Parasitic infections in relation to practices and knowledge in a rural village in Northern Thailand with emphasis on fish-borne trematode infection.

The present study integrates several aspects of a parasitological survey in a rural community village combining community knowledge of parasites, their potential transmission routes and health risk factors. A rural community located in Northern Thailand was surveyed for intestinal parasites, and an overall prevalence of 45.2% for helminths and 4.8% for protozoan infections was identified. Socio-demographic characteristics, customs and perceptions were compiled using individual questionnaires and interviews for participants surveyed for parasitic screening. The results allowed us to determine the knowledge and perception of local people concerning helminthic infection and transmission. Despite the fact that the participants in this community were aware of parasitic transmission routes, their widespread custom of eating raw fish and meat render the reduction of helminthiasis difficult. A detailed study on the infection of fish-borne parasitic trematodes, the most prevalent helminth, allowed us to determine that the distance from a given household to the river is a determinant of infection intensity. Health education activities organised in the local community resulted in a change in perception of risks associated with parasite transmission.

Environmental factors and public health policy associated with human and rodent infection by leptospirosis: a land cover-based study in Nan province, Thailand.

Leptospirosis incidence has increased markedly since 1995 in Thailand, with the eastern and northern parts being the most affected regions, particularly during flooding events. Here, we attempt to overview the evolution of human prevalence during the past decade and identify the environmental factors that correlate with the incidence of leptospirosis and the clinical incidence in humans. We used an extensive survey of Leptospira infection in rodents conducted in 2008 and 2009 and the human incidence of the disease from 2003 to 2012 in 168 villages of two districts of Nan province in Northern Thailand. Using an ad-hoc developed land-use cover implemented in a geographical information system we showed that humans and rodents were not infected in the same environment/habitat in the land-use cover. High village prevalence was observed in open habitat near rivers for the whole decade, or in 2008-2009 mostly in rice fields prone to flooding, whereas infected rodents (2008-2009) were observed in patchy habitat with high forest cover, mostly situated on sloping ground areas. We also investigated the potential effects of public health campaigns conducted after the dramatic flood event of 2006. We showed that, before 2006, human incidence in villages was explained by the population size of the village according to the environmental source of infection of this disease, while as a result of the campaigns, human incidence in villages after 2006 appeared independent of their population size. This study confirms the role of the environment and particularly land use, in the transmission of bacteria, emphasized by the effects of the provincial public health campaigns on the epidemiological pattern of incidence, and questions the role of rodents as reservoirs.

Indoor terrestrial gamma dose rate mapping in France: a case study using two different geostatistical models.

Terrestrial gamma dose rates show important spatial variations in France. Previous studies resulted in maps of arithmetic means of indoor terrestrial gamma dose rates by "departement" (French district). However, numerous areas could not be characterized due to the lack of data. The aim of our work was to obtain more precise estimates of the spatial variability of indoor terrestrial gamma dose rates in France by using a more recent and complete data base and geostatistics. The study was based on the exploitation of 97,595 measurements results distributed in 17,404 locations covering all of France. Measurements were done by the Institute for Radioprotection and Nuclear Safety (IRSN) using RPL (Radio Photo Luminescent) dosimeters, exposed during several months between years 2011 and 2012 in French dentist surgeries and veterinary clinics. The data used came from dosimeters which were not exposed to anthropic sources. After removing the cosmic rays contribution in order to study only the telluric gamma radiation, it was decided to work with the arithmetic means of the time-series measurements, weighted by the time-exposure of the dosimeters, for each location. The values varied between 13 and 349 nSv/h, with an arithmetic mean of 76 nSv/h. The observed statistical distribution of the gamma dose rates was skewed to the right. Firstly, ordinary kriging was performed in order to predict the gamma dose rate on cells of 1*1 km(2), all over the domain. The second step of the study was to use an auxiliary variable in estimates. The IRSN achieved in 2010 a classification of the French geological formations, characterizing their uranium potential on the bases of geology and local measurement results of rocks uranium content. This information is georeferenced in a map at the scale 1:1,000,000. The geological uranium potential (GUP) was classified in 5 qualitative categories. As telluric gamma rays mostly come from the progenies of the (238)Uranium series present in rocks, this information, which is exhaustive throughout France, could help in estimating the telluric gamma dose rates. Such an approach is possible using multivariate geostatistics and cokriging. Multi-collocated cokriging has been performed on 1*1 km(2) cells over the domain. This model used gamma dose rate measurement results and GUP classes. Our results provide useful information on the variability of the natural terrestrial gamma radiation in France ('natural background') and exposure data for epidemiological studies and risk assessment from low dose chronic exposures.

Binomial cokriging for estimating and mapping the risk of childhood cancer.

The incidences of human diseases vary from place to place, and this is also likely to be so for the risk of people developing many of them. We have analysed the spatial distribution of childhood cancer in the West Midland Health Authority Region of England from 1980 to 1984. This is a rare disease which is considered to be noncontagious. The observed frequencies of the disease in the electoral wards have been converted to proportions that estimate the risk of a child's developing it. The spatial autocorrelation of the risk, expressed in the variogram, was determined in a novel way from the proportions within electoral wards by treating them as binomial variables dependent on the risk and the numbers of children in the wards. The observed variogram was modelled by Whittle's elementary two-dimensional correlation. Covariances of the proportion and cross covariances between the proportion and the risk were derived, and from the latter and the proportions the risk was estimated in two ways by a form of cokriging: ordinary and conditional unbiased cokriging. The variogram of the risk shows strong autocorrelation, and the kriged estimates, when mapped, have a distribution that is far from even. There are patches where the estimated risk is large, especially in the rural south west and the suburban north east; and there are other patches, notably the more densely populated areas, where it is small.

[Dermatological aspects of AIDS in western Africa. Apropos of 140 cases]. / Aspects dermatologiques du SIDA en Afrique de l'Ouest. A propos de 140 observations.

This clinical survey, carried out during a 3 years period in the Dermatological Department of Bouake Hospital (Ivory Coast) analyses the skin and mucous membranes troubles caused by AIDS among adults. It is the first of that kind in Western Africa. 140 patients were concerned, showing carious dermatological troubles, 25 of them were counted. Few tropical skin diseases have their clinical picture altered by immunodeficiency. However, the Buruli ulcer may be described, which has in this condition a particularly development. We have underlined the particularities of some ubiquitous diseases, either because they appear on black skin (seborrheic dermatitis, Kaposi's sarcoma, prurigo, woolly hair syndrome, ichtyosis) or because they were neglected, or because they take an extensive form (chronic herpes, profuse condyloma). At the end of the survey, we are proposing a classification of the dermatological troubles, according to their features which might suggest AIDS. On this account, erythroderma, scattered forms of Mycobacterium ulcerans infection, and noma, find a place among the troubles suggesting adult AIDS in sub-saharian Africa.