Seroepidemiology of enteric fever and brucellosis in a developing country

The seroepidemiology of infection due to S. typhi and Brucella spp. in a sub-tropical, developing country of the Middle East was investigated in 130 children of age less than 1 to 15 years, 117 young adults (16-30 years) and in a further 40 adults (greater than 30 years) using an agglutination test to detect antibodies to of S. typhi, B. abortus and B. melitensis. Only 4.5% of the children's and adult's sera respectively showed the presence of antibodies to both O and H antigens of S. typhi with reciprocal titers greater than or equal to 80. Prevalence rates of 11.6%, 11.3% respectively in children and adults of antibodies to B. abortus with reciprocal titers greater than or equal to 80 and similarly 13.1%, 12.4% to B. melitensis were found. The usefulness of a single Widal test to diagnose enteric fever in a non-endemic area and the agglutination test in the diagnosis of brucellosis in an endemic area was investigated. Of 244 patients with suspected enteric fever, the sera of 100 showed reciprocal antibody titers 80 to both O and H antigens and included in these were 8 patients with concurrent culture positivity. Among 138 children and adults with suspected brucellosis, 29 culture proven cases where serologically confirmed and a further 90 were detected serologically. The sera of all the culture proven cases exhibited antibody reciprocal titer greater than or equal to 640. A similar antibody response was noted in seventy-two of the culture negative cases diagnosed serologically for brucellosis. In culture proven, cases B. melitensis was the isolate. Comparative evaluation indicated the potential usefulness of the Rose Bengal Antigen Slide Agglutination Test (Brucelloside Test) as a screening test in the serodiagnosis of human brucellosis.     

The pattern of morbidity after typhoons in a tropical country

The paper examines whether there was a greater risk of certain infectious diseases after typhoons combined with floods in Manila, which experienced three typhoons in 1970 one of which was the most disastrous ever recorded. The data on morbidity of cholera, typhoid and clinical syndromes diagnosed as gastroenteritis, pneumonia, bronchitis and influenza from routine but active collecting were statistically examined and compared for seasonal trends with those of Baguio, a town which did not experience typhoons. In spite of increased rainfall, destruction and temporary breakdown of sanitation, no significant differences attributable to the typhoons were detected in any of the studied diseases. In particular, there was no increase in typhoid nor in cholera in this cholera endemic town. The observed higher incidence of respiratory and to some extent also of gastrointestinal diseases was not statistically significant.

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Zusammenfassung In der Arbeit wird geprüft, ob die Häufigkeit von bestimmten Infektionskrankheiten nach Taifunen in Verbindung mit Überschwemmungen in Manila, zunahm, wo 1970 3 Taifune auftraten, von denen einer der verheerendste war, der je vorher berichtet wurde. Die Krankheitshäufigkeiten von Cholera, Typhus, Gastroenteritis, Pneumonie, Bronchitis und Influenza wurden statistisch ausgewertet und mit den Häufigkeiten der gleichen Krankheiten in Baguio, einer Stadt ohne Taifune, verglichen. Trotz vermehrter Regenfälle, Zerstörungen und vorübergehendem Ausfall der sanitären Einrichtungen ergab sich kein signifikanter Anstieg in der Häufigkeit der Krankheiten als Folge der Taifune. Obwohl Cholera in Manila endemisch ist, ergab sich weder ein Anstieg von Cholera noch Typhus. Ein beobachteter Anstieg der Häufigkeit von Krankheiten der Atemwege und des Magendarmtraktes war statistisch nicht signifikant.

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Resume Dans ce mémoire, on recherche si la fréquence de certaines maladies infectieuses augmente à Manille après le passage de typhons suivis d'innondations. Pour ce faire, on s'est basé sur 3 typhons de 1970, dont l'un fut le plus dévastateur de mémoire d'homme. Le nombre de décès dûs au choléra et à la typhoïde ainsi que celui des diagnostiques cliniques de gastroentérite, de pneumonie, de bronchite et de grippe signalés dans les rapports de routine furent analysés statistiquement et comparés aux valeurs correspondantes de Banguio, ville qui n'avait pas été ravagée par des cyclones. Malgré l'augmentation des précipitations, la destruction des canalisations et l'absence momentanée d'installations sanitaires, on n'a pas pu déceler d'augmentation significative, dûe aux typhons, du nombre de cas de maladies infectieuses. Bien que le choléra soit endémique à Manille, on n'en a pas constaté davantage de cas, d'ailleurs de ceux de typhus. L'augmentation constatée des maladies des voies respiratoires ou du système gastro-intestinal n'est pas significative, elle non plus.

     

Environmental health in primary schools in a developing country

In an effort to elucidate the environmental health in developing countries, the environmental and sanitary conditions of Riyadh primary schools were assessed by use of a scoring evaluation sheet for 20 schools representative of primary schools of Riyadh. 20% of schools have been found to be ideally situated and only one fourth of schools with proper building. As regards class rooms, only 25% of them have adequate floor area, window area and are suitably illuminated. Drinking fountains per pupil were inadequate. Overall, environmental rating of 10% excellent, 30% good, and 60% bad were detected in present study. The bad situation of almost two-thirds of primary school buildings in Riyadh is alarming. Remedial suggestion have been forwarded.     

