The impact of airborne dust on respiratory health in children living in the Aral Sea region.

BACKGROUND: Anecdotally, people living in the Aral Sea region report an increase in the prevalence of respiratory illnesses, particularly in children, and there is widespread belief that this is due to dust from the Aral Sea bed. METHODS: We conducted a survey of respiratory symptoms and lung function in children aged 7-10 years living in 18 communities in 6 geographical regions in the Aral Sea area. We monitored dust deposition rates monthly for the duration of the study. RESULTS: The overall prevalence of recent wheeze was low at 4.2%, but this figure varied with region and was higher in the more accessible urban and delta regions and lower in the more remote regions. We found no evidence of an association between local annual dust deposition and specific respiratory symptoms. Lung function results also showed variation between geographical regions not explained by annual dust deposition. After allowing for region of residence, however, there was some evidence of an inverse association between percentage predicted forced expiratory volume in 1 s(FEV1) and dust exposure during the summer months (change in percentage predicted FEV1 per 1,000 kg/ha annual dust deposition -1.465) (95% confidence interval -2.519 to -0.412); however, in winter, the reverse was true. CONCLUSIONS: The prevalence of asthma is low in the Aral Sea area and appears to be unrelated to dust exposure. Exposure to dust did not explain the main variations in lung function between geographical regions but high levels of dust exposure during the summer may have an adverse effect on lung function.

A breath test to assess compliance with disulfiram.

AIMS: To evaluate the ability of a hand-held breath analyser, the Zenalyser((R)) (Zenics Medical), to identify alcohol-dependent patients receiving disulfiram therapy and to assess the sensitivity and specificity of the instrument at different time intervals post-disulfiram dosing. DESIGN: Breath samples were taken from two groups of alcohol-dependent patients, one group on a daily disulfiram regimen and one group receiving no disulfiram. The breath samples were analysed for the combined concentration of carbon disulphide and acetone produced from the metabolism of disulfiram. From these data, two reference ranges were prepared and used for sensitivity and specificity assessments. SETTING: Breath samples for the reference ranges were obtained from patients at Shelton Hospital, Shrewsbury. Breath samples used to assess the sensitivity and specificity of the instrument were obtained from patients at the Edinburgh Alcohol Problems Clinic. PARTICIPANTS: Twenty in-patients from Shelton Hospital receiving a daily 200 mg disulfiram regimen and 20 in-patients receiving no disulfiram. At the Edinburgh Clinic, 54 patients taking a thrice-weekly disulfiram regimen and 22 patients not on disulfiram. MEASUREMENTS: A total of 489 breath samples from Shelton Hospital and 391 breath samples from the Edinburgh Clinic were analysed for the combined concentrations of carbon disulphide and acetone. FINDINGS: The breath analyser produced results that distinguished between the disulfiram-treated and untreated groups (P < 0.001). At 1 day post-dose, the sensitivity was 100% and the specificity was 100%. At 2 and 3 days post-dose, the sensitivities and specificities were 84.6% and 100% and 88.2% and 100%, respectively. CONCLUSION: The breath analyser can improve the assessment of the compliance status of patients receiving a daily dose regimen of disulfiram, but is less useful for this purpose if disulfiram is taken on a thrice-weekly regimen.

DengueTools: innovative tools and strategies for the surveillance and control of dengue.

Dengue fever is a mosquito-borne viral disease estimated to cause about 230 million infections worldwide every year, of which 25,000 are fatal. Global incidence has risen rapidly in recent decades with some 3.6 billion people, over half of the world's population, now at risk, mainly in urban centres of the tropics and subtropics. Demographic and societal changes, in particular urbanization, globalization, and increased international travel, are major contributors to the rise in incidence and geographic expansion of dengue infections. Major research gaps continue to hamper the control of dengue. The European Commission launched a call under the 7th Framework Programme with the title of 'Comprehensive control of Dengue fever under changing climatic conditions'. Fourteen partners from several countries in Europe, Asia, and South America formed a consortium named 'DengueTools' to respond to the call to achieve better diagnosis, surveillance, prevention, and predictive models and improve our understanding of the spread of dengue to previously uninfected regions (including Europe) in the context of globalization and climate change.The consortium comprises 12 work packages to address a set of research questions in three areas:Research area 1: Develop a comprehensive early warning and surveillance system that has predictive capability for epidemic dengue and benefits from novel tools for laboratory diagnosis and vector monitoring.Research area 2: Develop novel strategies to prevent dengue in children.Research area 3: Understand and predict the risk of global spread of dengue, in particular the risk of introduction and establishment in Europe, within the context of parameters of vectorial capacity, global mobility, and climate change.In this paper, we report on the rationale and specific study objectives of 'DengueTools'. DengueTools is funded under the Health theme of the Seventh Framework Programme of the European Community, Grant Agreement Number: 282589 Dengue Tools.