The epidemiology of soil-transmitted helminth infections in children up to 8 years of age: Findings from an Ecuadorian birth cohort.

BACKGROUND: There are few prospective longitudinal studies of soil-transmitted helminth (STH) infections during early childhood. We studied the epidemiology of and risk factors for soil-transmitted helminth infections from birth to 8 years of age in tropical Ecuador. METHODS: 2,404 newborns were followed to 8 years of age with periodic stool sample collections. Stool samples were collected also from household members at the time of the child's birth and examined by microscopy. Data on social, environmental, and demographic characteristics were collected by maternal questionnaire. Associations between potential risk factors and STH infections were estimated using generalized estimated equations applied to longitudinal binary outcomes for presence or absence of infections at collection times. RESULTS: Of 2,404 children, 1,120 (46.6%) were infected with at least one STH infection during the first 8 years of life. The risk of A. lumbricoides (16.2%) was greatest at 3 years, while risks of any STH (25.1%) and T. trichiura (16.5%) peaked at 5 years. Factors significantly associated with any STH infection in multivariable analyses included age, day-care (OR 1.34, 95% CI 1.03-1.73), maternal Afro-Ecuadorian ethnicity (non-Afro vs. Afro, OR 0.55, 95% CI 0.43-0.70) and lower educational level (secondary vs. illiterate, OR 0.31, 95% CI 0.22-0.45)), household overcrowding (OR 1.53, 95% CI 1.21-1.94)), having a latrine rather than a water closet (WC vs. latrine, OR 0.77, 95% CI 0.62-0.95)), and STH infections among household members (OR 2.03, 95% CI 1.59-2.58)). T. trichiura was more associated with poverty (high vs. low socioeconomic status, OR, 0.63, 95% CI 0.40-0.99)] and presence of infected siblings in the household (OR 3.42, 95% CI 2.24-5.22). CONCLUSION: STH infections, principally with A. lumbricoides and T. trichiura, peaked between 3 and 5 years in this cohort of children in tropical Ecuador. STH infections among household members were an important determinant of infection risk and could be targeted for control and elimination strategies.

Integrated positron emission tomography/computed tomography fusion imaging: an emerging gold standard in lung cancer.

Positron emission tomography (PET) has emerged as an important diagnostic tool in the management of lung cancers. Although PET is sensitive in detection of lung cancer, but FDG (2-deoxy-2- 18 fluro-D-glucose) is not tumor specific and may accumulate in a variety of nonmalignant conditions occasionally giving false positive result. Addition of CT to PET improves specificity foremost, but also sensitivity in tumor imaging. Thus, PET/CT fusion images are a more accurate test than either of its individual components and are probably also better than side-by-side viewing of images from both modalities. PET/CT fusion images are useful in differentiating between malignant and benign disease, fibrosis and recurrence, staging and in changing patient management to more appropriate therapy. With analysis and discussion it appears that PET/ CT fusion images have the potential to dramatically improve our ability to manage the patients with lung cancer and is contributing to our understanding of cancer cell biology and in development of new therapies.

Energy, protein, fat and carbohydrate intakes of underweight, normal weight and obese government office workers in an urban area.

Diet is one of the major factors contributing to the development of obesity, apart from heredity and energy balance. The objective of this cross-sectional study is to assess energy, carbohydrate, protein and fat intakes in relation to bodyweight status among government office workers in Kuala Lumpur. A total of 185 Malay men and 196 Malay women aged 18 and above were randomly selected as the study sample. Height and weight were taken to determine body mass index (BMI). The dietary profile was obtained by using 24-hour dietary recalls and food frequency methods. This was analysed to determine average nutrient intake per day. Other information was ascertained from tested and coded questionnaires. The subjects were categorised into three groups of bodyweight status namely underweight (BMI < 20 kg/m2), normal weight (BMI 20-25 kg/m2) and obese (BMI > 25 kg/m2). The prevalence of obesity was 37.8%. The study showed that the mean energy intake of the respondents was 1709 ± 637 kcal/day. The energy composition comprised of 55.7 ± 7.6% carbohydrates, 29.7 ± 21.7 % fat and 15.6 ± 3.8% protein. There was no significant difference in diet composition among the three groups. The findings indicate that normal weight and overweight individuals had a lower intake of calories and carbohydrates than the underweight individuals (p<0.05). However, there were no significant differences in fat intakes.