{"title":"The point of view of a low prevalence country: The Netherlands.","authors":"J F Broekmans","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The elimination of tuberculosis in the Netherlands is not envisaged before 2025. The evidence presented in this paper suggests that the elimination phase asks for a revision of existing control strategies. In the Netherlands a new role is identified for a voluntary tuberculosis organisation like the Royal Netherlands Tuberculosis Association (KNCV) in the areas of expert consultation, surveillance, post-graduate education and consensus and protocol development. A major challenge for a low prevalence country is the existence of high prevalence countries; KNCV's contribution to the success of the Mutual Assistance Programme of the IUATLD in Tanzania, Malawi, Benin, Kenya and Mali is discussed. A major role is identified for the IUATLD and voluntary organisations like KNCV in WHO's new global programme against tuberculosis. The involvement of a Dutch voluntary organisation, the Medical Committee The Netherlands-Vietnam (MCNV) in support of the national tuberculosis programme in Vietnam illustrates this development.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 4","pages":"179-83"},"PeriodicalIF":0.0,"publicationDate":"1991-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12852015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"On the risk of infection.","authors":"I Sutherland","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The epidemiological importance of the annual risk of infection with tubercle bacilli has been recognized only recently. Calendar trends in the risk and its association with age have been assessed from tuberculin test data. In The Netherlands, this information has been used to estimate the development of clinical tuberculosis following infection or re-infection. The calendar trend in the risk of infection is the best index of improvement or deterioration in a community. The difficulties of assessing it are outlined.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 4","pages":"189-91"},"PeriodicalIF":0.0,"publicationDate":"1991-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12852017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The point of view of a high prevalence country: Malawi.","authors":"D S Nyangulu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The National Tuberculosis Programme switched to short-course chemotherapy for smear-positive cases when the IUATLD started to assist in 1984. Treatment results in smear-positive cases improved from a 50-55% cure rate to an 87% cure rate in new cases (and 89% in retreatment cases). The hope of reducing the tuberculosis problem was then challenged by the occurrence of HIV-related cases of tuberculosis which are now considerably over-stretching services. Smear-negative cases and extrapulmonary tuberculosis now represent almost two thirds of all patients. For them, standard chemotherapy has now been changed to 2 R3H3Z3/2 HE(or TH)/4H in order to try and save money on syringes, needles and water for injection as well as prevent transmission of HIV through injections. This regimen will also enable the programme to depart from hospitalization since patients will take medication on an ambulatory basis. It may also give more time to district tuberculosis officers for the supervision of health centers.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 4","pages":"173-4"},"PeriodicalIF":0.0,"publicationDate":"1991-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12852013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tuberculosis in a low prevalence country: A wolf in sheep's clothing.","authors":"J Veen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In low prevalence countries group epidemics or \"micro-epidemics\" of tuberculosis behave as a point-prevalence epidemic. Contact tracing follows the \"Stone-in-the-Pond Principle\", persons belonging to the inner circle of a source of infection being examined first. Important factors contributing to the occurrence of a micro-epidemic are prolonged patient's and doctor's delay and the dark damp atmospheres of discotheques.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 4","pages":"203-5"},"PeriodicalIF":0.0,"publicationDate":"1991-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12852021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High dose-short duration ribavirin aerosol treatment--a review.","authors":"V Knight, B E Gilbert, P R Wyde, J A Englund","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A high-dose, short-duration treatment with ribavirin aerosol consisting of a three-fold increase in concentration of drug (60 mg versus 20 mg of ribavirin per mL in the liquid reservoir of the generator administered for about one-third the time of the standard treatment) was as effective as the standard dosage in the treatment of experimental influenza A and B infections in mice and in the treatment of experimental respiratory syncytial virus infection in cotton rats. Despite some minor pulmonary intolerance, it was considered to be suitable for use in treatment of patients with severe chronic pulmonary disease, and it was well-tolerated and apparently effective in the treatment (by face mask and endotracheal tube) of infants with bronchiolitis principally caused by respiratory syncytial virus infection. Pharmacokinetic studies in mice revealed very high concentrations of drug in the lungs, about triple the level with the standard dose, with similar blood and brain concentrations. Ribavirin concentrations were similarly high in respiratory secretions of infants given the triple dose.