Trends in mortality rates for infectious and parasitic diseases in Australia: 1907-1997.

AIMS: To characterize long-term mortality trends for infectious and parasitic diseases in Australia during the twentieth century, explore influencing factors and provide suggestions to health policy-makers. METHODS: A descriptive study was conducted. Deaths due to communicable diseases from 1907 to 1997 were tallied, according to the International Classification of Diseases version 9 (ICD-9). Trends in infectious disease mortality in overall population and in the 0-4 years age group were examined and standardized by sex. Death rates were also studied for: (i) diarrhoea/enteritis, (ii) pneumonia and all respiratory diseases and (iii) tuberculosis. RESULTS: There has been a substantial decline in -mortality from communicable diseases over the study period. The death rate dropped from 258.9 per 100,000 population in 1907 to 7.2 per 100,000 population in 1997. Six phases of the decline were observed. CONCLUSIONS: A combination of improved living conditions and access to readily available treatments over the twentieth century played an important role in the reduction of infectious disease mortality in Australia.

Family self-medication and antibiotics abuse for children and juveniles in a Chinese city.

To identify the determinants of self-medication and antibiotics abuse by parents treating their children aged between 2 and 18 over the previous year, an investigation was conducted in Hefei City, China in April, 1995. A total of 1596 students from a kindergarten, a primary school and a high school were included in the study, and 1459 completed questionnaires were collected (the response rate: 91.4%). The results showed the rate of parental self-medication for their children in the sample was 59.4%. It increased with children's age; about 51% of children had received parental self-medication on six or more occasions during the 1-year period and 32.8% on four to five occasions; there were associations between parental self-prescribers and sources of medicine and severity of disease. The rate of antibiotics abuse was 35.7%. Logistic regression analysis showed that there were significant associations between self-medication and payment of the mother's medical fees by employers, severity of diseases as well as the mother's educational level.

Seasonal rainfall variability, the incidence of hemorrhagic fever with renal syndrome, and prediction of the disease in low-lying areas of China.

To investigate determinants of hemorrhagic fever with renal syndrome (HFRS) in low-lying areas of China, the authors studied Chuigang and Wanggang communities in Anhui Province. These adjacent farming communities have a population of about 100,000. Data were collected from the two communities in 1961-1977 and from Yingshang County in 1983-1995; information covered the incidence of HFRS, amount of precipitation, differences in the water level of the Huai River, density of Apodemus agrarius, autumn crop production, and areas of inundated farmland. Correlation and multiple linear regression analyses were used to estimate the relation between seasonal rainfall, density of mice, occupational factors, and occurrence of the disease. Associations were observed between the incidence of HFRS and the amount of precipitation, the water level of the Huai River, and the areas of inundated farmland in Chuigang community. The smaller the water-level difference, the less farmland was inundated and the higher the incidence of HFRS. In Wanggang community, the density of A. agrarius (r1=0.63, p=0.02), the water-level difference in the Huai River (r2=-0.81, p=0.007), and crop production (r3=0.96, p=0.005) were correlated with the incidence of HFRS. The regression analyses based on Wanggang community suggested that these indexes could be used as predictive variables, and the results from the model were well calibrated with the actual incidence of HFRS in that community (R2=0.88, p < 0.01) and Yingshang County (R2=0.91, p < 0.01).

PIP: The determinants of hemorrhagic fever with renal syndrome (HFRS) in low-lying areas of China were investigated in studies conducted in Chuigang and Wanggang (Anhui Province) in 1961-77 and in Yingshang County in 1983-95--communities with consistently high incidence rates of HFRS. The incidence of HFRS was assessed in relation to amount of precipitation, differences in the water level of the Huai River, density of Apodemus agrarius mice, autumn crop production, and areas of inundated farmland. An inverse association was found between the amount of rainfall, the Huai River's level, areas of inundated farmland (an index reflecting people's contact with rodents), and HFRS incidence. Results from estimation models based on these three predictive factors were well calibrated with the actual incidence of HFRS. In years with less-than-normal rainfall, more farmland is available for planting, creating a favorable microenvironment for mice and increases in their numbers. The local density of mice was 10% in 1961-62, when there was a relatively low amount of precipitation, compared with 2% in 1963-64, when precipitation was above average.