Last month saw the end of the first year of operation of the Abortion Act in Britian, and statistics are now available for the first 10 months, from April 1968, to February 1969. In that time, legal, notified abortions totalled 28,849, of which 20,746 were on the grounds of risk of injury to the physical or mental health of the women. A further 1350 were carried out because of risk to the life of the woman, 1137 because of risk to the physical or mental health of existing children, 965 because of the risk of the woman bearing a physically or mentally handicapped child, and 52 as emergencies to save the life of the woman or prevent grace injury to her health. Another 4599 abortions were carried out for more than 1 of these reasons. An earlier set of statistics, covering the period up to December 1968, showed that 22,256 abortions legally carried out up to then, 13,609 were in National Health Service hospitals and 8601 in other approved hospitals. It is likely that the total number of legal abortions in Britain for the first full year of the Act will be about 34,000. In the years leading up to the introduction of the Abortion Act, the number of abortions carried out in Britain for reasons then legal had been growing steadily, and had reached 7600 in National Health Service hospitals in 1967. An unknown further number of legal abortions had been done in private nursing homes - these cannot be computed because they were not notifiable before the Abortion Act came into force. There are 4 legal abortions for every 100 live births in Britain; this is about 1/2 the figure for Denmark and one tenth that of Czechoslovakia.
In the last several years, West Nile virus (WNV) was proven to be present especially in the neighboring countries of Austria, such as Italy, Hungary, and the Czech Republic, as well as in eastern parts of Austria, where it was detected in migratory and domestic birds. In summer 2010, infections with WNV were reported from Romania and northern Greece with about 150 diseased and increasingly fatal cases. We tested the sera of 1,607 blood donors from North Tyrol (Austria) and South Tyrol (Italy) for antibodies against WNV by using IgG enzyme-linked immunosorbent assay (ELISA). Initial results of the ELISA tests showed seroprevalence rates of 46.2% in North Tyrol and 0.5% in South Tyrol, which turned out to be false-positive cross-reactions with antibodies against tick-borne encephalitis virus (TBEV) by adjacent neutralization assays. These results indicate that seropositivity against WNV requires confirmation by neutralization assays, as cross-reactivity with TBEV is frequent and because, currently, WNV is not endemic in the study area.
High rates of tuberculosis, including multidrug-resistant tuberculosis (MDR-TB), have been reported from the former Soviet Union. Our laboratory has supported operational studies in jails in Baku, Azerbaijan, and Mariinsk, Siberia. Combining the results from these two penal systems, the rates of MDR-TB among 'newly enrolled' and 'non-responding' cases were 24.6% and 92.1%, respectively. Restriction fragment length polymorphism (RFLP) studies strongly suggest transmission of MDR-TB between prisoners. In Mariinsk, the high rates of MDR-TB have been associated with failure rates of 23%-50% among smear-positive cases receiving fully-supervised standard short-course treatment. There are no coherent guidelines for TB control programmes confronted by high pre-existing levels of MDR-TB but who have only limited laboratory, clinical, pharmaceutical and financial resources. A 'DOTS plus' strategy has been advocated in which an established TB control programme is complemented by facilities to treat MDR-TB patients. However, the exact format of these programmes remains unresolved. Further research is required to describe the natural history of MDR-TB infection, to determine the failure rate of (and the additional resistance induced by) standard short-course treatment when MDR-TB is prevalent, to decide whether standardised or individualised second-line regimens can be employed, and to define the laboratory facilities required by a 'DOTS plus' programme.
Nasopharyngeal carcinoma is a disease with a remarkable racial and geographical distribution. In most parts of the world it is a rare condition and in only a handful of places does this low risk profile alter. These include the Southern Chinese, Eskimos and other Arctic natives, inhabitants of South-East Asia and also the populations of North Africa and Kuwait.
Multiple sclerosis (MS) most commonly affects individuals of Northern European descent who live in countries at high latitude. The relative contributions of ancestry, country of birth and residence as determinants of MS risk have been studied in adult MS, but have not been explored in the pediatric MS population. In this study, we compare the demographics of pediatric- and adult-onset MS patients cared for in Toronto, Ontario, Canada, a multicultural region. The country of birth, residence during childhood, and ancestry were compared for 44 children and 573 adults. Our results demonstrate that although both the pediatric and adult cohorts were essentially born and raised in the same region of Ontario, Canada, children with MS were more likely to report Caribbean, Asian or Middle Eastern ancestry, and were less likely to have European heritage compared with individuals with adult-onset MS. The difference in ancestry between the pediatric and adult MS cohorts can be explained by two hypotheses: (1) individuals raised in a region of high MS prevalence, but whose ancestors originate from regions in which MS is rare, have an earlier age of MS onset, and (2) the place of residence during childhood, irrespective of ancestry, determines lifetime MS risk -- a fact that will be reflected in a change in the demographics of the adult MS cohort in our region as Canadian-raised children of recent immigrants reach the typical age of adult-onset MS.
A recent method of age-standardisation of relative survival ratios for cancer patients does not require calculation of age-specific relative survival ratios, as ratios of age-specific proportions between the standard population and study group at the beginning of the follow-up are used to substitute the original individual observations. This method, however, leads to direct age-standardisation with weights that are different for each patient group if the general population mortality patterns for the groups are different. This is the case in international comparisons, and in comparisons between genders and time periods. The magnitude of the bias caused by the differences in general population mortality is investigated for comparisons involving European countries and the USA. Patients in each country are assumed to have exactly the same age-specific relative survival ratios as those diagnosed in Finland in 1985-2004. An application of a properly functioning age-standardisation method should then give exactly equal age-standardised relative survival ratios for each country. However, the recent method shows substantial differences between countries, with highest relative survival for populations, where the general population mortality in the oldest ages is the highest. This source of error can thus be a serious limitation for the use of the method, and other methods that are available should then be employed.
OBJECTIVE: To facilitate the quantitative comparison of AIDS incidence statistics between countries and with other diseases using statistics based on age-standardized incidence rates instead of absolute number of cases. DESIGN: AIDS incidence rates for 19 countries belonging to the World Health Organization (WHO) European region, and for comparative purposes, the United States. METHODS: Incidence rates were standardized using the world standard population for all ages, from 1985 to 1992. The data were derived from the WHO European Non-Aggregate AIDS Dataset and the Centers for Disease Control and Prevention (CDC) AIDS Public Information Dataset, adjusted for reporting delays in each country. RESULTS: The AIDS incidence rate for men (81 in 1,000,000) in the United States was fourfold higher than the highest rate in a European country (Switzerland) in 1985; incidence rates in all other European countries, except France and Denmark, were below 10 in 1,000,000. Subsequently, AIDS incidence has increased more rapidly in southern Europe than in the rest of the continent. The estimated incidence rate for men in Spain (243 in 1,000,000) approached that in the United States (304 in 1,000,000) in 1992, and three additional countries (France, Switzerland and Italy) showed rates above 100 per million. The spread of the AIDS epidemic among women in some southern European countries was faster than in the United States. In Switzerland and Spain the standardized incidence rates in women were higher than in the United States by 1988 and 1992, respectively. CONCLUSIONS: Analysis trends in incidence rates avoids some weaknesses of AIDS statistics based on absolute numbers, and should become one of the standard tools for AIDS surveillance.