[Seroprevalence of pertussis toxin antibody in Manisa province of Turkey, after six years implementation of acellular pertussis vaccine]. / Hücre içermeyen bogmaca asi uygulamasinin altinci yilinda Türkiye'nin Manisa ilindeki pertussis toksin antikoru seroprevalansi.

Vaccination is the most effective way of preventing pertussis disease. Turkey commenced a routine infant immunization program using whole cell (wP) pertussis vaccine in 1968. Immunization accelerated in 1985 after participation of Turkey in the Expanded Programme on Immunization initiated by the World Health Organization. Acellular vaccine (aP) replaced wP in 2008 and a booster was added to age 6 in 2010. The immunization programme was successful in reducing the morbidity rate from 20.58 per 100.000 in 1970 to the lowest level of 0.01 per 100.000 in 2009. However, reduction of vaccine-induced protection and reduced natural boosting of circulating Bordetella pertussis are likely to increase the susceptibility of the population. As a result, morbidity rate increased from 0.09 per 100.000 to 0.41 per 100.000 in 2015 compared to the previous year. The aim of this epidemiological study was to determine the seroprevalence of pertussis toxin (PT) antibodies among healthy people and its association with various social determinants in Manisa province in Turkey, 6 years after aP replaced wP vaccine. The study was conducted as a cross-sectional study with a sample of 1250 people that was randomly selected from the over 2 years of age population in Manisa in 2014. Seroprevalence of PT antibody was determined as the dependent variable of the study. Independent variables of the study were; gender, age, migration in the last 5 years, occupational class, perceived income, house ownership, number of people per room, annually per capita equivalent income. The presence of anti-PT IgG was detected by quantitatively using a commercially available ELISA kit. The antibody levels were categorized into groups according to pertussis infection or vaccination immune response status. The groups consisted of undetectable (< 5 IU/ml), mid-range (5-< 62.5 IU/ml: more than one year previously), high (62.5-< 125: with in 12 months) and very high (≥ 125 IU/ml: with in 6 months) antibody levels. The test results with ≥ 5 IU/ml were defined as seropositive. Level > 100 IU/ml detected among adolescent and adult participants indicated acute or recently recovered pertussis infection. Chi-square test was used to evaluate association between social determinants and pertussis seropositivity. The seroprevalence of the whole study population was 58.1% (95% CI 55.32-60.79) and no association was found with any of the social determinants. The highest seroprevalence was found among 2-9 age group (68.3%) followed by 70-79 age group (63.5%). The lowest seroprevalence was found among 20-29 age group (50.9%) followed by 10-19 age group (51.6%). When seropositivity levels according to ages were compared, it was found that there was a decrease one year after the first vaccination at 2nd, 4th and 6th months and the booster at the 6th year, with a lowest rate (19%) in 11 year-old. The highest seropositivity (77.3%) with a level of >100 IU/ml (13.6%) were detected at age 15 among all adolescent and adult participants. Adding an adolescent booster to immunization schedule and recommendation of vaccine to elderly people should be considered to reduce the incidence of pertussis disease in Turkey.

Seroprevalence of West Nile virus, Crimean-Congo hemorrhagic fever virus, Francisella tularensis and Borrelia burgdorferi in rural population of Manisa, western Turkey.

BACKGROUND & OBJECTIVES: Zoonotic diseases are well recognised threat to public health globally. The information of regional prevalence and associated risk factors allow the national programmes to determine and frame better strategies for their control, as they also provide the actual status of zoonosis in the region. The aim of this study was to determine the seroprevalence of West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus (CCHFV), Francisella tularensis and Borrelia burgdorferi among the rural residents of Manisa region, Turkey and to identify the associated risk factors. METHODS: Cross sectional study was conducted in rural parts of Manisa, Aegean region of western Turkey in 2012. Blood samples from 324 randomly selected subjects were screened for the presence of IgG antibodies to WNV, CCHFV, F. tularensis and B. burgdorferi with commercially available kits. The demographic structure of the rural residents and risk factors related to lifestyle such as outdoor agriculture activities, animal husbandry, hunting and history of tick bite were questioned and their relationships with positive results were analyzed statistically. RESULTS: It was observed that 49 subjects (15%) had IgG antibodies to at least one of the zoonotic agents studied. The seroprevalence of F. tularensis was highest with a percentage of 7.1% (n = 23). Distribution of the positive results for WNV, CCHFV and B. burgdorferi were 4.3% (n = 14), 3.7% (n = 12) and 0.9% (n = 3), respectively. Older age and uncompleted secondary education were the statistically significant risk factors for seropositivity to at least one zoonotic agent investigated. Logistic regression analyses confirmed that older age (over 50) increased the risk of WNV and CCHFV seropositivity. INTERPRETATION & CONCLUSION: Seropositivity rates were not found to be higher than the expected rates. Further, studies are needed to evaluate the threat of vector borne zoonoses and associated risk factors in the study area.

[How is quality of life affected in women in the presence of anxiety and depression symptoms?]. / Kadinlarda yasam kalitesi anksiyete ve depresyon belirtilerinin varliginda nasil etkileniyor? kesitsel bir alan çalismasi.

OBJECTIVE: To assess how quality of life is affected among reproductive age women from the presence of anxiety and depression symptoms and the risk factors related to both. METHOD: A cross sectional analytic study was performed in person with 461 women. General Health Questionnarie-12 and WHOQOL-BREF were used. RESULTS: 35.5% of the women displayed symptoms of anxiety and depression and those who had experienced domestic violence had a 2.61-fold increase in symptom frequency and those with an income below 500 TL had a 2.49-fold more frequent occurrence of symptoms compared to others. General health quality mean score was 3.33 ± 0.804, the mean overall quality of life was 3.62 ± 0.791; Physical Health Domain: 15.95 ± 2.422; Psychological Health Domain: 14.70 ± 2.337; Social Relations Domain 14.64 ± 3,027; Environmental Domain 14:27 ± 2.20; National Domain 14:29 ± 2.144l. The total score of GHQ-12 and the first two questions of WHOQOL-BREF had a negative, moderate and highly significant correlation, whereas the Psychological HD score had a a negative,, strong and significant correlation All other domains and the total score of GHQ-12 had negative, moderate and significant correlations. CONCLUSION: Screening with GHQ-12 as well as offering the possibility of early diagnosis and treatment, is also important to prevent impairment in all areas of quality of life among women. Early diagnosis and treatment of psychological problems of women with risk factors such as exposure to domestic violence and low socio-economic status are the intervention areas with priority.

Nutritional status and risk factors of chronic malnutrition in children under five years of age in Aydin, a western city of Turkey.

We aimed to assess the prevalence and risk factors of chronic malnutrition in children under five years old in Aydin province, Turkey. A cross-sectional design was used to study a group of 1,400 children. Multistage sampling, including cluster and random sampling, respectively, was used in the selection of the study group. Stunting, wasting and underweight were used as indicators of nutritional status for children. The prevalence of malnutrition in children under five years was found as 10.9% for stunting, 4.8% for underweight and 8.2% for wasted. Increased risk was found in families without social security by 2.071, with low birth weight by 2.516 and with giving no colostrum by 2.787 in stunted children. Improving social security coverage is essential. Mothers should be informed on the usefulness of breast-feeding at antenatal care services during their pregnancies and taught appropriate breast-feeding practices, including the importance of giving colostrum, at baby-friendly institutions after birth.