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1.
Trop Med Int Health ; 19(4): 398-406, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24405627

RESUMO

OBJECTIVE: We tested whether soap presence in the home or a designated handwashing station was associated with diarrhoea and respiratory illness in Kenya. METHODS: In April 2009, we observed presence of a handwashing station and soap in households participating in a longitudinal health surveillance system in rural Kenya. Diarrhoea and acute respiratory illness (ARI) in children < 5 years old were identified using parent-reported syndromic surveillance collected January-April 2009. We used multivariate generalised linear regression to estimate differences in prevalence of illness between households with and without the presence of soap in the home and a handwashing station. RESULTS: Among 2547 children, prevalence of diarrhoea and ARI was 2.3 and 11.4 days per 100 child-days, respectively. Soap was observed in 97% of households. Children in households with soap had 1.3 fewer days of diarrhoea/100 child-days (95% CI -2.6, -0.1) than children in households without soap. ARI prevalence was not associated with presence of soap. A handwashing station was identified in 1.4% of households and was not associated with a difference in diarrhoea or ARI prevalence. CONCLUSIONS: Soap presence in the home was significantly associated with reduced diarrhoea, but not ARI, in children in rural western Kenya. Whereas most households had soap in the home, almost none had a designated handwashing station, which may prevent handwashing at key times of hand contamination.


Assuntos
Diarreia/prevenção & controle , Desinfecção das Mãos/instrumentação , Doenças Respiratórias/prevenção & controle , Sabões/provisão & distribuição , Abastecimento de Água/estatística & dados numéricos , Doença Aguda , Pré-Escolar , Diarreia/epidemiologia , Feminino , Desinfecção das Mãos/métodos , Humanos , Lactente , Recém-Nascido , Quênia/epidemiologia , Modelos Lineares , Masculino , Vigilância da População/métodos , Prevalência , Características de Residência , Doenças Respiratórias/epidemiologia , Saúde da População Rural
2.
Epidemiol Infect ; 141(1): 212-22, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22417876

RESUMO

Influenza causes severe illness and deaths, and global surveillance systems use different clinical case definitions to identify patients for diagnostic testing. We used data collected during January 2007-July 2010 at hospital-based influenza surveillance sites in western Kenya to calculate sensitivity, specificity, positive predictive value, and negative predictive value for eight clinical sign/symptom combinations in hospitalized patients with acute respiratory illnesses, including severe acute respiratory illness (SARI) (persons aged 2-59 months: cough or difficulty breathing with an elevated respiratory rate or a danger sign; persons aged ≥5 years: temperature ≥38 °C, difficulty breathing, and cough or sore throat) and influenza-like illness (ILI) (all ages: temperature ≥38 °C and cough or sore throat). Overall, 4800 persons aged ≥2 months were tested for influenza; 416 (9%) had laboratory-confirmed influenza infections. The symptom combination of cough with fever (subjective or measured ≥38 °C) had high sensitivity [87·0%, 95% confidence interval (CI) 83·3-88·9], and ILI had high specificity (70·0%, 95% CI 68·6-71·3). The case definition combining cough and any fever is a simple, sensitive case definition for influenza in hospitalized persons of all age groups, whereas the ILI case definition is the most specific. The SARI case definition did not maximize sensitivity or specificity.


Assuntos
Medicina Clínica/métodos , Medicina de Emergência/métodos , Influenza Humana/diagnóstico , Influenza Humana/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Tosse/etiologia , Diagnóstico Diferencial , Feminino , Febre/etiologia , Hospitalização , Humanos , Lactente , Quênia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Adulto Jovem
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