Traumatic spinal cord injury in Arkansas, 1980 to 1989.

To develop and implement target prevention strategies, we studied the causes of spinal cord injuries in Arkansas and the groups most affected by SCI. Any Arkansas resident with a spinal cord injury who satisfied the state registry criteria was defined as a subject. Transportation-related incidents caused 319 (49.5%) of the SCIs. Males 15 to 24 years of age experienced the highest incidence of SCI because of transportation and sport-related injuries. The rate of SCI from falls was 2.8 times higher for people 65 years of age and older than for people 64 years of age and younger. Minority males 15 to 44 years of age were at the greatest risk of violence-related SCIs. More intervention is needed in the areas of transportation and sport-related causes involving males 15 to 24 years of age, fall-related causes involving the elderly, and violence-related causes involving minority males 15 to 44 years of age.

Clinical manifestations, disability and use of folk medicine in dracunculus infection in Nigeria.

A cross-sectional survey of households was carried out in a dracunculiasis endemic village in Oyo state Nigeria. Data were collected on history of dracunculiasis, occupational and domestic sources of drinking water, clinical manifestations, disability, use of folk medicine, and incorporation of previous dracunculiasis control programmes. The findings indicated that dracunculiasis patients were usually unaware of their infection 3-5 days before the appearance of a bleb; that religious affiliation appeared to be positively related to increasing morbidity; and that ulcers were predominantly in the ankles and feet, particularly among young children. Severe disability was related to age, site and number of ulcers, and the form of selected treatment. Indigenous remedy was the treatment of choice, although traditional healers in the community indicated no knowledge of any efficacious remedy. Mortality from secondary tetanus infection was associated with outbreak of dracunculiasis. The impact of dracunculiasis on agricultural, economic and recreational activities was considerable, with the infected farmers being unable to attend to their farms at the critical farming period. Sixty-one per cent of the residents were opposed on religious and aesthetic grounds to the treatment of the local surface water which contained cyclops species. Sixty-three per cent regarded the boiling and filtration of portions of their domestic water as an additional burden, cumbersome and impracticable.(ABSTRACT TRUNCATED AT 250 WORDS)

Source of drinking water supply and transmission of guinea worm disease in Nigeria.

During 1982, ecological factors associated with freshwater pollution were investigated in Idere, a rural Nigerian community with endemic guinea worm infection. Data were collected on the quality of all pond water sources, and on rainfall patterns and potable piped water available in the community. Pond water provided 76% of the total water used in Idere. This source of drinking water provided the classical ecological environment for the transmission of Dracunculus medinensis, other helminth parasites and bacterial enteric infections. The bacteriological analysis of drinking water from the ponds reflects the absence of sanitary arrangements for human waste disposal in the community, as the ponds are collectors of storm run-offs. Okina, the spring-fed pond which was nearest to the households, was the most reliable year-round source of water to the community; however, Okina also contained the highest density of infective Thermocyclops and the highest faecal coliform (FC) to faecal Streptococcus (FS) ratio (FC/FS), thus providing a central reservoir for guinea worm and bacterial infections. The transmission season of guinea worm infection corresponded with the period of greatest water scarcity in Idere. The amount of portable water available to Idere residents in 1981 was 3.6 litres per person per day. Frequent mechanical breakdowns, electric power failures, lack of fuel to run the water pumping engines and the direct link of the water pipeline supplying water to Idere with a water pipeline serving another major city in the same district were some of the reasons for potable water shortage in the community.

Age and sex differences in new and recurrent cases of guinea worm disease in Nigeria.

In this population-based cross-sectional survey of the prevalence and incidence of guinea worm disease in Idere, a rural agricultural community of Oyo state in Nigeria, epidemiological data were collected by household interview of all 501 households (6527 persons, 3594 females and 2933 males). 86% of the households had at least one case. The prevalence was 32.4% in the overall population, but varied markedly by age and sex. About 10% of prevalent cases were first-time infections or new cases. Males over 19 years of age had a higher prevalence rate than adult females; however, females had a higher prevalence rate at younger ages. The prevalence in females peaked (47%) at 35 to 44 years; for males the proportion was highest (57%) at ages 45 to 54 years.

Impact of guinea worm disease on children in Nigeria.

School attendance records of all primary schools in a guinea worm-endemic village in southwestern Nigeria were examined to determine the cause of missed school days and school drop-outs. At the time of the survey, 1,495 pupils (768 boys and 727 girls were registered in the 4 primary schools in the village, of which 21% of the pupils were infected with guinea worm disease (GWD). Female pupils had a higher infection rate than their male counterparts. Guinea worm-infected pupils missed up to 25% of school year days compared to a non-guinea worm-infected absence of 2.5%. At the height of guinea worm season in the study area, guinea worm-related absences contributed virtually all of the absenteeism recorded in the schools. Implications of the findings within the context of educational attainment of the pupils are discussed.