The effect of systematic screening of the general population on TB case notification rates

2021 ◽  
Vol 25 (12) ◽  
pp. 964-973
Author(s):  
L. Telisinghe ◽  
D. Shaweno ◽  
R. J. Hayes ◽  
P. J. Dodd ◽  
H. M. Ayles
Keyword(s):  
General Population ◽  
Method Development ◽  
Transmission Model ◽  
Published Data ◽  
Systematic Screening ◽  
Model Simulations ◽  
Targeted Screening ◽  
Relative Decline ◽  
Case Notification ◽  
Incidence Prevalence

BACKGROUND: Understanding how TB case notification rates (TB-CNR) change with TB screening and their association with underlying TB incidence/prevalence could inform how they are best used to monitor screening impact.METHODS: We undertook a systematic review to identify articles published between 1 January 1980 and 13 April 2020 on TB-CNR trends associated with TB screening in the general-population. Using a simple compartmental TB transmission model, we modelled TB-CNRs, incidence and prevalence dynamics during 5 years of screening.RESULTS: Of 27,282 articles, seven before/after studies were eligible. Two involved population-wide screening, while five used targeted screening. The data suggest screening was associated with initial increases in TB-CNRs. Increases were greatest with population-wide screening, where screening identified a large proportion of notified people with TB. Only one study reported on sustained screening; TB-CNR trends were compatible with model simulations. Model simulations always showed a peak in TB-CNRs with screening. Following the peak, TB-CNRs declined but were typically sustained above baseline during the intervention. Incidence and prevalence decreased during the intervention; the relative decline in incidence was smaller than the decline in prevalence.CONCLUSIONS: Published data on TB-CNR trends with TB screening are limited. These data are needed to identify generalisable patterns and enable method development for inferring underlying TB incidence/prevalence from TB-CNR trends.

Personality of Clown Doctors

2016 ◽  
Vol 37 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Alberto Dionigi
Keyword(s):  
General Population ◽  
Personality Traits ◽  
Big Five ◽  
Normal Population ◽  
Big Five Personality Traits ◽  
Published Data ◽  
Big Five Personality

Abstract. In recent years, both professional and volunteer clowns have become familiar in health settings. The clown represents a peculiar humorist’s character, strictly associated with the performer’s own personality. In this study, the Big Five personality traits (BFI) of 155 Italian clown doctors (130 volunteers and 25 professionals) were compared to published data for the normal population. This study highlighted specific differences between clown doctors and the general population: Clown doctors showed higher agreeableness, conscientiousness, openness, and extraversion, as well as lower neuroticism compared to other people. Moreover, specific differences emerged comparing volunteers and professionals: Professional clowns showed significantly lower in agreeableness compared to their unpaid colleagues. The results are also discussed with reference to previous studies conducted on groups of humorists. Clowns’ personalities showed some peculiarities that can help to explain the facility for their performances in the health setting and that are different than those of other groups of humorists.

scholarly journals The Denominator problem: estimating the size of local populations of men-who-have-sex-with-men and rates of HIV and other STIs in Switzerland

2019 ◽  
Vol 95 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Axel Jeremias Schmidt ◽  
Ekkehardt Altpeter
Keyword(s):  
General Population ◽  
Population Data ◽  
Hiv Prevalence ◽  
Postal Code ◽  
Published Data ◽  
Similar Data ◽  
Online Surveys ◽  
Credible Intervals ◽  
Sex With Men ◽  
Notification Data

