The association between subjective and clinical indicators of health in prospective Vietnamese migrants.

We conducted a cross-sectional survey of 1669 prospective Vietnamese migrants who had applied to migrate to Australia to describe the association between self-reported health status and several commonly used clinical indicators of health among prospective Vietnamese migrants. Participants were recruited from the International Organization for Migration's standardised medical screening program.' We found that clinical indicators of health are related to self-reported health status among prospective Vietnamese migrants. Self-reported health status, which was assessed using a modified version of the Short Form-36 health survey, was significantly associated with clinical indicators of health, including the number of body system abnormalities identified during medical screening, evidence of tuberculosis on chest radiograph, and self-reported weight loss over the previous six months. These findings support the validity of self-reported health status assessment among prospective migrants, although the assessment of subjective indicators of health during compulsory medical screening may be limited by reporting bias.

Prevalence of tuberculosis in Vietnamese migrants: the experience of the Orderly Departure Program.

This study aimed to describe the Internal Organization for Migration (IOM) tuberculosis screening and treatment program in Ho-Chi-Minh City (Vietnam); and to review the prevalence of tuberculosis and treatment outcome in a cohort of Vietnamese migrants and refugees prior to their departure. From 1 November 1992 to 1 June 1993, prospective migrants and refugees bound to the United States, Australia, and Canada underwent medical examination by IOM in Ho-Chi-Minh City. Screening for tuberculosis was based on chest x-rays, and the diagnosis was confirmed by smear examination. Smear-positive patients received short-course chemotherapy, directly supervised, with isoniazid, rifampicin, ethambutol, and pyrazinamide. Out of 39,581 persons screened, 322 were smear-positive (641 per 100,000), and started treatment. Follow-up varied from a minimum of 12 months to a maximum of 18 months. At that time, 265 (82%) were cured, while the remaining either continued treatment with first-line drugs (24), started second-line treatment (17), or failed to be cured for various reasons (16). This report confirms the efficacy of short course chemotherapy and directly observed treatment for tuberculosis, in the context of one of the largest screening programs for prospective migrants. Follow-up in receiving countries would help clarify risk factors for both new infection and relapse of tuberculosis.

Epidemiology of HIV infection among prostitutes in the Philippines.

Between 1985 and 1987, examinations for human immune deficiency virus (HIV) antibody were done on 25,392 prostitutes working in 64 cities throughout the Philippines. The country-wide seropositivity rate among prostitutes based on this sample was 0.8/1,000. Of the HIV cases, 85% were working in just two cities whose prostitute populations comprised 50% of the total sample. The average incidence rate for the same two cities after 1 year was 2.3/1,000. HIV antibody-positive women were enrolled in a case-control study to determine demographic and epidemiologic risk factors. This study involving 34 HIV-positive prostitutes and 61 randomly selected negative control prostitutes did not reveal any risk factors related to sexual or other types of behavior. A history of genital warts, a history of abnormal vaginal discharge, and cytomegalovirus antibody were significantly more frequent in the HIV-positive cases than in the controls; however, by logistic regression analysis, only an abnormal vaginal discharge was independently associated with HIV infection. Absence of any evidence of transmission by blood transfusion or i.v. drug abuse suggests that HIV was introduced by the heterosexual route.

Dengue fever in American military personnel in the Philippines: clinical observations on hospitalized patients during a 1984 epidemic.

From June - August, 1984, 24 American military personnel were hospitalized with dengue (DEN) at Clark Air Base in the Philippines. Their infections were confirmed by serology using the hemagglutination-inhibition test and/or by virus isolation in Aedes pseudoscutellaris cell cultures. Most of the patients had a secondary type of antibody response probably reflecting prior vaccination against yellow fever. Three serotypes of DEN virus were isolated; 7 isolates of DEN 1, 4 isolates of DEN 3 and 3 isolates of DEN 2. All of the patients were Caucasian males between the ages of 20-43 years. All of the cases were clinically diagnosed as classical dengue fever. A platelet count of less than or equal to 100,000/microliters was a common finding (83.3%); however, hemoconcentration was not documented. Other major findings were the occurrence of mild hypotension (62.5%) and petechiae (37.5%). One patient presented with shock and upper gastrointestinal bleeding, but his diagnosis was complicated by a history of epigastric pain and use of aspirin. Although all of the patients fully recovered, the severity of illness was clearly documented by the average-length of hospitalization (5.9 days) and average time absent from work (8.7 days).

Parasitic diseases with emphasis on schistosomiasis in Cambodian refugees, in Prachinburi Province Thailand.

Epidemiologic surveys were carried on 24,619 Cambodian refugees in Khao-I-Dang holding center, employing a skin test as a screening device to determine the prevalence of schistosomiasis. The diagnosis of Schistosoma mekongi was confirmed in 62 by positive stool examination. The majority of the positive cases came from Battambang province which is probably a new endemic area of schistosomiasis in Cambodia.