Urban Chagas disease in children and women in primary care centres in Buenos Aires,Argentina

The primary objective of this study was to estimate the prevalence of this disease inwomen of childbearing age and children treated at health centres in underservicedareas of the city of Buenos Aires. Demographic and Chagas disease status data werecollected. Samples for Chagas disease serology were obtained on filter paper and thereactive results were confirmed with conventional samples. A total of 1,786 subjectswere screened and 73 positive screening results were obtained: 17 were from childrenand 56 were from women. The Trypanosoma cruzi infection risk wasgreater in those individuals who had relatives with Chagas disease, who rememberseeing kissing bugs, who were of Bolivian nationality or were born in the Argentineprovince of Santiago del Estero. The overall prevalence of Chagas disease was 4.08%.Due to migration, Chagas disease is currently predominantly urban. The observedprevalence requires health programme activities that are aimed at urban children andtheir mothers. Most children were infected congenitally, which reinforces the needfor Chagas disease screening of all pregnant women and their babies in Argentina. Theactive search for new cases is important because the appropriate treatment inchildren has a high cure rate.     

Evolution of the prevalence and incidence of consumption of antidepressants in a Spanish region (2002-2007)

Background The treatment of depressive disorders involves the administration of drugs of proven efficacy at the correct doses and for specific periods of time, in conjunction with psychotherapeutic support.Aim To assess the evolution of the consumption of antidepressants in the Health Region of Lleida (Spain).Method A retrospective cohort study of the antidepressant medication prescribed via the Spanish National Health System in the Health Region of Lleida between 2002 and 2007. The variables recorded in the study were age, sex, number of patients in antidepressant treatment in the Health Region of Lleida, length of treatment and type of drug. The prevalence of the population of the health region who were receiving antidepressant drugs and the incidence for each particular year was calculated.Results The mean prevalence of patients in treatment with antidepressant drugs was 8.5% (5% in men and 12.1% in women). The highest prevalence was observed in the higher age groups. By therapeutic groups, selective serotonin reuptake inhibitors (SSRIs) were the most frequently prescribed, five times more than the next group, tricyclics/heterocyclics. The follow-up assessment of the medication prescribed showed that one out of every four patients did not continue treatment after the first month, and 38.4% did not continue after three months. Very few were treated for more than six months.Conclusion This study stresses the high rate of antidepressant treatment in the older women's group. One of every four treatments initiated did not last more than one month. Over the six-year period, 16 506 patients dropped out of treatment.     

Time trends in the prevalence of birth defects in Texas 1999–2007: Real or artifactual?

BACKGROUND: Few studies have reported time trends for total birth defects or for a comprehensive range of phenotypes. METHODS: We examined data from the Texas Birth Defects Registry (TBDR) from 1999 through 2007. Poisson regression was used to fit trend lines to birth prevalence over time for total birth defects (each infant/fetus counted once), for every birth defect collected by the TBDR, and for subsets of cases or defects grouped various ways. RESULTS: From 1999 through 2007, birth prevalence of total birth defects in Texas increased 3.6% per year. Increases were observed in all population groups, persisted after adjustment for demographic characteristics, and were strongest in regions of Texas that were more urban. There was a wide variety of different defects showing significant increases. The trends of several defects were driven by their mild cases. Perhaps the most compelling finding was that larger upward trends were observed in defects that had been rated as more susceptible to diagnostic variation. One notable exception to that was gastroschisis, which showed an average increase of over 5% per year, the total birth defects rate in TBDR increased at 3.6% per year, similar to 3.7% per year in birth certificate check boxes. CONCLUSIONS: In our opinion, the weight of evidence in our study suggests that the observed increase over time in total birth defects and in many specific birth defects is artifactual. This likely reflects increased awareness, referral, detection, or documentation in health care facilities visited by TBDR staff, resulting in more complete ascertainment by the registry, rather than a true change over time in the occurrence of most birth defects. Birth Defects Research (Part A), 2011. © 2011 Wiley‐Liss, Inc.