ObjectivesThere is no estimate of the current number of men who have sex with men (MSM) in Switzerland, or of their geographical distribution. We aimed to (1) estimate MSM concentration factors and population sizes for 83 Swiss postal code areas (PCA), including the nine largest Swiss cities, and (2) calculate MSM-specific local HIV prevalence and yearly rates of diagnosed HIV, hepatitis C virus (HCV), syphilis and gonorrhoea.MethodsWe triangulated data from general population estimates, MSM online surveys, published data on HIV prevalence and Swiss notification data for HIV and STDs. We compared two different formulae for the estimation of local MSM populations and calculated Bayesian 95%-credible-intervals (CrI) for each PCA.ResultsAcross Switzerland, we estimate the MSM population aged 15–64 at roughly 80 000 men (95% CrI 64 000–96 000). (1) MSM in Switzerland were most concentrated in the five largest cities of Zurich, Geneva, Lausanne, Bern and Basel. (2) We estimate that in 2012, 6300 MSM, or 8.0%, were living with HIV, both diagnosed and undiagnosed and 1700 MSM, or 2.2%, had non-suppressed HIV infection. Between 2010 and 2013, average yearly rates of diagnosed HIV, HCV, syphilis and gonorrhoea were 0.3%, 0.02%, 0.4 % and 0.4 %, respectively.ConclusionsCombining general population data, MSM online surveys and notification data allows the calculation of realistic estimates of local MSM populations and thus proportions of MSM with diagnosed HIV and other STIs, with implications for prevention planning, commissioning of health services and counselling MSM on HIV/STI risk. Our methodology for Switzerland is transferable to other countries with similar data sources.

scholarly journals Risk of death among people with rare autoimmune diseases compared to the general population in England during the 2020 COVID-19 pandemic

Rheumatology ◽  
2020 ◽  
Author(s):  
Emily Peach ◽  
Megan Rutter ◽  
Peter Lanyon ◽  
Matthew J Grainge ◽  
Richard Hubbard ◽  
...  
Keyword(s):  
General Population ◽  
Healthcare Services ◽  
Mortality Rates ◽  
Published Data ◽  
Risk Of Death ◽  
Increased Risk ◽  
Specific Mortality ◽  
Population Mortality ◽  
The Uk ◽  
Recorded Diagnosis

Abstract Objectives To quantify the risk of death among people with rare autoimmune rheumatic diseases (RAIRD) during the UK 2020 COVID-19 pandemic compared with the general population, and compared with their pre-COVID risk. Methods We conducted a cohort study in Hospital Episode Statistics for England 2003 onwards, and linked data from the NHS Personal Demographics Service. We used ONS published data for general population mortality rates. Results We included 168 691 people with a recorded diagnosis of RAIRD alive on 01/03/2020. Their median age was 61.7 (IQR 41.5–75.4) years, and 118 379 (70.2%) were female. Our case ascertainment methods had a positive predictive value of 85%. 1,815 (1.1%) participants died during March and April 2020. The age-standardised mortality rate (ASMR) among people with RAIRD (3669.3, 95% CI 3500.4–3838.1 per 100 000 person-years) was 1.44 (95% CI 1.42–1.45) times higher than the average ASMR during the same months of the previous 5 years, whereas in the general population of England it was 1.38 times higher. Age-specific mortality rates in people with RAIRD compared with the pre-COVID rates were higher from the age of 35 upwards, whereas in the general population the increased risk began from age 55 upwards. Women had a greater increase in mortality rates during COVID-19 compared with men. Conclusion The risk of all-cause death is more prominently raised during COVID-19 among people with RAIRD than among the general population. We urgently need to quantify how much risk is due to COVID-19 infection and how much is due to disruption to healthcare services.

scholarly journals Population-Based Screening or Targeted Screening Based on Initial Clinical Risk Assessment for Atrial Fibrillation: A Report from the Huawei Heart Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1493
Author(s):  
Yutao Guo ◽  
Hao Wang ◽  
Hui Zhang ◽  
Yundai Chen ◽  
Gregory Y. H. Lip
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Population Based ◽  
Population Screening ◽  
Smart Devices ◽  
Preventive Strategy ◽  
Population Approach ◽  
Clinical Risk ◽  
Heart Study ◽  
Targeted Screening