Seasonality of births: stability and change in a developing country

A marked seasonality of births for the two main ethnic groups of peninsular Malaysia, far exceeding the cyclic fluctuations in births in the United States and Canada, was reported for the 1960s. A 36% excess of births over the average monthly number was observed among Malays each January. Among the ethnic Chinese in Malaysia a regular periodicity in the numbers of births was also found, but it was far less marked and the peak occurred in October or November. The peaks in both groups were due in large measure to conceptions that correlate with religious observances or holidays. Here I report on cyclic birth patterns in peninsular Malaysia for the period 1970-1985. Rapid economic development has occurred during this time and has brought with it demographic changes, such as a massive rise in contraceptive use and a decline in birth rates. These demographic changes have been accompanied by the loss of the pronounced seasonal pattern of births among the Malays. The seasonality of Malay births is now of roughly the same magnitude as the seasonality in the United States and Canada, whereas seasonality of births among the Chinese in Malaysia remains essentially unchanged.     

Adolescent lifestyle and behaviour: a survey from a developing country

Introduction

Adolescents form two-thirds of our population. This is a unique group of people with special needs. Our survey aims to identify the lifestyle and behavioral patterns in this group of people and subsequently come up with issues that warrant special attention.

Methods

A survey was performed in various schools of Karachi. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire. Participants included all willing persons between 12–19 years of age.

Results

Most adolescents with lifestyle issues fell in the age group of 16–18 years. Females were more depressed than males and had more sleep problems. Substance abuse and other addictions were documented more in males. Watching television or listening to music was stated as the most common late night activity (61.8%) and therefore was also referred to as the contributory factor for less than eight hours of sleep each day. (58.9%) of the respondents are getting less than eight hours of sleep daily. (41.5%) of the respondents who felt depressed sought treatment for it. Quite a few of them were also indulged in substance abuse and other addictions. Only (16.8%) of the respondents opined that physical activity is essential for health. Thirty-five adolescents out of all the respondents were smoking cigarettes currently, whereas 7% of the respondents chewed paan (areca nut). Peer pressure was the most common reason (37.1%) to start smoking.

Conclusion

Adolescents need to be treated as a distinct segment of our population and it is important to realize and address their health and lifestyle problems. Inadequate sleep, depression and smoking were the leading unhealthy behaviours among the respondents. Families can play an important role to help these adolescents live a healthier life. Further research studies should be carried out to highlight issues of concern and their possible solutions in this population.     

Bacteriological quality control in human milk-banking.

The bacteriological quality of pooled human milk donated to the Oxford milk bank was analysed and the effects on bacteriology of sterilisation of the milk-collecting vessels in the home with hypochlorite solution and of Holder pasteurisation in a purpose-built human-milk pasteuriser were studied. Collecting milk in hypochlorite-sterilised vessels resulted in a significantly lower bacterial count of both pathogens and species of unlikely pathogenicity before pasteurisation and significantly increased the chance of pasteurisation giving a sterile product. Potentially pathogenic organisms grown in untreated milk were Escherichia coli, Staphylococcus aureus, and group B beta-haemolytic streptococci. Seven species of organisms of unlikely pathogenicity were also identified. Pasteurisation eliminated all potential pathogens from milk but did not reliably remove any of the species of unlikely pathogens. Banked human milk may be contaminated with bacteria which are known to be capable of producing lipases, proteases, and decarboxylases. Accurate pasteurisation, together with attention to the sterility of the collecting vessels, results in a bacteriologically safe product that retains many of the protective properties of raw milk.     

Local environmental risk assessment of anticancer drugs in a developing country

Abstract

Anticancer drugs used in cancer treatment are excreted unchanged or as metabolites by feces and urine in hospitals and households. These drugs enter the municipal sewage system but wastewater treatment plants are not capable of removing all of these micro pollutants. In many countries such as Brazil, sanitation departments do not provide service, nor have access to all of the population, therefore most sewage is still released into untreated receiving bodies. This study analyzes the consumption of anticancer drugs in a Brazilian hospital located in one of the 10 municipalities with the best sanitation index in the country. It estimates its environmental risk in aquatic matrixes by the European Guideline on the Environmental Risk Assessment of Medicinal Products for Human Use. Among the 20 drugs analyzed, the three most consumed (cyclophosphamide, 5-fluoruracil, and cytarabine) show a predicted environmental concentration value greater than the action limit of 0.01?µg/L recommended by the guideline. The risk assessment was performed on all pharmaceuticals consumed to get a greater awareness of risk. Results do not indicate local environmental risk but, considering that the study was performed under the best sanitation scenario, it cannot be extrapolated in the other municipalities. The study highlights that development of suitable methodologies should be considered to perform environmental risk assessment of pharmaceuticals in developing countries sanitation conditions.     

Transfer of medical technology from a developed to a developing country

Medical care is increasingly dependent on technology, but what are the problems involved in the transfer of technology from a developed to a developing country? What are the administrative, personnel and engineering problems? We address these questions in the context of our experience of transferring the medical technology and knowledge necessary for the development of nuclear medicine facilities in Kuwait.     

