Revista de sanidad e higiene publica最新文献

Background: The incidence of arterial hypertension and other cardiovascular diseases has undergone an increase in Spain during recent years, particularly in rural areas, as a consequence of progressive population aging. A study is made of drug prescriptions associated with non-complicated arterial hypertension in a rural setting.

Methods: Field work was initiated in four rural municipalities of Castellon province on the Spanish Mediterranean coast, with highly aged populations. Out of a total population of 1064, 60% made use of the area health care services in the course of year. Of these, 11% had at one time or other suffered one or more episodes of non-complicated arterial hypertension.

Results: The drugs most commonly prescribed were calcium antagonists, angiotensin converting enzyme inhibitors, and diuretics, although differences in order of importance were seen depending on patients age. The cost of the active components prescribed were below the average of those commercialized within each therapeutic group.

Conclusions: To conclude, interactions were detected with other drugs used by the patients while on hypotensives. The most relevant in this sense were nonsteroidal anti-inflammatory agents; consumption of these drug was very high, in part also due to the high incidence of osteomuscular complaints among the geriatric population of the zone.

Tobacco smoking is the most important health problem in Spain, as in the rest of the developed countries; been also recognized as the most preventable cause of premature morbidity and mortality in the western world. Interventions to reduce tobacco consumption in Spain, has been mainly addressed by means of physician-patient interaction, lacking the approach for community and workplace interventions. This article emphasize the need for the implementation of strategies of smoking cessation programs in the worksite, encouraging to health professionals to design, to apply and to evaluate these interventions. The most often used approaches to reduce tobacco smoking at the worksite are considered, addressing cost-effectiveness issues related with the characteristics of the Spanish Health System.

Hydatidosis is a serious Public Health problem in the Province of Río Negro, Argentina. This situation has promoted the implementation of a control programme based on the canine systematic deparasitation with Praziquantel, health education, work control and care of persons. The accumulated experience of 15 years works, carried out to develop the last work--line mentioned above, is presented in this study. The activities includes the registry of human cases, the early identification of asymptomatic carries, the infected persons derivation to the hospital system in order to allow their appropriate treatment, the longitudinal follow up of the operated cases and the epidemiologic surveillance of the human hydatidosis situation. A network of laboratories was organized, as a support to satisfy the hospital demand, under the coordination of a central laboratory of reference and serologic surveys, among the groups at risk, were also carried out. The information registered indicates that a total of 60,078 serologic tests were carried out in the whole Province: out of them, 22,899 corresponded to hospital demand (DD5) and 37,179 to serologic surveys (originally latex, then DD5, and now Elisa). 65% of the cases, diagnosed by official register, is derived from rural areas to complexity hospitals, to be put under surgical treatment, and, out of these operated persons, only 3.9% is derived from the appearance of clinical symptomatology. A sustained reduction in the average days of stay, in lethality and in the rate of serologic prevalence in school children from 7 to 13 years of age, are achieved.(ABSTRACT TRUNCATED AT 250 WORDS)

Background: Nutritional conditions of a population constitute an important health indicator. Children and adolescents are considered to be at high risk of suffering excess of defect nutritional problems; however, preventive action is easier in this group. For this reason, we decided to carry out a valuation of nutritional status in a school children population of a marginal area in Cádiz Province.

Methods: Students, registered in the second level of Primary School of the only public school in the area, were studied. They were directly examined on their nutritional condition by clinical, anthropometrical and biochemical study. In the same way, a valuation of the population socio-economical status was carried out, according to GRAFFAR criteria. The information obtained was tabulated and analyzed using the computerized programme EPINFO. Results were compared with the OMS Standard International and with the Ruiz's study, carried out in the same province.

Results: Both: body weigh/age and Quetelex indexes shown lower values than the standard and than Ruiz's study, specially in the groups of higher age (except for boys of 15 years old). This was also shown for the arm perimeter. Nevertheless, in the tricipital skin fold, values were higher than the standard in the ages of 12 and 13 years; but lower than the Ruiz ones in some ages.

