Chagas disease: from bush to huts and houses. Is it the case of the Brazilian amazon?

Two of the major problems facing the Amazon - human migration from the other areas and uncontrolled deforestation - constitute the greatest risk for the establishment of endemic Chagas disease in this part of Brazil. At least 18 species of triatomines had been found in the Brazilian Amazon, 10 of them infected with Trypanosoma cruzi, associated with numerous wild reservoirs. With wide-range deforestation, wild animals will perforce be driven into other areas, with tendency for triatomines to become adapted to alternative food sources in peri and intradomicilies. Serological surveys and cross-sectional studies for Chagas disease, carried out in rural areas of the Rio Negro, in the Brazilian Amazon, showed a high level of seropositivity for T. cruzi antibodies. A strong correlation of seroreactivity with the contact of gatherers of piaçava fibers with wild triatomines could be evidenced.

A soil emergence trap for collections of phlebotomine sand flies

The identification of breeding sites of sand flies is of great epidemiological interest. A soil emergence trap for investigating potential sand fly breeding sites is described. The trap was tested in two rural areas in the Mogi Guaçu River Valley where the American cutaneous leishmaniasis is an endemic disease. Seventy-three sand fly individuals of three species, Lutzomyia intermedia s. l., L. whitmani and L. pessoai, were collected on the forest floor and peridomicile.

Health And Social Care Inequalities Monitoring System: First Update Bulletin 2004 (PDF 273 KB)

The Inequalities Monitoring System comprises a basket of indicators which are monitored over time to assess area differences in morbidity, utilisation of and access to health and social care services in Northern Ireland. Inequalities between the 20% most deprived electoral wards and Northern Ireland as a whole are measured with deprived areas identified from an update of the Noble Income domain for current ward boundaries. Results for 20% most rural areas were also compared against Northern Ireland overall using population density from the 2001 Census of Population as a measure of rurality. This report is the first annual update of the baseline results presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004) which focused on 2001/2002. The morbidity and utilisation data in this report are the latest available while the locations of services for the accessibility analysis will be updated in subsequent years åÊ

Triatoma sordida Stål 1859 (Hemiptera, Reduviidae: Triatominae) in palms of northeastern Argentina

Several palms species provide an important habitat for triatomines and associate vertebrates in tropical America. The objective of this work is to identify the triatomine species living in the palms of rural areas in the Province of Corrientes, and to estimate the potential epidemiological risk they represent for the residents of nearby houses. The survey was carried out in a palm community in Colonia Laurel, Department San Roque, Province of Corrientes, Argentina. Samplings were performed in October, November and December 1998; January, February and March 1999; May and June 1999. Thirty palms: 27 (90%) Butia yatay (Mart.) Becc. and 3 Acrocomia aculeata (Jacq.) Lodd ex Mart. were dissected. Triatoma sordida Stål 1859 was found in 96.2% of B. yatay and in all the A. aculeata palms. A total of 272 live T. sordida was collected; 36 of them (13.2%) were found in bird nests in the frond and the remainder in other locations of the tree. The mean number of triatomines per palm was 9.6 (range 1-60, mode 2). T. sordida was collected during all the sampling months and all stages were present at all seasons. The highest population density was reached in spring and the lowest in autumn. Trypanosoma cruzi was detected in 38.5% in feces of 174 examined insects and identified as such, both by microscopical examination and PCR. This is the first finding of T. sordida populations in B. yatay, an endemic palm of South America distributed in southern Brazil, Uruguay and northeastern Argentina. The high infection prevalence found in this work suggests that T. sordida plays an essential role in the maintenance of the wild T. cruzi transmission cycle in northeastern Argentina.

Health and Social Care Inequalities Monitoring System (PDF 273 KB)

The Inequalities Monitoring System comprises a basket of indicators which are monitored over time to assess area differences in morbidity, utilisation of and access to health and social care services in Northern Ireland. Inequalities between the 20% most deprived electoral wards and Northern Ireland as a whole are measured with deprived areas identified from an update of the Noble Income domain for current ward boundaries. Results for 20% most rural areas were also compared against Northern Ireland overall using population density from the 2001 Census of Population as a measure of rurality. This report is the firståÊ annual update of the baseline results presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004) which focused on 2001/2002. The morbidity and utilisation data in this report are the latest available while the locations of services for the accessibility analysis will be updated in subsequent years. åÊ åÊ

