubercular infection was indicated in 113 people of whom 29 refused (25.7%). Of the 84 patients who initiated treatment for their tubercular infection, 22 (26.2%) abandoned it, 39 (46.4%) had finalized the treatment, and 23 (27.4%) were still undergoing treatment. Of the latter, 95.7% showed positive to the Eidus-Hamilton test. 48% of those infected by M. tuberculosis, either had finalized or were undergoing the treatment against tubercular infection correctly. CONCLUSION: The prevalence of tubercular infection observed in this group is very high. Acceptable levels of access and adherence to the treatment of tubercular infection have been observed, which translates into a high level of treatment coverage of this infection in the population studied.

Adult↗

PubMed2003

Prevalence of current cigarette smoking among adults and changes in prevalence of current and some day smoking--United States, 1996-2001.

Tobacco use, particularly cigarette smoking, is the leading preventable cause of death in the United States and is responsible for approximately 440,000 deaths each year. One of the national health objectives for 2010 is to reduce the prevalence of cigarette smoking among adults to < or = 12% (objective 27.1). To examine the prevalence of smoking for the 50 states, the District of Columbia (DC), Guam, Puerto Rico, and the Virgin Islands, CDC analyzed data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicate that, during 2001, the median adult current smoking prevalence was 23.4% (range: 13.3%-30.9%) for the states and DC, and 12.5% (range: 9.8%-31.4%) for Guam, Puerto Rico, and the Virgin Islands. During 1996-2001, the prevalence of current smoking was relatively stable in 41 states and DC, and the proportion of current smokers who were some day smokers increased significantly in 31 of those states and DC. Because the only safe alternative to smoking is cessation, interventions should target all smokers to help them quit smoking completely.

Adult↗

PubMed2003

Prevalence of nosocomial infections in 15 Italian hospitals: first point prevalance study for the INF-NOS project.

BACKGROUND: The aim of our study was to assess the magnitude of nosocomial infections (NI) in 15 Italian hospitals. PATIENTS AND METHODS: A multicenter point prevalence study of NI was carried out in October 2001 among eight medical, surgical and intensive care units in hospitals with more than 400 beds, after a pilot phase performed in April 2001. RESULTS: Of the 2,165 surveyed patients, 163 had a total of 179 NIs. The global prevalence rate of patients with NI and of NI was respectively 7.5% (95% CI 6.4-8.6) and 8.3% (95% CI 7.1-9.4), ranging from 5.5% (95% CI 4.2-6.8) in medical wards to 34.2% (95% CI 25.7-42.7) in intensive care units (ICUs). The NI prevalence was higher in: hospitals that did not have an infection control committee (ICC) compared to hospitals with an ICC (10.3%, 95% CI 6.4-10.1 versus 7.2, 95% CI 6.0-8.3, p = 0.08); university hospitals compared with non-teaching hospitals (9.4%, 95% CI 4.5-14.2 versus 7.4%, 95% CI 6.3-8.5, p = 0.4) and; hospitals with 1,000 or more beds compared to lower volume hospitals (9.5%, 95% CI 7.3-11.7 versus 6.6%, 95% CI 5.3-7.8, p = 0.02). The most prevalent infections found were lower respiratory tract infections, urinary tract infections and surgical-site infections, representing 38.0%, 20.1% and 12.8%, respectively, of all NI. Among 1,674 patients without any infection, 575 (34.3%) of them had been undergoing antibiotic treatment at the time of the survey. CONCLUSION: The high rate of NI, particularly in ICUs, and the high number of improper procedures emphasize the need to develop clinically-oriented guidelines, tailor active infection control programs and implement an active ICU surveillance system.

Bacteremia↗

PubMed1988

HTLV-1 in Switzerland: low prevalence of specific antibodies in HIV risk groups, high prevalence of cross-reactive antibodies in normal blood donors.

Sera from various Swiss population groups were tested for antibodies against the human T-cell leukemia virus type I (HTLV-I). Particle agglutination and ELISA were performed for screening; Western blot was done for confirmation. True-positive sera were found at a prevalence of 0.12% in a cohort of 846 individuals at risk for AIDS tested in 1984-1985. Prevalences of 0.35% were found among 575 HIV-I positives tested in 1987, and of 1.3% among 292 HIV-I positives of a different group tested in 1988. The 6 positives found in our study represent the first cases of HTLV-I infection, or HIV-I/HTLV-I double infection, diagnosed in Switzerland. In addition, high proportions of sera, regardless of whether they were from normal blood donors, HIV-positives, or individuals at risk for AIDS, had antibodies that reacted weakly with one or several proteins of the size of viral gag proteins. The prevalence of such antibodies in normal donors was in the range of 10 to 40%, depending on the strictness of interpretation. Competition Western blots performed with some of these sera showed that these antibodies reacted with HTLV-I, but not with HIV-I or cellular antigens, and had a lower affinity to HTLV-I proteins than the antibodies of human or goat antisera. The results indicate that these antibodies may be induced by agents immunologically related to, but different from, HTLV-I, which are highly prevalent in the Swiss population. Oligopeptide stretches with sequence homology to HTLV-I are known to exist in various normal body proteins, several infectious agents including common viruses and protozoa, but the results might also indicate the existence of additional human retroviruses. Screening of blood donors with sensitive tests for antibodies to HTLV-I might produce an unacceptably high rate of false-positive results, if stringent rules of interpretation analogous to those common in HIV screening are not used.

Acquired Immunodeficiency Syndrome↗