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Ballard SB, Requena D, Mayta H, Sanchez GJ, Oyola-Lozada MG, Colquechagua Aliaga FD, Cabrera L, Vittet Mondonedo MD, Taquiri C, Tilley CAPTDH, Simons CDRMP, Meza RA, Bern C, Saito M, Figueroa-Quintanilla DA, Gilman RH. Enteropathogen Changes After Rotavirus Vaccine Scale-up. Pediatrics 2022; 149:183843. [PMID: 34918158 PMCID: PMC9647525 DOI: 10.1542/peds.2020-049884] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To inform next steps in pediatric diarrhea burden reduction by understanding the shifting enteropathogen landscape after rotavirus vaccine implementation. METHODS We conducted a case-control study of 1788 medically attended children younger than 5 years, with and without gastroenteritis, after universal rotavirus vaccine implementation in Peru. We tested case and control stools for 5 viruses, 19 bacteria, and parasites; calculated coinfection-adjusted attributable fractions (AFs) to determine pathogen-specific burdens; and evaluated pathogen-specific gastroenteritis severity using Clark and Vesikari scales. RESULTS Six pathogens were independently positively associated with gastroenteritis: norovirus genogroup II (GII) (AF 29.1, 95% confidence interval [CI]: 28.0-32.3), rotavirus (AF 8.9, 95% CI: 6.8-9.7), sapovirus (AF 6.3, 95% CI: 4.3-7.4), astrovirus (AF 2.8, 95% CI: 0.0-4.0); enterotoxigenic Escherichia coli heat stable and/or heat labile and heat stable (AF 2.4, 95% CI: 0.6-3.1), and Shigella spp. (AF 2.0, 95% CI: 0.4-2.2). Among typeable rotavirus cases, we most frequently identified partially heterotypic strain G12P[8] (54 of 81, 67%). Mean severity was significantly higher for norovirus GII-positive cases relative to norovirus GII-negative cases (Vesikari [12.7 vs 11.8; P < .001] and Clark [11.7 vs 11.4; P = .016]), and cases in the 6- to 12-month age range relative to cases in other age groups (Vesikari [12.7 vs 12.0; P = .0002] and Clark [12.0 vs 11.4; P = .0016]). CONCLUSIONS Norovirus is well recognized as the leading cause of pediatric gastroenteritis in settings with universal rotavirus vaccination. However, sapovirus is often overlooked. Both norovirus and sapovirus contribute significantly to the severe pediatric disease burden in this setting. Decision-makers should consider multivalent vaccine acquisition strategies to target multiple caliciviruses in similar countries after successful rotavirus vaccine implementation.
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Affiliation(s)
- Sarah-Blythe Ballard
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland,Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland,Naval Medical Research Unit No. 6, Callao, Peru,Address correspondence to Sarah-Blythe Ballard, MD, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Room W5515, Baltimore, MD 21205. E-mail:
| | - David Requena
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Holger Mayta
- Infectious Disease Research Laboratory, Department of Cellular and Molcular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru,Asociación Benéfica PRISMA, Lima, Peru
| | - Gerardo J. Sanchez
- Infectious Disease Research Laboratory, Department of Cellular and Molcular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria G. Oyola-Lozada
- Infectious Disease Research Laboratory, Department of Cellular and Molcular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Macarena D. Vittet Mondonedo
- Infectious Disease Research Laboratory, Department of Cellular and Molcular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carmen Taquiri
- Infectious Disease Research Laboratory, Department of Cellular and Molcular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - CAPT Drake H. Tilley
- Naval Medical Research Unit No. 6, Callao, Peru,Fleet Surgical Team SEVEN, Okinawa, Japan
| | | | | | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Mayuko Saito
- Infectious Disease Research Laboratory, Department of Cellular and Molcular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru,Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Robert H. Gilman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland,Infectious Disease Research Laboratory, Department of Cellular and Molcular Sciences, Universidad Peruana Cayetano Heredia, Lima, Peru,Asociación Benéfica PRISMA, Lima, Peru
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2
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Rojas JD, Reynolds ND, Pike BL, Espinoza NM, Kuroiwa J, Jani V, Ríos PA, Nunez RG, Yori PP, Bernal M, Meza RA, Kosek MN, McCoy AJ, Simons MP, Gregory MJ, Guerry P, Poly FM. Distribution of Capsular Types of Campylobacter jejuni Isolates from Symptomatic and Asymptomatic Children in Peru. Am J Trop Med Hyg 2020; 101:541-548. [PMID: 31392944 PMCID: PMC6726929 DOI: 10.4269/ajtmh.18-0994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Campylobacter jejuni is the leading bacterial cause of diarrhea worldwide. A capsular polysaccharide (CPS) conjugate vaccine is under development and requires determination of the valency. However, distribution of CPS types circulating globally is presently poorly described. We aimed to determine whether CPS type distribution in Peru differs from that in other endemic regions. We used a multiplex polymerase chain reaction (PCR) assay for the detection of CPS encoding genes capable of distinguishing all 35 CPS types on Campylobacter isolates in two prospective communities based studies conducted in cohorts of children less than 59 months of age in Peru. Results showed that CPS type HS4 complex was the most prevalent, followed by HS3 complex and HS15. Differences in CPS type for symptomatology were not statistically significant. Most subjects demonstrated repeated infections over time with different CPS types, suggesting that CPS types may confer of a level of homologous protective immunity. In this dataset, some differences in CPS type distribution were observed in comparison to other low-middle income countries. Further studies need to be conducted in endemic areas to increase our knowledge of CPS type distribution and guide vaccine development.