Equality and Inequalities in Health and Social Care in Northern Ireland

A Statistical Overview: 2002 Following some scene setting, the report draws together wide ranging information to document inequalities in health and social care in Northern Ireland that are relevant to the New Targeting Social Need (New TSN) policy, including the base report of the ‘Inequalities Monitoring System’. The overview also documents comparisons between people living in rural and non-rural areas, and between the statutory equality categories of Section 75 of the Northern Ireland Act. While some of the information has been previously published most of the results are new, and the majority of the new analyses has been undertaken by IAD. åÊ

Phlebotomine sand flies (Diptera: Psychodidae) associated with the appearance of urban leishmaniasis in the city of Sincelejo, Colombia

Although once associated only with rural areas, the American leishmaniasis vectors now appear to be associated also with urban and suburban areas of the Neotropics. Following the appearance of the first autochthonous visceral and cutaneous leishmaniasis cases in the urban area of the city of Sincelejo, Colombia, a preliminary entomological survey of the sand fly species composition was performed using Shannon and CDC light traps. A total of 486 sand flies representing six Lutzomyia species were collected. L. evansi, L. panamensis and L. gomezi, known vectors of Leishmania spp. were the predominant sand fly species around dwellings. The finding of these species in relation to the appearance of the first cases of leishmaniasis in the city mentioned is discussed.

LLT Community Association

Laurencetown, Lenaderg & Tullylish Community Association (LLT) manage a community centre which serves the surrounding rural areas. Programmes include: parent & toddler, youth group, older peopleï¿_s group (offering 1-1 support) and supports other outlying rural groups. LLT has completed 3 Level 2 projects in the past.The first 3 projects have helped develop better understanding and promoted better access to pharmacy services etc (3 miles away), have raised the profile of LLT and put health on the agenda and has worked well with a range of specific groups including men, older people, pre schoolers etc and is currently seeking to target teenagers and parents. A good working relationship has developed between the pharmacist and LLT. They want to continue a similar approach developed through their Level 2 applications but with an increased focus on pre-school children and young people (teenagers) with their parents. Year 1 includes a health fair, 6 talks to local groups, 10 consultations for older people, 4 sessions for mothers, 4 sessions for fathers and 3 sessions with young people. Most of these, apart from the Health Fair, will be repeated in Year 2 & 3.

PHE-CRCE-010: Estimating Local Mortality Burdens associated with Particulate Air Pollution

The increase in mortality risk associated with long-term exposure to particulate air pollution is one of the most important, and best-characterised, effects of air pollution on health. This report presents estimates of the size of this effect on mortality in local authority areas in the UK, building upon the attributable fractions reported as an indicator in the public health outcomes framework for England. It discusses the concepts and assumptions underlying these calculations and gives information on how such estimates can be made. The estimates are expected to be useful to health and wellbeing boards when assessing local public health priorities, as well as to others working in the field of air quality and public health. The estimates of mortality burden are based on modelled annual average concentrations of fine particulate matter (PM2.5) in each local authority area originating from human activities. Local data on the adult population and adult mortality rates is also used. Central estimates of the fraction of mortality attributable to long-term exposure to current levels of anthropogenic (human-made) particulate air pollution range from around 2.5% in some local authorities in rural areas of Scotland and Northern Ireland and between 3 and 5% in Wales, to over 8% in some London boroughs. Because of uncertainty in the increase in mortality risk associated with ambient PM2.5, the actual burdens associated with these modelled concentrations could range from approximately one-sixth to about double these figures. Thus, current levels of particulate air pollution have a considerable impact on public health. Measures to reduce levels of particulate air pollution, or to reduce exposure of the population to such pollution, are regarded as an important public health initiative.

Update on Chagas disease in Venezuela: a review

The present article reviews the status of Chagas disease in Venezuela based on the detection of Trypanosoma cruzi infections both in referred patients with clinical presumptive diagnosis (1988-2002) and in individuals sampled from rural localities representative of the different geographical regions of the country (1995-2002). In the former group from 306 individuals examined, 174 (56.8%) were seropositive to T. cruzi; 73 (42%) in the acute phase with 52 (71%) showing blood circulating parasites, and from these 38% were children under 10 years old. The other 101 (58%) showed chronic infection at different degrees of cardiac complication. In addition, serologic examination of 3835 individuals from rural areas revealed 11.7% seroprevalence. From these, 8.5% (38/448) were children aged from 0 to 10 years old. These figures suggest that Chagas disease may be re-emerging in Venezuela judging for the active transmission detected during the last decade. The success of the Venezuelan anti-chagasic campaign during the last 40 years is evaluated in the frame of the present results. The epidemiological situation is discussed and recommendation to consider Chagas disease as a national priority is given.