Background: A general-population approach has been advocated to improve the screening of patients with atrial fibrillation (AF). A more pragmatic alternative may be targeted screening of patients at high risk of developing AF. We assess the value of a simple clinical risk score, C2HEST (C2, coronary artery disease/chronic obstructive pulmonary disease; COPD (1 point each); H, hypertension; E, elderly (age ≥75, doubled); S, systolic heart failure; HF (doubled); T, hyperthyroidism)); to facilitate population screening and detection of incident AF in the general population, in a prespecified ancillary analysis of the Huawei Heart Study. Methods: The Huawei Heart Study investigated general population screening for AF, identified using photoplethysmography (PPG)-based HUAWEI smart devices. We compared the value of a general population approach to a target screening approach between 26 October 2018 and 20 November 2019. Results: There were 644,124 individuals (mean age ± standard deviation, SD 34 ± 11; female 15.9%) who monitored their pulse rhythm using smart devices, among which 209,274 individuals (mean age 34 years, SD11; 10.6% female) completed the questionnaire on cardiovascular risk factors, with 739 detecting AF. Of these, 31.4% (n = 65,810) subjects reported palpitations. The median (interquartile range, IQR) duration to first detected AF was 11 (1–46), 6 (1–49), and 4 (1–24) in the population with low, intermediate, and high C2HEST score category, respectively (p = 0.03). Detected AF events rates increased with increasing C2HEST score points, stratified by age (p for trend, p < 0.001). Hazard ratios of the components of the C2HEST score for detected AF were between 1.31 and 2.75. A combination of symptomatic palpitations and C2HEST score increased prediction of AF detection, compared to using C2HEST score alone (c-indexes 0.72 vs. 0.76, Delong test, p < 0.001). Conclusions: The C2HEST score, especially when combined with symptoms, could facilitate a targeted population-based screening and preventive strategy for AF.

scholarly journals Systematic literature review of the burden and outcomes of infections due to multidrug-resistant organisms in Europe: the ABOUT-MDRO project protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e030608 ◽  
Author(s):  
Blanca Anaya-Baz ◽  
Natalia Maldonado ◽  
Zaira R Palacios-Baena ◽  
Virginia Palomo ◽  
Maria Diletta Pezzani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Multidrug Resistant ◽  
Cochrane Library ◽  
Published Data ◽  
Surveillance Systems ◽  
Carbapenem Resistant ◽  
Hospitalised Patients ◽  
Multidrug Resistant Organisms ◽  
Tract Infections ◽  
Incidence Prevalence

IntroductionDespite the increasing importance of infections due to multidrug-resistant organisms (MDROs), there is a lack of comprehensive information about the burden of disease and outcomes of key infections caused by these pathogens. The aim of the ABOUT-MDRO (A systematic review on the burden and outcomes of infections due to multidrug resitant organisms) project is to provide estimations of the burden of some key infections and their outcomes caused by the target MDROs.Methods and analysisA systematic literature search will be performed using MEDLINE/PubMed, Elsevier’s SCOPUS, Cochrane library, Clinical trials and Web of Science, as well as the Surveillance Systems from Public Health Institutions and Scientific Societies for Antimicrobial Resistance and Healthcare-Associated Infections in Europe database of European surveillance systems, for data on prevalence/incidence, mortality and length of stay of target infections in hospitalised patients (including ventilator-associated pneumonia, hospital-acquired pneumonia, complicated intra-abdominal infections, complicated urinary tract infections, skin and soft tissue infections and bloodstream infections) and in specific populations (children, hospital wards, neutropenic patients) caused by cephalosporin-resistant or carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter spp., methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococcus spp. The information retrieved will be tabulated and pooled estimates and 95% CIs calculated of rates and outcomes, using random effects models. Relationships between rates and outcomes in randomised control trials and epidemiological studies, and data of proportions and incidence/prevalence rates will also be analysed. The information collected in this study will be useful for identifying gaps in our knowledge in terms of incidence/prevalence and clinical outcomes of infections caused by MDROs, and for informing priorities in infection control and the research and design of appropriate studies.Ethics and disseminationThis study will be based on published data so we did not require ethical approval. Formal consent is not required. The results of this review will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Data will be presented at international conferences and published in peer-reviewed journals.Registration detailsPROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42019124185).

Depressive syndromes and the classification of patients

1971 ◽  
Vol 1 (4) ◽  
pp. 333-338 ◽  
Author(s):  
R. K. Garside ◽  
D. W. K. Kay ◽  
I. C. Wilson ◽  
I. D. Deaton ◽  
M. Roth
Keyword(s):  
General Population ◽  
Published Data ◽  
Depressed Patients ◽  
Category Type ◽  
Depressive Syndromes ◽  
The Relationship

SYNOPSISThe scores of 269 depressed patients on the Depressive Category-Type Scale were analysed. The distributions of component and total scores were found to be bimodal, indicating that most depressed patients can be divided into an endogenous group and another characterized by the presence of neurotic features and the absence of endogenous ones. These findings were discussed in relation to those of other investigators. The relationship between the differentiation of syndromes and the classification of patients into corresponding diagnostic groups was considered. Finally, it was suggested that it should be interesting to try to estimate, from published data, the correlation between endogenous and neurotic depression in the general population.

