Today, we know a lot about HIV and AIDS, yet too little to be able to stop the pandemic by a vaccination or by medication. Until that day is at hand, the only means of controlling the pandemic is by information--information about the diffusion of the virus, about risk behaviour, about safe sex, and about social responsibility. Educating people must be based on concise clinical experience, an up-to-date picture of the epidemiological situation, and reliable forecasts about the future course of the epidemic. Producing reliable forecasts about the HIV epidemic has proved to be a more complicated task than expected. The proven, reliable, and in most cases very useful epidemiological models have been far from successful when applied to the HIV epidemic. The reason for this is mostly due to the lack of reliable data depicting the true HIV seroprevalence. Instead of being handicapped by the problems of inadequate data, geographical modelling of the HIV epidemic is able to rely on its theoretical understanding and good knowledge about the spatial organization and the functioning of societies to make is forecasts. Due to its flexibility of approach, geographical modelling can adjust itself to less accurate data, thus providing an interim forecasting instrument until epidemiological modelling becomes successful. This paper presents the results of an analysis of the HIV epidemic in Finland based on cartographic analysis of municipal data and the use of a simple growth model.
The tuberculosis epidemiological situation was studied among the children of the Udmurt Republic and the tuberculosis morbidity rates in children, the risk of primary infection, and the infection rates were predicted by the Bayes procedure. To study the impact of chemoprophylaxis on the incidence of tuberculosis in children, the risk of its primary infection, and the infection rates, the authors used the multivariate statistical method--hypotheses theorem (the Bayes formula). The application of the hypotheses theorem has shown that if the cohort of children who had chemoprophylaxis in 2007, they should receive it at the same rate as in 2002, which is 30% greater, the morbidity rates in children should show a 1.1-fold reduction.
The major epidemiological parameters were analyzed in 7 autonomous districts of the Far North of Russia from 1975 to 2002. Throughout the period of observation, tuberculosis morbidity in native dwellers was 5 times higher or more than that in the newcomers and in 2002 it increased up to 292 per 100,000. The incidence of its bacterial forms in the natives was 7-9 or more times greater than that in the newcomers (this index was as high as 126.6 in 2002). The prevalence of tuberculosis accompanied by bacterial isolation in the indigenous dwellers was 7-9 or more times greater than that in the newcomers and ran up to 619.9. In the natives, mortality rates were almost 10 times higher than those in the newcomers. The bulk of the indigenous dwellers live in isolated inaccessible localities. In the indigenous dwellers, the multifold increase in the major indices, as compared to the normal values, was characteristic of the development of the epidemic situation in the Far North. The native dwellers determine the specific features of development of the epidemic situation in the region, thus requiring that special approaches to delivering antituberculous care should be developed.
Four outbreaks of botulism in the Faroe Islands in 1979, 1988 og 1989 are reported. Seven patients were involved and one died. All persons had eaten dried mutton. In one case, Clostidium botulinum type was not determined, while in other outbreaks one patient had type B botulism and two type E botulism.
The paper substantiates and provides evidence for that it is necessary to use summarized estimates to characterize the tuberculosis endemic situation. Some individual epidemiological indices are inadequately estimated to give a correct idea of epidemiological well-being. By using his own method for deriving an integral estimates, the author has analyzed the dynamics of the tuberculosis situation in Russia in 1985 to 2003. Two turning points have been established in the dynamics of the epidemic situation: 1) improvement up to 1991 inclusive and 2) a subsequent deterioration up to 2002, thereafter the epidemic situation had tended to improve. A correlation matrix has been derived, which reflects a correlation of integral estimates with individual epidemiological indices.
The statistical reports by 21 subjects of the Russian Federation (the Siberian and Far-Eastern Federal Districts) have been analyzed to define the rates of extrathoracic tuberculosis morbidity in these regions and its structure. It has been established that new trends have been recently evident in the pattern of extrathoraric tuberculosis. Firstly, there has been an increase in the incidence of bone and joint tuberculosis, young men and old women being predominant in its structure. Secondly, the steep rise in the incidence of genital tuberculosis, caused by the appearance of an experienced phthisiological gynecologist in one of the regions emphasizes that the fact that there is a large proportion of undetected extrathoracic tuberculosis cases is pressing. There is concern for the high percentage of children with extrapulmonary tuberculosis--this fact reflects the tense epidemic situation in the areas.
The description of the epidemic manifestations of cholera in the Republic of Daghestan at the period of the seventh pandemic, linked with the action of such common transmission factors as water, food and everyday contacts, is presented and their role in the territorial spread of this infection is evaluated. The analysis of family foci in the Derbent and Kaiakent regions in 1994 is given; the conclusion is made that a low sanitary level of human dwellings leads to a wide spread of cholera among close relations due to the action of water, alimentary and contact factors of transmission.
We present a detailed analysis of the pattern of measles outbreaks in the small isolated community of the Faroe Islands. Measles outbreaks in this population are characterized by frequent fade-out of infection resulting in long intervals when the disease is absent from the islands. Using an analysis of the distribution of epidemic sizes and epidemic durations we propose that the dynamical structure observed in the measles case returns reflects the existence of an underlying scaling mechanism. Consequently the dynamics are not as purely stochastic as is usually thought for epidemiological systems of this sort. We use a lattice-based epidemic model to provide a theoretical estimate of the scaling exponents and show that a conventional compartmental SEIR model is unable to reproduce this result. The methods discussed in this paper are general and represent a novel way to consider the dynamics of any other communicable disease where there is frequent fade-out in the case returns.