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 2-3","pages":"97-101"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12920029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of asthma in a region of Algeria.","authors":"M Belhocine, N Ait-Khaled","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 1984-85 an epidemiological survey on asthma was carried out on a representative population sample in the \"Daira de Chéraga\" region in Algeria. It had two objectives: to estimate the prevalence of asthma and to describe its epidemiological pattern. The study was divided into two parts: the first was a household survey based on a questionnaire and the second, another interview at hospital, with clinical examination and pulmonary function tests with pharmacodynamic tests. The cumulative prevalence of respiratory symptoms was 2.38%. The cumulative prevalence of asthma was 1.34% and the annual prevalence 1.21%. Asthma was more prevalent in boys than girls aged under 20 years (sex ratio = 2.66) with an equal proportion after age 20 years. Asthma most often occurred in childhood in males and at an adult age in females. In 40% of cases there were family antecedents of asthma. It is impossible to extrapolate these results to the entire country and the existence of regional disparities pleads in favour of further research in this field.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 2-3","pages":"91-3"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12918689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nosocomial tuberculosis in the AIDS era: strategies for interrupting transmission in developed countries.","authors":"E A Nardell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In developed countries where tuberculosis is increasing in association with HIV infection, nosocomial transmission among patients and from patients to health care workers is being increasingly reported. Nosocomial tuberculosis among HIV-infected patients is difficult to prevent by conventional control measures because the clinical presentation of the disease may be atypical and confused with other respiratory infections, because the tuberculin skin test is less reliable, because cough generating procedures may increase the probability of transmission, because HIV-infected patients may progress rapidly from infection to disease, and because the organisms are increasingly drug resistant, making preventive therapy difficult. Substandard ventilation and the recirculation of air in many contemporary buildings has also been implicated in widespread nosocomial transmission. Source control through isolation and effective treatment of known or suspected cases remains the most effective strategy for preventing transmission. Dilution of infectious droplet nuclei through ventilation with outside air is important, but incompletely protective. Like ventilation with outside air, filtration of recirculated air may reduce the chance of infection by dilution, but it is expensive. Traditional surgical masks offer the wearer little or no protection. Finally, ultraviolet air disinfection may augment ventilation by inactivating organisms in the upper room air, or in ventilation ducts.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 2-3","pages":"107-11"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12918828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Three decades of tuberculosis in Singapore.","authors":"B H Heng, K K Tan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tuberculosis (TB) mortality for the period 1955-1959 to 1985-1989 declined 87% from 72 to 9 per 100,000 in males, and 90% from 31 to 3 per 100,000 in females. The mean annual rate of decline of mortality was 6.8%. Older persons had a lower 4.2-5.2% decline annually compared to 14.1-16.0% in the 0-4 year age group. The incidence of TB declined 80% from 438 to 88 per 100,000 in males, and 71% from 152 to 43 per 100,000 in females over the period 1960-64 to 1985-89. The mean annual rate of decline in incidence was 5.9%. The lowest decline was observed in the children below 15 years (2.8-3.2%) and elderly persons 65 years and above (2.3-5.5%). Birth cohorts of 1945-49 and earlier had progressively higher mortality risks, but declining morbidity risks as they advanced with age. Singapore has overcome the early phase of the TB epidemic as evidenced by its relatively low rates among children and females and the low rates of extra-pulmonary TB and meningitis. The high incidence rates in old people are the residue of even higher rates experienced by this cohort of persons who experienced higher risks of infection in their early lives. At the prevailing rates of decline under the present conditions and control measures, TB will not be eliminated in Singapore over the next 50 years.</p>","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 2-3","pages":"125-8"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12918830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bulletin of the International Union Against Tuberculosis and Lung Disease. Introduction.","authors":"J Chrétien","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 2-3","pages":"75"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12920028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Worldwide trends in asthma morbidity and mortality.","authors":"A S Buist","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77502,"journal":{"name":"Bulletin of the International Union against Tuberculosis and Lung Disease","volume":"66 2-3","pages":"77-8"},"PeriodicalIF":0.0,"publicationDate":"1991-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12920031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}