A five-year audit of the treatment of extensive anogenital warts by day case electrosurgery under general anaesthesia

2002 ◽  
Vol 13 (11) ◽  
pp. 786-789 ◽  
Author(s):  
Rachel Challenor ◽  
Ian Alexander
Keyword(s):  
General Population ◽  
Confidence Interval ◽  
General Anaesthesia ◽  
Treatment Modalities ◽  
Published Data ◽  
Anogenital Warts ◽  
Clearance Rates ◽  
Day Case ◽  
Recurrence Rates ◽  
Repeat Procedures

A retrospective five-year audit of patients with extensive anogenital warts (AGW) treated by day case electrosurgery was undertaken to determine clearance rates and recurrence rates. Published studies using these treatment modalities are few and most involve small numbers of patients. We present a series of 213 patients. One hundred and seventy-six patients underwent single procedures, 35 underwent repeat procedures and two (1%) spontaneously cleared before surgery. The outcome was known in 137 patients. Sixty-five (57%) of the single procedures, 18 (78%) of the repeat procedures and 83 (61%, {95% confidence interval [CI] 52.4-68.8%}) of the whole sample were clear by three months. Recurrence rates were 27 (24%), six (23%) and 33 (24%, {95 CI 16.9-31.2%}) respectively. These figures appear to be consistent with published data using electrocautery and surgical/scissor excision. There was a higher prevalence of smokers (compared to general population) but there was no difference in outcome between smokers and non-smokers.

Epidemiology of supraventricular tachycardias

ESC CardioMed ◽  
2018 ◽  
pp. 2050-2050
Author(s):  
Gregory Y. H Lip
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Published Data ◽  
Supraventricular Arrhythmias ◽  
Precise Description ◽  
Specific Focus ◽  
Poor Differentiation ◽  
Supraventricular Tachycardias

The precise description of the epidemiology of supraventricular tachycardias is difficult as the published data often has poor differentiation between atrial fibrillation, atrial flutter, and other supraventricular arrhythmias. In contrast to the extensive epidemiology on atrial fibrillation, a specific focus on supraventricular tachycardia population epidemiology is sparse, especially in the general population (rather than observational cohorts from specialized centres).

scholarly journals The immune status of a population at the termination of a severe epidemic of poliomyelitis

1957 ◽  
Vol 55 (2) ◽  
pp. 239-253 ◽  
Author(s):  
C. A. Evans ◽  
Velma C. Chambers ◽  
W. R. Giedt ◽  
A. N. Wilson
Keyword(s):  
New York ◽  
General Population ◽  
Neutralizing Antibodies ◽  
Immune Status ◽  
The United States ◽  
Published Data ◽  
School Age ◽  
Type 3

