Is Adult Tetanus an Endemic in India?

Background: Tetanus is a life-threatening disease in developing country like India, with high morbidity and mortality rate. Though maternal and neonatal tetanus is eliminated, adult tetanus still remains in boom and is overlooked. Methods: An observational descriptive study using retrospective secondary data was undertaken among the patients admitted to a regional referral hospital to study the epidemiological factors influencing tet-anus, clinical features and the outcome of tetanus. Results: Analysis of 41 clinically diagnosed cases of tetanus showed that, majority were in 50-69 years of age group who resided in rural area and agriculture was their main occupation. Case fatality rate was 53.6% which revealed that mortality was the major outcome. And 95% of those infected were not aware of their immunization status. Conclusion: An early diagnosis, a proper wound management immediately after the injury, health edu-cation programs to create awareness among the public not to neglect even trivial injuries would definite-ly lead India to the path of elimination of adult tetanus. Strong emphasis is to be laid on adult immuniza-tion beyond the age of 10 years.

Prevalence and influencing factors of mild cognitive impairment among the elderly in Zhoushan City / 预防医学

Objective To learn the prevalence, distribution and risk factors of mild cognitive impairment (MCI) among elderly in Zhoushan City, and to provide the reference for MCI control. Methods A total of 1801 elderly people aged 60 to 79 years old from six districts of Zhoushan City were sampled by method of stratified random sampling. After self-evaluated with Ascertain Dementia 8 (AD8) and screened with Screening Scale for Mild Cognitive Impairment (sMCI), the diagnosis by specialists was conducted for that positive to AD8 and sMCI. Results of 1801 respondents, 873 (48.47％) people were male, and the other 928 (51.53％) people were female; 38.65％ of the people selected aged 60-<65; 90.28％ had a primary school education or were illiterate; 78.51％ had legitimate and healthy wives. A total of 122 elderly people were diagnosed with MCI, and the prevalence of MCI was 6.77％. Multivariate logistic regression analysis showed that male elderly people (OR=0.53, 95％CI:0.28-1.00) were less likely to develop MCI compared to the female, and the illiterate (OR=2.09, 95％CI: 1.16-3.77) were more likely to develop MCI compared to the educated . Conclusion The prevalence of MCI among the elderly in Zhoushan was 6.77％; the female and the illiterate were more likely to develop MCI.

13-2Bath-related deaths in Kagoshima, Japan from 2006 to 2013: Differences in epidemiological factors between locations where the death occurred / 日本温泉気候物理医学会雑誌

  In Japan, sudden death in the bathroom (‘bath-related death’) occurs particularly in the elderly population in winter. Previously, we showed that bath-related death in Kagoshima Prefecture occurs at similar frequency as that in other prefectures, despite its warm environment. In this study, we performed a retrospective review of the inquest records in Kagoshima from between 2006 and 2013 in order to compare the demographic and circumstantial factors of the following 3 groups classified by the location where the death occurred: home bathroom, spa, and nursing home bathroom. The total number of the deaths was 1533 (759 males and 774 females), which corresponds to a crude mortality rate of 11.3 per 100,000 person-years. Most of the deaths occurred at home (1319; 86.0%), followed by spa (159; 10.4%), nursing home (18; 1.2%), and others (37; 2.4%). In all 3 groups, most of the deceased were over 65 years old and were found sinking in the bathtub. The greatest number of deaths occurred in the winter at home (52.6%) and at a spa (54.7%) compared to other seasons. In contrast, death occurred most frequently in the spring at nursing homes (44.4%), when unexperienced staff begin to work in Japan. There was no significant difference in gender between home and nursing home cases, whereas significant more men died at a spa (p=0.0014). Although most deaths occurred at home between 16:00 and 20:00, a time when the elderly usually take a bath in Japan (49.4%), those at a spa and nursing home occurred earlier (12:00-16:00). The most common past history of illness was hypertension in home and spa cases, and that in nursing home cases was cardiovascular disease. Cardiac events leading to tragic results may occur more frequently in people with these illnesses than in healthy individuals while bathing. A history of drinking alcohol before bathing was observed in minor populations in home and spa cases, although it is also a known risk factor for death. However, the positive rate of spa cases was higher than that of home cases (8.2% vs. 3.3%). In all 3 groups, the most common cause of death indicated on the death certificate was heart disease such as myocardial infarction and arrhythmia (about 50%), followed by drowning. Except for 10 cases in which autopsy was performed, the cause of death in most cases was determined by only external examinations. Instead of autopsy, postmortem computed tomography (PMCT) scanning was performed in 44.9% of cases from 2010 to 2013. Cases that were diagnosed as drowning based on the findings by PMCT imaging have increased in recent years. However, PMCT is inferior to autopsy in detecting intrinsic disease and in elucidating a pathophysiological mechanism leading to drowning. In order to reduce the number of bath-related deaths, it is necessary to accumulate further evidence by increasing the number of cases undergoing autopsy, and to prompt the government and society to develop protective activities not only for known risk factors for death, but also for those peculiar to the bathing location.