Application of ergonomic principles in the factories of a developing country.

Several examples of the need for the application of sound ergonomic principles in Singapore factories are presented. Emphasis is laid on the necessity to consider local habits and customs in the devising of ergonomic solutions to occupational health problems. Examples are given concerning vehicle cabin design, difficulties due to climate differences in applying personal protective equipment or in building design, inadequate displays warning dangers, and health consequences of technical improvements, safety measures, or measures to achieve greater efficiency. Sometimes ergonomic practices may promote productivity but be prejudicial to health. In rapidly-changing and cosmopolitan Singapore, ergonomic principles are vital to all facets of manufacturing processes and the transportation and distribution of goods, but ergonomic practice can be complicated by several factors as indicated by such examples.     

Bacteriological quality of organically grown leaf lettuce in Norway

AIM: To investigate bacteriological quality in organically grown leaf lettuce, including the presence of selected pathogenic bacteria, and to obtain information about organic lettuce production, including fertilizing regimes. METHODS AND RESULTS: Altogether 179 samples of Norwegian organically grown lettuce were collected from 12 producers. Escherichia coli was isolated from 16 of the lettuce samples, but in 12 of these contamination was sufficiently low (<100 CFU g(-1)) that they would be considered to be of acceptable bacteriological quality. Escherichia coli O157 and Salmonella were not detected in any of the samples. Listeria monocytogenes serogroups 1 and 4 were isolated from two samples. CONCLUSIONS: Organic lettuce produced in Norway was generally of acceptable bacteriological quality, but the results show that contamination of organic lettuce with E. coli and L. monocytogenes do occasionally occur. SIGNIFICANCE AND IMPACT OF THE STUDY: These results suggest that organically grown lettuce may be contaminated with E. coli and L. monocytogenes during cultivation.     

Bacteriological quality and shelf life of ground beef.

The bacteriological quality of unfrozen raw ground beef was evaluated after 0, 3, 6, 9, 12, 15, and 18 days of storage at 29 +/- 1 F (-1.7 +/- 0.6 C). At the time of fabrication, all of the ground beef samples contained 10(6) or fewer total aerobic and psychrotrophic bacteria/g; 81% contained 100 or fewer coliforms/g; 94% contained 100 or fewer Escherichia coli/g; and all of the samples contained 100 or fewer coagulase-positive Staphylococcus aureus and Clostridium perfringens/g. Total aerobic and psychrotrophic bacteria increased by 1 log between 3 and 18 days of storage. Coliform and E. coli counts decreased during storage, whereas coagulase-positive S. aureus and C. perfringens counts did not change significantly. These data indicate that meat processors, wholesalers, and retailers could improve the bacteriological quality and prolong the shelf life of ground beef packaged in oxygen-impermeable film if the temperature of product never exceeded 29 +/- 1 F (-1.7 +/- 0.6 C).     

Bacteriological quality of fabrics washed at lower-than-standard temperatures in a hospital laundry facility

We determined whether the bacteriological quality of fabrics cleaned in a hospital laundry could be maintained at wash temperatures lower than 75 degrees C by the use of economically reasonable formulas and wash conditions. Three groups of bacteria were examined to determine bacteriological quality: aerobic, nonexacting chemoorganotrophs, staphylococci, and total coliforms. The distribution of bacteria on soiled fabric was patchy, with staphylococci and total coliforms ranging from less than 0.1 to greater than 4 X 10(3) CFU/cm2 and chemoorganotrophs ranging from less than 0.1 to greater than 5 X 10(5) CFU/cm2. The washing process routinely produced fabric containing less than 1 CFU/cm2. Low-temperature (47.8 to 60.0 degrees C) wash procedures eliminated all bacterial groups at least as effectively as did high-temperature procedures. The effectiveness of bacterial density reduction at low temperature was augmented by increased concentrations of bleach. Successful low-temperature washing such as that shown here may save both energy and money for hospitals.     

Benthic quality assessment in a naturally- and human-stressed tropical estuary

Cochin estuary, one of the largest tropical estuaries of India, supports high levels of human pressure throughout the year and natural stress during monsoon season. Six stations were monitored between 2002 and 2004 covering the pre-monsoon, monsoon, and post-monsoon seasons. Ecological status of macrobenthos was assessed using the AZTI's Marine Biotic Index (AMBI) and the multivariate-AMBI (M-AMBI). The overall ‘moderate’ disturbance classification (according to AMBI) and ‘moderate-poor’ ecological status (according to M-AMBI) indicate that the macrobenthos in the estuary experiences stress. There was a gradient of increasing quality from the most degraded northern site to the main estuary, downstream. Monsoon caused further reductions in quality of macrobenthos in the main estuary, while the degraded northern station showed improvement in 2003, when the monsoon was strong. The assessment of the Cochin Estuary using AMBI and M-AMBI indicates where this water body stands in comparison to European and other water bodies, which may be useful for developing required protective measures in tropical systems and to design monitoring strategies.