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Affiliation(s)
- Jesús D Rojas
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru.,Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | - Brian L Pike
- U.S. National Medical Research Center, Singapore
| | - Nereyda M Espinoza
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Janelle Kuroiwa
- Enteric Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, Maryland
| | - Vihasi Jani
- Enteric Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, Maryland
| | - Paul A Ríos
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Rosa G Nunez
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Pablo P Yori
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia
| | - Manuela Bernal
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Rina A Meza
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Margaret N Kosek
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia
| | - Andrea J McCoy
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Mark P Simons
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Michael J Gregory
- Bacteriology Department, Naval Medical Research Unit-6 (NAMRU-6), Lima, Peru
| | - Patricia Guerry
- Enteric Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, Maryland
| | - Frédéric M Poly
- Enteric Diseases Department, Infectious Diseases Directorate, Naval Medical Research Center, Silver Spring, Maryland
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Ali Munive A, Varon Vega FA, Hernandez Parra A, Molina F, Poveda M, Meza RA, Castro H, Urbina Z, Mercado J, Martinez J, Mayorga M, Pareja M, Cepeda E, Sanchez M, Vega R, Camargo F, Vergara J. Epidemiology, clinical differences and outcomes of tracheobronchitis and pneumonia associated to mechanical ventilation in intensive care units of latin america (LATINNAVE). Intensive Care Med Exp 2015. [PMCID: PMC4798223 DOI: 10.1186/2197-425x-3-s1-a703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
OBJECTIVES To compare two methods of data collection of patient-practitioner encounter data in general practice: from medical records consultation notes and from data recorded on encounter forms. METHOD Data were collected from two sources: (i) Medical Records Study: a study of the efficacy of an intervention designed to improve the quality of medical records provided details of 3107 patient encounters with 163 general practitioners (GPs) which had been photocopied from medical records; and (ii) Australian Morbidity and Treatment Survey (AMTS): from a national sample of 495 GPs and over 100,000 patient encounters, data from 47 GPs in the same geographical area as those in the Medical Records Study provided encounter forms for 10,392 patient encounters including details about patient demographics, reason for encounter, management, treatment, tests and investigations, admissions, referrals and planned follow-up. The International Classification of Primary Care (ICPC) was used to code reasons for encounter and problems managed. Drugs were classified according to an in-house classification by generic name and broad drug group. RESULTS Patient details and all items of clinical information were recorded less frequently or were more often illegible in medical records than on encounter forms. There was a higher rate of management of problems classified as general or non-specific in the medical records. A lower prescribing rate for drugs acting on the cardiovascular system was recorded in the medical records, but higher rates were found for antibiotics, drugs acting on the immune system and miscellaneous drugs. Coding of all data was more reliable both between and within coders using the data from the encounter forms compared to the medical records. CONCLUSION General practice data obtained from encounter forms are more comprehensive and are coded more reliably than those drawn from medical records.
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Affiliation(s)
- H Britt
- Family Medicine Research Unit, University of Sydney, Australia
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5
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Traynor V, Britt H, Bridges-Webb C, Sayer GP, Meza RA, Charles J. Immunisation in general practice. Results from the Australian Morbidity and Treatment Survey, 1990-1991. Aust Fam Physician 1996; 25:355-9. [PMID: 8867187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Immunisation is the sixth most commonly managed problem in general practice in Australia. This paper provides an overview of its management in general practice.