13-2 Bath-related deaths in Kagoshima, Japan from 2006 to 2013: Differences in epidemiological factors between locations where the death occurred / 日本温泉気候物理医学会雑誌

  In Japan, sudden death in the bathroom (‘bath-related death’) occurs particularly in the elderly population in winter. Previously, we showed that bath-related death in Kagoshima Prefecture occurs at similar frequency as that in other prefectures, despite its warm environment. In this study, we performed a retrospective review of the inquest records in Kagoshima from between 2006 and 2013 in order to compare the demographic and circumstantial factors of the following 3 groups classified by the location where the death occurred: home bathroom, spa, and nursing home bathroom. The total number of the deaths was 1533 (759 males and 774 females), which corresponds to a crude mortality rate of 11.3 per 100,000 person-years. Most of the deaths occurred at home (1319; 86.0%), followed by spa (159; 10.4%), nursing home (18; 1.2%), and others (37; 2.4%). In all 3 groups, most of the deceased were over 65 years old and were found sinking in the bathtub. The greatest number of deaths occurred in the winter at home (52.6%) and at a spa (54.7%) compared to other seasons. In contrast, death occurred most frequently in the spring at nursing homes (44.4%), when unexperienced staff begin to work in Japan. There was no significant difference in gender between home and nursing home cases, whereas significant more men died at a spa (p=0.0014). Although most deaths occurred at home between 16:00 and 20:00, a time when the elderly usually take a bath in Japan (49.4%), those at a spa and nursing home occurred earlier (12:00-16:00). The most common past history of illness was hypertension in home and spa cases, and that in nursing home cases was cardiovascular disease. Cardiac events leading to tragic results may occur more frequently in people with these illnesses than in healthy individuals while bathing. A history of drinking alcohol before bathing was observed in minor populations in home and spa cases, although it is also a known risk factor for death. However, the positive rate of spa cases was higher than that of home cases (8.2% vs. 3.3%). In all 3 groups, the most common cause of death indicated on the death certificate was heart disease such as myocardial infarction and arrhythmia (about 50%), followed by drowning. Except for 10 cases in which autopsy was performed, the cause of death in most cases was determined by only external examinations. Instead of autopsy, postmortem computed tomography (PMCT) scanning was performed in 44.9% of cases from 2010 to 2013. Cases that were diagnosed as drowning based on the findings by PMCT imaging have increased in recent years. However, PMCT is inferior to autopsy in detecting intrinsic disease and in elucidating a pathophysiological mechanism leading to drowning. In order to reduce the number of bath-related deaths, it is necessary to accumulate further evidence by increasing the number of cases undergoing autopsy, and to prompt the government and society to develop protective activities not only for known risk factors for death, but also for those peculiar to the bathing location.

Epidemiología de las infecciones de inicio precoz en el Servicio de Neonatología del Hospital General "Orlando Pantoja Tamayo" / Epidemiology of the early onset infections in the Neonatology Service of "Orlando Pantoja Tamayo" General Hospital

Se realizó un estudio descriptivo y transversal de 48 recién nacidos con infección de inicio precoz, atendidos en el Servicio de Neonatología del Hospital General Docente "Orlando Pantoja Tamayo" de Contramaestre, provincia de Santiago de Cuba, desde enero hasta julio de 2012, con el objetivo de caracterizarles según algunas variables de interés para la investigación. La información fue procesada con el programa SPSS, versión 11.5 y se utilizó el porcentaje como medida de resumen. En la serie predominaron la bronconeumonía (91,6 %), así como las infecciones vaginales, el cateterismo y la ventilación en el total de los integrantes; también se obtuvo que 60,4 % de los gérmenes fueron aislados en hemocultivo y la mayoría resultaron ser gramnegativos.

A descriptive and cross sectional study of 48 newborns with infection of early onset, assisted in the Neonatology Service of "Orlando Pantoja Tamayo" Teaching General Hospital in Contramaestre, Santiago de Cuba province, was carried out from January to July of 2012, with the objective of characterizing them according to some variables of interest for the investigation. The information was processed with the program SPSS, version 11.5 and the percentage was used as summary measure. In the series bronchopneumonia (91,6%), as well as vaginal infections, catheterism and the ventilation in all the members prevailed; it was also obtained that 60,4% of the organisms were isolated from blood culture and most turned out to be gramnegative organisms.