Conclusions: The results obtained might suggest the existence of an unbalanced and/or poor diet among school children; this fact could be verified carrying out a complete dietetic assessment of this collective.

Background: In Spain, the problems caused by cocaine and opiates consumption are monitored through the State Information System on Drug Abuse (SEIT); one of its indicators is the number of admissions for ambulatory treatment for these drugs abuse/addiction (Treatment Indicator).

Methods: The information quality of this indicator was evaluated retrospectively during 1988 by comparing the data notified to SEIT with those registered in the treatment centres. For that, a random sample of cases among the clinical records from the notifying centres, and another among the cases registered in the SEIT Central Unit, were selected and crossed, calculating the precision and concordance indexes and observing the possible differences between both samples. In addition, mechanisms of notification and information organization were examined in the selected centres.

Results: In 1988, at state level, the sensibility was 81% and the predictive positive value 96%. As a whole, the SEIT underestimated the number of cases by 16%. Although the sample was not representative by Autonomous Communities, important between-regions differences in precision were observed. No significant differences of the information quality were found in relation to the centre size (although quality was lower in small centres) nor between the "true cases" notified and those not notified. Disparities, among centres, in relation to mechanisms of notification and information organization were found.

Conclusions: The SEIT is of a great value to know the characteristics of the persons treated for opiates or cocaine in Spain; but the between-regions variations on its precision might limit seriously geographic comparisons in the number of cases. It is necessary to evaluate periodically the indicator quality and to improve the consistency of data registration mechanisms.

Background: Deaths by acute reaction from drugs consumption (RAD) particularly heroine or cocaine, collected in routine morality statistics, have not changed substantially during the last ten years, whereas an specific collection system (State Information System on Drug-Abuse SISD) presented a great increase. For this reason, we try to measure the validity of drug-related deaths certificate.

Methods: The cause of death, corresponding to the persons, from 15 to 39 years of age, decreased in 1988 and residing in the Municipality of Madrid, registered in the Civil Register Decease Book and in the death Statistics Bulletins (DSB) was compared with the cause present in the autopsy report.

Results: A detection rate of 2.45% for the CR and 3.27% for the DSB were obtained. With the consequent correction, the RAD for this age group would be the second cause of mortality in the Municipality of Madrid and deaths related to circulatory and respiratory system would decrease in a great measure.

Conclusions: It is necessary to improve substantially the collection of this cause of death in mortality statistics if we want a correct measurement of drug abuse lethal effects and the effectiveness of control programmes on this health problem.

Background: The control of Hepatitis B as a community health problem which implies the reduction of the number of cases and carriers cannot be achieved merely through selective vaccination of high risk groups and immunization of newborns whose mothers are carriers. The decision to introduce universal vaccination on a constant basis should be based on the epidemiological characteristics of the infection in the community, among other reasons.

Methods: Along these lines, a study of seroprevalence of the infection was carried through a random sampling of ages groups taken from a population with no history of hepatitis and low risk groups, using a survey of 855 people and a retrospective study of seroprevalence in different high risk groups with a survey of 2,183 people.

Results: The prevalence of infection estimated at intervals in the general population not included in high risk groups is 8.05-12.07, and that of carriers of HBs Ag 0.07-1.09. The risk of infection increases significantly after 14 years of age (p < 0.001) with an OR of 25.22. Sexual transmission as a means of spreading the virus among the general public is demonstrated by the data obtained from sexual promiscuous People and prostitution: 58.53% and 44.21% respectively.

Conclusions: We consider it necessary to employ universal vaccination of adolescents within the children's immunization programmes, at a recommended age of 13 before finishing primary school and abandoning school, while still keeping the prophylactic measures and immunization of high risk groups. This will also allow us to simultaneously prevent infection by Hepatitis Delta in the Autonomous Community both as a co-infection by HBV and an overinfection. In this programme we advocate the elimination of serological studies on Hepatitis B (due to cost-efficiency studies) and are in favour of periodic future research on seroPrevalence.