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Affiliation(s)
- V Traynor
- Department of General Practice, University of Sydney, Westmead, NSW
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6
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Meza RA, Angelis M, Britt H, Miles DA, Seneta E, Bridges-Webb C. Development of sample size models for national general practice surveys. Aust J Public Health 1995; 19:34-40. [PMID: 7734591 DOI: 10.1111/j.1753-6405.1995.tb00294.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The most cost-effective method to measure the morbidity managed and treatments provided in general practice is from records of a cluster of consultations (encounters) from each general practitioner (GP) in a random sample. A cluster sampling method is proposed for future surveys for analysis of encounter-based general practice data. The sample sizes needed to measure the most common problems managed and drugs prescribed were estimated using ratio-estimator models for cluster sample surveys. Morbidity and treatment rates were estimated from the Australian Morbidity and Treatment Survey in General Practice 1990-1991 (AMTS). The 20 most common problems in the AMTS were managed at estimated rates of 1.5 to 9.5 per 100 encounters. The 20 most common drugs were prescribed at estimated rates of 0.7 to 3.6 per 100 problems. These rates were used to determine precision as a percentage of each true value for future surveys, that is, as relative precision. If we want to be 95 per cent confident that these rates will be within 5 per cent of each true rate, sample sizes of 552 to 5675 GPs are needed. If we fix the sample size at 1000 GPs, relative precision lies within 12 per cent of these rates. If the sample size is increased to 1500 GPs, relative precision improves only marginally. The differences in sample size for each of the most frequent morbidity and treatment data are largely due to their variable distributions and relatively infrequent occurrence in general practice. A sample size of 1000 GPs will enable measurement of the most common morbidity and treatments at 95 per cent confidence.
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Affiliation(s)
- R A Meza
- Department of General Practice, University of Sydney
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7
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Meza RA, Traynor V, Charles J, Miles DA, Britt H, Neary S. The management of arthritis in general practice. Results from the Australian morbidity and treatment survey, 1990-1991. Aust Fam Physician 1995; 24:188-93. [PMID: 7880139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Arthritis is the ninth most commonly managed problem in general practice in Australia. This paper provides an overview of its management in general practice and draws some comparisons with an earlier study.
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Affiliation(s)
- R A Meza
- Department of General Practice, University of Sydney
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8
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Traynor V, Britt H, Neary S, Sayer GP, Charles J, Meza RA. The management of osteoarthritis in general practice. Results from the Australian Morbidity and Treatment Survey, 1990-1991. Aust Fam Physician 1994; 23:1971-3, 1976-8. [PMID: 7818400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Osteoarthritis is the fourth most commonly managed problem in general practice in Australia. This paper provides an overview of its management in general practice.
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Affiliation(s)
- V Traynor
- Department of General Practice, University of Sydney, Croydon, New South Wales
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9
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Cooper RD, Meza RA, Schneider I. Anopheles farauti refractoriness to malaria infection with cultured gametocytes of Plasmodium falciparum. Med Vet Entomol 1994; 8:389-390. [PMID: 7841495 DOI: 10.1111/j.1365-2915.1994.tb00105.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- R D Cooper
- Army Malaria Research Unit, Liverpool Military Area, New South Wales, Australia
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10
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Beck LR, Rodriguez MH, Dister SW, Rodriguez AD, Rejmankova E, Ulloa A, Meza RA, Roberts DR, Paris JF, Spanner MA. Remote sensing as a landscape epidemiologic tool to identify villages at high risk for malaria transmission. Am J Trop Med Hyg 1994; 51:271-80. [PMID: 7943544 DOI: 10.4269/ajtmh.1994.51.271] [Citation(s) in RCA: 138] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A landscape approach using remote sensing and geographic information system (GIS) technologies was developed to discriminate between villages at high and low risk for malaria transmission, as defined by adult Anopheles albimanus abundance. Satellite data for an area in southern Chiapas, Mexico were digitally processed to generate a map of landscape elements. The GIS processes were used to determine the proportion of mapped landscape elements surrounding 40 villages where An. albimanus abundance data had been collected. The relationships between vector abundance and landscape element proportions were investigated using stepwise discriminant analysis and stepwise linear regression. Both analyses indicated that the most important landscape elements in terms of explaining vector abundance were transitional swamp and unmanaged pasture. Discriminant functions generated for these two elements were able to correctly distinguish between villages with high and low vector abundance, with an overall accuracy of 90%. Regression results found both transitional swamp and unmanaged pasture proportions to be predictive of vector abundance during the mid-to-late wet season. This approach, which integrates remotely sensed data and GIS capabilities to identify villages with high vector-human contact risk, provides a promising tool for malaria surveillance programs that depend on labor-intensive field techniques. This is particularly relevant in areas where the lack of accurate surveillance capabilities may result in no malaria control action when, in fact, directed action is necessary. In general, this landscape approach could be applied to other vector-borne diseases in areas where 1) the landscape elements critical to vector survival are known and 2) these elements can be detected at remote sensing scales.