Violencia de pareja en el Departamento del Quindío, Colombia / Intimate partner violence in the Quindio, Department of Colombia

Objetivo Identificar los factores de riesgo para violencia de pareja mediante análisis de los datos del sistema de vigilancia epidemiológica para violencia intrafamiliar (SIVIF) en el Quindío del año 2009. Materiales y Métodos Se realizó un estudio descriptivo de corte transversal, sobre 1.906 notificaciones del (SIVIF) del departamento del Quindío, Colombia, del año 2009, donde 583 (n=583) corresponden a casos donde el agredido y agresor eran parejas. Resultados Los principales municipios generaron la mayoría de los casos. Las mujeres, las más agredidas. Son frecuentes la violencia física, múltiple y sexual; la agresión con el propio cuerpo; la influencia de la ira, consumo de alcohol y drogas, celos, y problemas emocionales y psicológicos; agredidos y agresores ≤35 años; las mujeres agredidas amas de casa e informales; violencia psicológica, verbal o grave negligencia y las mujeres ≥35 años agredidas de forma reiterativa, y que no convivían en la misma residencia ni tampoco estaban casadas. Conclusiones No existen muchos estudios ni antecedentes acerca del tema, es una necesidad regional imperiosa, contar con ulteriores estudios, pues éste es un fenómeno social urbano y repetitivo marcado por la violencia física, sexual o múltiple, con víctimas mujeres jóvenes, más frecuente en personas con educación superior.(AU)

Objective Identify risk factors for intimate partner violence by analyzing data from the surveillance system to domestic violence (SIVIF) in Quindio, 2009. Materials and Methods We conducted a cross- sectional descriptive study, about 1,906 notifications SIVIF database in the department of Quindío, Colombia, in 2009, of which 583 (n=583) correspond to cases where the independent of marital relationship between the victim-offender was married, a number that was taken as sample size, analyzing 100 % of such cases as to the origin, receipt of notification, type of coexistence of the couple, circumstances through aggression also features assaulted/aggressor. Results The two main municipalities generated most cases. Women, the most abused. More common types of physical violence, multiple sexual aggression with the body of the offender, the influence of anger, alcohol and drugs, jealousy, and emotional and psychological problems, the people attacked and attackers ≤ 35 years; battered women housewives and informal psychological violence, verbal or gross negligence and women ≥35 years so repeatedly assaulted, and who were not living in the same residence nor were married. Conclusions There are many studies on the subject, even unprecedented in the region and in the national literature. It is imperative for the department of Quindio, further studies have to extend the present. Dating violence in Quindio, is a purely social phenomenon with chronicity of the city, marked by physical, sexual or multiple, with victims young women, more common in people with higher education, although the elderly were more often victimized so psychological, verbal and gross negligence.(AU)

STUDIES ON EPIDEMIOLOGICAL FACTORS AND CONTROL STRATEGIES OF SCHISTOSOMIASIS IN BEACH REGIONS OF CHANGJIANG RIVER / 中国血吸虫病防治杂志

This paper reports on the studies of epidemiological factors and optimum control strate-gies of schistosomiasis in beach regions of Changjiang River in Anhui and Jiangsu Provinces in 1991 - 1995. The results demonstrated that the infection sources are varied in the beach re-gions.The essential ones contributed to schistosomiasis transmission are cattle,pig and man. People contact with infested water via production and daily activities ; naturally, the mode of infestation is different with areas. Generally ,swimming is the most intense pattern of con-tact.The distribution of infected Oncomelania snails is related to the kinds of vegetation and frequency of man and animal activities,presenting a negative binomial pattern. The presence of endemic area is closely associated with the degradation /formation and alteration of beach.The water level of Changjiang River and precipitation are important factors influencing the prevalence of schistosomiasis of the regions. Judging from the comparative studies of eral strategies on the basis of snail and schistosomiasis control effects as well as cost-effec-tiveness,the authors suggest that to keep pace with the major target of "diseasa control".the optimum strategies against schistosomiasis in the beach regions of Changjiang River should be chemotherapy of man and farm animals and health education. Additionally ,transformation of beach should be taken into consideration provided funds are sufficient. In areas where schistosomiasis has been basically under cotrol,the strategies of "repeated examination and treatment of man and farm animals and elimination of foci of infected snails " and " Chemotherapy of target population and cattle plus health education plus elimination of snails in high risk areas plus individual prevention / protection" are recommended, so as to consolidate the previous achievements.

Endemic diversity and interventions on schistosomiasis after reserving plain for flooding in Jicheng and Qingshanhu / 中国血吸虫病防治杂志

Objective To understand endemic diversity on schistosomiasis transmission after reserving plain for flooding. Methods In two study pilots, Jicheng and Qingshanhu, epidemiological factors were investigated longitudinally, and the effectiveness of the interventions was evaluated. Results The infection rates of mobile people who engaged in activities in the discarded plain were increased year by year. The density of infected snails was high. The snail habitats increased significantly in Jicheng, but decreased in Qingshanhu. The infection rate and number of livestock pastured in the discarded plain increased. In the discarded plain, most of the mobile people came from the local areas, and main activities for water contact were fishing and pasturing. About 90% of local residents migrated into endemic areas, and the others into non-endemic areas. Conclusions The discarded plains were evolving to a serious transmission zone of schistosomiasis. Interventions combined with agriculture and fisher productions can decrease snail-spreading. Schistosomiasis examination and chemotherapy for the migrants to non-endemic areas are vital.