Health and Social Care Inequalities Northern Ireland: First sub-regional report

The Department of Health, Social Services and Public Safety (Northern Ireland) published its first sub-regional bulletin of the Health and Social Care Inequalities Monitoring System (HSCIMS) on Wednesday, 7th July.The bulletin provides a picture of health inequalities at Health and Social Care (HSC) Trust level and a detailed comparison of morbidity, mortality, utilisation and access to health and social services between the 20% most deprived areas within a Trust and the overall Trust as well as NI as a whole. Health and Social Services Inequalities Monitoring System. Sub-Regional Inequalities HSC Trusts 2010 (PDF 5.6MB)��The Inequalities Monitoring system comprises various indicators which are monitored over time to assess area differences across morbidity, utilisation and access to Health and Social Care services in NI. Results for each indicator for the 20% most deprived (as per 2005 NISRA Measures of Deprivation) and the 20% most rural areas are compared with the NI average. There is also a comparison of the Section 75 equality group profiles of the areas with the 20% worst outcomes with NI overall for selected indicators.��

The state of the Countryside Annual Report

The State of the Countryside Report, published by the Commission for Rural Communities, provides a comprehensive picture of the quality of life in rural England. It shows that, in the most disadvantaged rural areas, almost one in three households lives on a low income and, across rural England as a whole, the price of housing is out of reach of many local people and some services, such as banking, continue to decline.

National Youth Work Development Plan 2003-2007

Irish society today is dramatically different from the one in which youth work services were first provided on a spontaneous and philanthropic basis more than one hundred years ago. At no time has the process of change been more striking than in the last ten to fifteen years. At least four major types of recent change, all clearly interrelated, can be identified: economic, political, technological and cultural. A further important aspect of cultural change in Ireland has been the continuing trend towards urbanisation, and the corresponding impact, largely negative, on rural communities. Particularly significant in the context of a Development Plan for Youth Work is the migration of young people away from rural areas to study or work, with most of them unlikely to return on a permanent basis. This, along with the rapid reduction in farm holdings and other changes in the countryside, has profound sociological and psychological repercussions for rural Ireland and indeed for Irish society as a whole. For young people living in rural areas the challenge is to provide youth work opportunities which are specially tailored to their needs and which take account of the ways in which their circumstances (e.g. regarding transport and access) are different from those of their urban peers

Dynamics of feeding and defecation in Triatoma vitticeps (Stal, 1859) (Hemiptera, Reduviidae, Triatominae) and its potential in the transmission of Trypanosoma cruzi

Adults of Triatoma vitticeps infected by flagellates similar to Trypanosoma cruzi are frequently captured by the inhabitants of rural areas in the Brazilian state of Espírito Santo. The dynamics of feeding and defecation were observed in three groups of adult triatomines, consisting of sylvatic T. vitticeps and laboratory-reared specimens of this species and T. infestans. Triatomines were observed from the moment they were presented with an immobilized chicken as a bloodmeal source until 240 min after feeding had ended. Mean times between the end of feeding and defecation for T. infestans, wild T. vitticeps and laboratory-reared specimens of the latter species were 1.2, 21.1, and 64 min respectively. All T. infestans defecated within 10 min of feeding, while only 29.9 of wild and 52.8% laboratory-reared specimens of T. vitticeps did so within this period. These results may explain the low efficiency of T. vitticeps in T. cruzi transmission to man. The shorter time between feeding and defecation in laboratory-reared T. vitticeps may indicate a change in behaviour of this species as a result of adaptation to an artificial environment.

Urban and suburban malaria in Rondônia (Brazilian Western Amazon) II: perennial transmissions with high anopheline densities are associated with human environmental changes

Longitudinal entomological surveys were performed in Vila Candelária and adjacent rural locality of Bate Estaca concomitantly with a clinical epidemiologic malaria survey. Vila Candelária is a riverside periurban neighborhood of Porto Velho, capital of the state of Rondônia in the Brazilian Amazon. High anopheline densities were found accompanying the peak of rainfall, as reported in rural areas of the region. Moreover, several minor peaks of anophelines were recorded between the end of the dry season and the beginning of the next rainy season. These secondary peaks were related to permanent anopheline breeding sites resulting from human activities. Malaria transmission is, therefore, observed all over the year. In Vila Candelária, the risk of malaria infection both indoors and outdoors was calculated as being 2 and 10/infecting bites per year per inhabitant respectively. Urban malaria in riverside areas was associated with two factors: (1) high prevalence of asymptomatic carriers in a stable human population and (2) high anopheline densities related to human environmental changes. This association is probably found in other Amazonian urban and suburban communities. The implementation of control measures should include environmental sanitation and better characterization of the role of asymptomatic carriers in malaria transmission.