[Increasing number of Chlamydia infections--how can we reverse this trend?]. / Klamydiainfektionerna ökar--hur vänder vi trenden?

The incidence of chlamydia in Göteborg, the second largest city in Sweden, increased by 81 percent between 1995 and 2001. The majority (82%) of men and women diagnosed with chlamydia were aged 15-29 years. The incidence of chlamydia was higher among teenagers from areas of lower socio-economic index during the first years of the study but after 1995 there was no difference between low and high socio-economic groups. Chlamydia tests were taken three times more often in women than men. Analysis of original data from the Swedish survey of sexual behaviour 1996 demonstrated a strong correlation between the number of sexual partners and STD. Strategies for preventing the spread of chlamydia should be to a greater extent directed towards men and include better accessibility for men to STD clinics as well as a general improvement in contact tracing. The general public should be informed about the fact that chlamydia infections do not always give symptoms and may lead to infertility. Campaigns about condom use in order to avoid chlamydia, HIV-infection and other STD are needed.

Nasal symptoms are associated with school performance in adolescents.

Children with asthma and allergy have higher school absence rates than others, but little is known about their school performance. In a study of 9538 adolescents, nasal symptoms severe enough to affect daily activity were associated with low-grade sum, particularly in adolescents using anti-allergy medication.

Influenza work on the regional level in Sweden: an integrated program for vaccination of risk groups, surveillance and pandemic planning which focuses on the role of the health care worker.

The aim of the study was to increase the vaccination rates of influenza among the risk groups in Region Västra Götaland, Sweden. The main interventions performed were education of doctors and nurses, information on the Internet and advice on administrative routines and organisation for the task. There was no campaign towards the risk group and no reimbursement. The vaccination rate increased from 33.6 to 54.6% in the Göteborg area between 1999 and 2004 and from 44.1 to 51.9% in the whole region. Vaccination rates increased with age and chronic disease in the elderly population, among person's 20-64 years of age with chronic disease only 23.8-34.0% were vaccinated. In order to increase the vaccination coverage in persons with chronic disease the program intensified the education of hospital staff. It was then evident that the awareness and knowledge about influenza and vaccination was limited among hospital doctors. The study demonstrates the key role of health care workers in a vaccination program and points at the importance of preparing the personnel for a pandemic situation. Co-ordination of the vaccination program with the surveillance and pandemic planning are effective means of strengthening the preventive work against influenza.

The impact of active intervention on the spread of penicillin-resistant Streptococcus pneumoniae in Swedish day-care centres.

Policies for handling cases of penicillin-non-susceptible Streptococcus pneumoniae (PNSP) in day-care groups vary between different counties in Sweden. The aim of this study was to evaluate the epidemiological effect of excluding PNSP-carriers from children's day-care centres (DCC). We followed the incidence in 14 DCC groups with ongoing PNSP-spread, by repeated group screens until no further cases could be identified. All identified carriers were excluded from DCC attendance in study area A (Skåne region) while they remained in the group in study area B (Göteborg and örebro), according to local policies. The intervention effect was evaluated by comparing the number of additional cases after the baseline screen (start of the intervention period) between the 2 study areas. All PNSP-isolates were characterized by resistance pattern, serotype and pulse-field gel electrophoresis. The relative risk for children in DCCs without active intervention was 6.4 (95% CI: 2.0-20.7). Each prevented case in area A can be estimated to have demanded the exclusion of 2 other children from day care for approximately 4 weeks each. The total cost-benefit outcome of this action has to be seen in the light of the local situation with regard to the population prevalence and the distribution of other risk factors.