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Affiliation(s)
- L R Beck
- Johnson Controls World Services, NASA Ames Research Center, Moffett Field, California
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11
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Sayer GP, Charles J, Traynor V, Bridges-Webb C, Meza RA, Miles D. The management of sprains and strains in general practice. Results from the Australian Morbidity and Treatment Survey, 1990-1991. Aust Fam Physician 1994; 23:1763-5, 1768. [PMID: 7980177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Sprains and strains were the eighth most commonly managed problem in general practice in Australia. This paper provides an overview of their management in general practice.
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Affiliation(s)
- G P Sayer
- Department of General Practice, University of Sydney, Croydon, New South Wales
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12
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Meza RA, Bridges-Webb C, Sayer GP, Miles DA, Traynor V, Neary S. The management of acute bronchitis in general practice: results from the Australian Morbidity and Treatment Survey, 1990-1991. Aust Fam Physician 1994; 23:1550-3. [PMID: 7980155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Acute bronchitis is the fifth most commonly managed problem in general practice in Australia. This paper provides an overview of its management in general practice and compares the results with those of an earlier study.
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Affiliation(s)
- R A Meza
- Department of General Practice, University of Sydney, Croydon, New South Wales
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Britt H, Meza RA, Charles J, Miles DA, Sayer GP, Neary S. The management of URTI in general practice. Results from the Australian Morbidity and Treatment Survey, 1990-1991. Aust Fam Physician 1994; 23:907-9, 912-3. [PMID: 8037630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Upper respiratory tract infection is the second most frequently managed problem in general practice in Australia. This paper provides an overview of its management in general practice and compares the results with those of an earlier study.
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Affiliation(s)
- H Britt
- Department of General Practice, University of Sydney, Croydon, New South Wales
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Sayer GP, Britt H, Meza RA, Charles J, Traynor V, Miles DA. The management of hypertension in general practice. Results from the Australian Morbidity and Treatment Survey, 1990-1991. Aust Fam Physician 1994; 23:697-700, 702. [PMID: 8198491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Hypertension is the most frequently managed problem in general practice in Australia. This paper provides an overview of its management in general practice and draws some comparisons with an earlier study.
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Affiliation(s)
- G P Sayer
- Department of General Practice, University of Sydney, Croydon, New South Wales
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15
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Rodríguez AD, Rodríguez MH, Meza RA, Hernández JE, Rejmankova E, Savage HM, Roberts DR, Pope KO, Legters L. Dynamics of population densities and vegetation associations of Anopheles albimanus larvae in a coastal area of southern Chiapas, Mexico. J Am Mosq Control Assoc 1993; 9:46-58. [PMID: 8468574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Spatial and seasonal variations on Anopheles albimanus larval densities and their plant associations were investigated in larval habitats in southern Mexico between April 1989 and May 1990. Thirty-four plant groups were dominant in larval habitats. Dense larval populations were associated with 3 genera of plants, Cynodon, Echinocloa and Fimbristylis and no larvae were found in habitats with Salvinia and Rhizophora. Low significant positive or negative associations were documented with the other 12 plant genera. Larval habitats were classified according to the morphology of their dominant plants. Higher larval densities were observed in the groups characterized by relatively short emergent vegetation. The distribution of habitat-types within 5 identified vegetation units showed a significantly dependent relationship. For the entire study period, highest larval densities were detected in flooded pasture/grassland vegetation units. For all vegetation units, higher larval densities were found when the dominant plant type covered between 25-50% of the breeding site. The integration of data from habitat-types into vegetation units did not result in loss of information.
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Affiliation(s)
- A D Rodríguez
- Centro de Investigación de Paludismo, Chiapas, México
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