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Braks M.,National Institute for Public Health and the Environment | van Ginkel R.,Municipal Public Health Service Rotterdam Rijnmond | Wint W.,University of Oxford | Sedda L.,University of Oxford | Sprong H.,National Institute for Public Health and the Environment
International Journal of Environmental Research and Public Health | Year: 2014

Public health authorities are required to prepare for future threats and need predictions of the likely impact of climate change on public health risks. They may get overwhelmed by the volume of heterogeneous information in scientific articles and risk relying purely on the public opinion articles which focus mainly on global warming trends, and leave out many other relevant factors. In the current paper, we discuss various scientific approaches investigating climate change and its possible impact on public health and discuss their different roles and functions in unraveling the complexity of the subject. It is not our objective to review the available literature or to make predictions for certain diseases or countries, but rather to evaluate the applicability of scientific research articles on climate change to evidence-based public health decisions. In the context of mosquito borne diseases, we identify common pitfalls to watch out for when assessing scientific research on the impact of climate change on human health. We aim to provide guidance through the plethora of scientific papers and views on the impact of climate change on human health to those new to the subject, as well as to remind public health experts of its multifactorial and multidisciplinary character. © 2013 by the authors; licensee MDPI, Basel, Switzerland.

Hahne S.J.M.,National Institute for Public Health and the Environment RIVM | Veldhuijzen I.K.,Municipal Public Health Service Rotterdam Rijnmond | Wiessing L.,European Monitoring Center for Drugs and Drug Addiction | Lim T.-A.,U.S. Center for Disease Control and Prevention | And 2 more authors.
BMC Infectious Diseases | Year: 2013

Background: Treatment for chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is improving but not benefiting individuals unaware to be infected. To inform screening policies we assessed (1) the hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus antibody (anti-HCV-Ab) prevalence for 34 European countries; and (2) the cost-effectiveness of screening for chronic HBV and HCV infection.Methods: We searched peer-reviewed literature for data on HBsAg and anti-HCV-Ab prevalence and cost-effectiveness of screening of the general population and five subgroups, and used data for people who inject drugs (PWID) and blood donors from two European organizations. Of 1759 and 468 papers found in the prevalence and cost-effectiveness searches respectively, we included 124 and 29 papers after assessing their quality. We used decision rules to calculate weighted prevalence estimates by country.Results: The HBsAg and anti-HCV-Ab prevalence in the general population ranged from 0.1%-5.6% and 0.4%-5.2% respectively, by country. For PWID, men who have sex with men and migrants, the prevalence of HBsAg and anti-HCV-Ab was higher than the prevalence in the general population in all but 3 countries. There is evidence that HCV screening of PWID and HBsAg screening of pregnant women and migrants is cost-effective.Conclusion: The prevalence of chronic HBV and HCV infection varies widely between European countries. Anti-HCV-Ab screening of PWID and HBsAg screening of pregnant women and migrants have European public health priority. Cost-effectiveness analyses may need to take effect of antiviral treatment on preventing HBV and HCV transmission into account. © 2013 Hahné et al.; licensee BioMed Central Ltd.

Zenner D.,Public Health England | Zenner D.,University College London | Southern J.,Public Health England | Van Hest R.,Municipal Public Health Service Rotterdam Rijnmond | And 5 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2013

In low-incidence countries, tuberculosis (TB) is now largely concentrated in high-risk groups such as migrants, homeless people, illicit drug users, alcoholics and prisoners. This has led to increased efforts to implement targeted active case finding for TB among specific populations. This review examines the evidence supporting active case finding in migrants and social risk groups, as well as the cost-effectiveness of interventions. While data from observational studies support active case finding in defined high-risk groups, further research to determine the effectiveness of specific tools and the cost-effectiveness of screening strategies is needed to inform evidence-based control methods in low-incidence countries. Inevitably, addressing TB in low-incidence countries will depend on effective disease control in high-burden countries. © 2013 The Union.

Jansen W.,Erasmus University Rotterdam | Borsboom G.,Erasmus University Rotterdam | Meima A.,Municipal Public Health Service Rotterdam Rijnmond | Zwanenburg E.J.-V.,Municipal Public Health Service Rotterdam Rijnmond | And 4 more authors.
International Journal of Pediatric Obesity | Year: 2011

Objectives. The purpose of this study was to evaluate the effect of a school-based intervention program to reduce overweight and improve fitness in primary school children. Methods. A cluster randomized controlled design was used over one school year with schools as unit of randomization. In total 20 schools and 2,622 children aged 6-12 years (grades 3-8) from multi-ethnic, low income inner-city neighbourhoods in Rotterdam, Netherlands, participated. The intervention, named Lekker Fit! (Enjoy being fit!) was a multi-component intervention based on behavioural and ecological models. Main components of the intervention are the implementation of three physical education (PE) sessions a week by a professional PE teacher, additional sport and play activities outside school hours and an educational program. Main primary outcome measures were weight status, body mass index (BMI), waist circumference and fitness (20 m shuttle run). Results. Significant positive intervention effects were found for percentage overweight children (OR 0.53; 95% CI 0.36-0.78), waist circumference (-1.29 cm; 95% CI -2.16 to -0.42 cm) and 20 m shuttle run (0.57 laps; 95% CI 0.13-1.01 laps) among pupils of grades 3-5 (6-9-year olds). The prevalence of overweight in grades 3-5 increased by 4.3% in the control group and by 1.3% in the intervention group. No significant effects were found for BMI or for grades 6-8 (9-12-year olds). Conclusions. Our results provide evidence for the effectiveness of the multi-component intervention Lekker Fit! among pupils of grades 3-5 and adds to the growing body of evidence that school-based programs with a focus on PA are most effective in reducing childhood obesity. [ISRCTN84383524] © 2011 Informa Healthcare.

Alberts C.J.,Rotterdam University | Smith W.C.S.,University of Aberdeen | Meima A.,Municipal Public Health Service Rotterdam Rijnmond | Wang L.,Jiangxi Provincial Institute of Parasitic Diseases | Richardus J.H.,Rotterdam University
Bulletin of the World Health Organization | Year: 2011

Objective To assess different countries' chances of attaining the 2011-2015 global leprosy target set by the World Health Organization (WHO) and to assess the strategy's effect on the prevalence of grade 2 disability (G2D). Methods Trends in G2D rate were analysed for Brazil, China, India and Thailand and figures were compared with the WHO target: a 35% decrease by 2015 relative to the 2010 baseline. To estimate the prevalence of G2D in 2015 and 2035 for each country three assumptions were made: (i) maintenance of the current trend; (ii) attainment of the WHO target, and (iii) reduction of G2D by 50% every 5 years relative to 2010. Findings Since 1995, the G2D rate has decreased every 5 years in Brazil, China, India and Thailand by 12.7% (95% confidence interval, CI: 6.6-18.3), 7.7% (95% CI: 1.1-12.8), 53.7% (95% CI: 38.1-65.4) and 35.9% (95% CI: 23.4-46.3), respectively. New cases with G2D detected after 2010 will contribute 15% (Brazil), 3% (China), 2.5% (India) and 4% (Thailand) to the total prevalence of G2D in 2015. If no policies are changed, between 2015 and 2035, the prevalence of G2D will decrease by more than half in China, India and Thailand, and by 16% in Brazil. Conclusion The implications of attaining the WHO target are different for each country and using indicators other than G2D prevalence will help monitor progress. The strategy will not immediately reduce the prevalence of G2D, but if it is applied consistently over the next 25 years, its long-term effect can be substantial.

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