SUMMARY AND CONCLUSIONSIn October, November and early December 1952, an epidemic of poliomyelitis, with an attack rate exceeding 1 %, occurred in Ketchikan, Alaska, a community of approximately 6000 persons. Approximately half of the cases were paralytic.Type 1 virus was regarded as the principal cause of the epidemic because Type 1 virus was isolated from one patient, and sera from eleven of twelve paralytic patients tested were positive for neutralizing antibodies to Type 1 virus. Three patients had antibodies to Type 2 virus and eight to Type 3.Serological tests were made to determine the immune status of the general population at the time the epidemic terminated. Approximately one-third of twenty-five children from 6 months to 4 years of age had antibodies to Type 1 virus. Of the 105 children aged 5 to 9 years, approximately three-quarters were positive for antibodies to this virus. All but two of the twenty-six persons more than 9 years of age who were tested were similarly positive.Spread of Type 2 and Type 3 viruses was more limited in Ketchikan than spread of Type 1 virus. Serological evidence is presented to show that Type 3 poliomyelitis virus was present in Ketchikan some time within the 3-year-period prior to the collection of serum in December 1952. Since the proportion of children showing antibodies to Type 3 virus did not increase with age from 3 to 9 years, it is surmised that virus of this type was not prevalent for a number of years prior to its last occurrence. It is further concluded that spread of Type 3 virus must have terminated when 40 % or less of the children of pre-school age and early school age had been infected and developed antibodies.Type 2 virus apparently had not been prevalent for several years prior to December 1952. Only one of twenty-one specimens of serum from children under age 5 showed definite evidence of neutralizing antibodies and this child had resided elsewhere during the first 3 months of its life. The proportion of positive results in all ages to 9 years inclusive was well below that obtained in tests with Type 1 virus.From a review of published data concerning the age distribution of cases in the 1916 epidemic in New York, it is concluded that termination of the spread of Type 1 virus in Ketchikan occurred when the proportion of susceptibles in the general population was comparable to that in New York in each of several non-epidemic years preceding 1916. It is further evident that spread of Type 2 virus in Baltimore during a period of low prevalence of poliomyelitic disease was comparable to that of Type 1 virus in Ketchikan in 1952, in that the proportion of susceptibles in the population at the end of the period of spread of virus was similar.Serological studies of residents of Metlakatla, an Indian community near Ketchikan, showed evidence of essentially uniform infection with Type 1 virus, a very high incidence of antibodies to Type 3 virus, and a much lower incidence of antibodies to Type 2 virus.The epidemiological aspects of poliomyelitis in Ketchikan cannot be reasonably attributed to susceptibility resulting from isolation of the community, since travel to and from Ketchikan was considerable and a relatively large proportion of persons with paralytic disease were adults who had travelled extensively, and resided for periods of years in various parts of the United States. It is noted that the municipal water supply showed frequent evidence of faecal pollution.The willing co-operation and valuable assistance of the following persons is gratefully acknowledged: Mr Alfred Baker, Mrs Dixie M. Baade, Miss Geneva Hubbard and Miss Lorraine Singer of the Ketchikan office of the Alaska Territorial Health Department; and Dr C. Earl Albrecht, Director and Dr Charles R. Hayman, Chief of Section of Preventive Medical Services, of the Alaska Territorial Department of Health.The National Foundation for Infantile Paralysis financed the initial visits to Ketchikan. Testing of specimens was accomplished through the support of the University of Washington Fund for Biological and Medical Research and the Office of Naval Research.

Quality of life and associated factors in parents of children with late diagnosed phenylketonuria. A cross sectional study in a developing country (Tunisia)

2020 ◽  
Vol 33 (7) ◽  
pp. 901-913
Author(s):  
Rim Ben Abdelaziz ◽  
Amel Ben Chehida ◽  
Henda Kachouri ◽  
Sana Ben Messaoud ◽  
Maherzia Ferchichi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
General Population ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Published Data ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sf 36

AbstractObjectivesWe investigated the quality of life (QOL) in parents of children with late treated phenylketonuria (PKU) and its associated factors.MethodsWe conducted a cross sectional study in the reference center of inherited metabolic disease in Tunisia. We used the Tunisian version of the 36-item short-form health survey questionnaire (SF-36). We compared variables in the groups with and without impaired QOL and the SF-36 scores between subgroups of parents and children and between our sample and the Tunisian general population based on published data. We looked for associations between SF-36 scores and quantitative variables. Linear regression and logistic binary regression were used for multivariate analysis.ResultsSixty-five parents from 42 families participated. QOL was impaired in 61% of them. The mean SF-36 score was 55.3 ± 25.07. The physical component sub-score was higher than that reported in the Tunisian general population (63.66 ± 27.77 vs. 50.11 ± 8.53; p<0.001). The mental component sub-score was comparable to that reported in the Tunisian general population (46.99 ± 25.94 vs. 47.96 ± 9.82; p=0.830). Gender (mothers) (p=0.008), low monthly income (p = 0.027), low education (p=0.011), and autism in PKU children (p = 0.001) were associated with impaired QOL.ConclusionsWe identified at risk parents for altered quality of life among parents of PKU children. Our findings were used to develop a psychological and social support strategy for at-risk parents and to promote the implementation of newborn screening of this treatable disease in our low-income country.

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