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Skoog G.,Public Health Agency of Sweden
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin | Year: 2016

This study sought to analyse antimicrobial pressure, indications for treatment, and compliance with treatment recommendations and to identify possible problem areas where inappropriate use could be improved through interventions by the network of the local Swedish Strategic Programme Against Antibiotic Resistance (Strama) groups. Five point-prevalence surveys were performed in between 49 and 72 participating hospitals from 2003 to 2010. Treatments were recorded for 19 predefined diagnosis groups and whether they were for community-acquired infection, hospital-acquired infection, or prophylaxis. Approximately one-third of inpatients were treated with antimicrobials. Compliance with guidelines for treatment of community-acquired pneumonia with narrow-spectrum penicillin was 17.0% during baseline 2003-2004, and significantly improved to 24.2% in 2010. Corresponding figures for quinolone use in uncomplicated cystitis in women were 28.5% in 2003-2004, and significantly improved, decreasing to 15.3% in 2010. The length of surgical prophylaxis improved significantly when data for a single dose and 1 day were combined, from 56.3% in 2003-2004 to 66.6% in 2010. Improved compliance was possibly the effect of active local feedback, repeated surveys, and increasing awareness of antimicrobial resistance. Strama groups are important for successful local implementation of antimicrobial stewardship programs in Sweden. This article is copyright of The Authors, 2016.


Bremberg S.G.,Karolinska Institutet | Bremberg S.G.,Public Health Agency of Sweden
Social Psychiatry and Psychiatric Epidemiology | Year: 2017

Purpose and methods: The aim of this study was to investigate, with multiple regression analyses, the effect of selected characteristics on the rate of decrease of suicide rates in 21 OECD (Organisation for Economic Co-operation and Development) nations over the period 1990–2010, with initial levels of suicide rates taken into account. Results: The rate of decrease seems mainly (83%) to be determined by the initial suicide rates in 1990. In nations with relatively high initial rates, the rates decreased faster. The suicide rates also converged. Conclusion: The study indicates that beta convergence alone explained most of the cross-national variations. © 2017 Springer-Verlag Berlin Heidelberg


GENEVA--(BUSINESS WIRE)--At this year’s World Health Assembly, GE Healthcare and Women in Global Health, a movement that strives for greater gender equality in global health leadership, are joining forces to honor and celebrate women in global health. Today, women make up 75 percent of the global healthcare workforce in many regions1 and contribute nearly $3 trillion to the industry. But too often their contributions go unpaid and unrecognized – and stories of their impact go untold. As we seek to increase the numbers of women in leadership in the field of global health, we are highlighting the valuable work and achievements of these women. Research has shown that women and girls are disproportionately affected by disease2, and that when women are in leadership roles, they will make decisions that are more supportive of women and children and lead to improved women’s health outcomes.3 Improving women’s health is a central focus of the global health community4 and advancing gender equality is therefore seen by many as a means of benefitting communities and public health. “These women are working tirelessly to improve global health with dedication and passion to champion better healthcare for all. To change the face of global health for the future, we are committed to help recognize, develop and grow women’s leadership – and to start by sharing the stories of women leading the charge,” said Terri Bresenham, President and CEO of Sustainable Healthcare Solutions, GE Healthcare. “At GE Healthcare, we place tremendous value on training and education of healthcare professionals across emerging markets and we are starting from the frontlines by ensuring that 50 percent of our training places are available for women.” "Investing in girls and women results in greater societal return. It is acknowledged that women are underpaid and under-recognized in many workforces. In the global health field, it becomes more pervasive as women are at the front lines, taking on the toughest health challenges to ensure there are healthier communities, yet they are not represented in decision-making positions. As we celebrate women in global health, we are taking a moment to recognize women's contributions to health and highlight their achievements. Through shining a light on the great leaders we have in the field, we aim to inspire everyone to do more to advance gender equality for the benefit of communities and public health all over the world,” said Roopa Dhatt, Director and Co-founder of Women in Global Health. The nominees have been selected across a number of focus areas and countries: Dr. Sharmila Anand (India) – Dr. Anand leads Santosh Educational & Health Care Pvt Ltd. (SEHPL), a social enterprise which focuses on developing the next generation of healthcare professionals and leaders who can transform the way healthcare is delivered in India. She works on various initiatives that focus on enhancing the skills of people in healthcare at various levels. Sreytouch Vong (Cambodia) – Vong is a research fellow, affiliated with ReBUILD and RinGs consortium which deals with gender analysis. She has engaged in extensive health system research and public health research, that focuses on improving health financing, gender and human resources, and nutrition within healthcare systems. Vong is also working to form a group of health researchers to bridge gaps between users of evidence and the research community in Cambodia. Elvira Dayrit (Philippines) – Dayrit has worked in the Philippine Department of Health for 27 years. She is dedicated to making government health programs work effectively, efficiently, and in a wide enough scale to create health impact. She is currently the Bureau Director for Health Human Resources where she works to streamline the Bureau. Dr. Semakaleng Phafol (Lesotho) – Dr. Phafol is a Lesotho Professional Nurse and Education Specialist with more than 25 years of experience in nursing practice, nursing education, community/public health and management of clinical services. She has helped to establish and strengthen clinical placements for over 1000 nursing midwifery students at over 60 health centres. Mwanamvua Boga (Kenya) – Boga is a nurse manager working with the Kenya Medical Research Institute – Wellcome Trust Research Programme in Kilifi on the Kenyan coast. She works in a high dependency pediatric unit at the Kilifi County Hospital that provides clinical care in parallel to conducting medical research in tropical diseases. The unit admits children with a range of conditions including extremely premature babies, children with meningitis, severe malaria, sepsis, cancers and more. Mercy Owuor (Kenya) - Owuor is a Community Programs Director at Lwala Community Alliance where she provides leadership for community programs including efforts to improve maternal and child health, adolescent sexual and reproductive health and HIV care, treatment and stigma reduction. She also works to build the independence of young adolescent girls through mentorship and economic empowerment. Rohani Dg Te’ne (Indonesia) – Te’ne has worked in health for more than 20 years and is now a volunteer community health motivator for Tamaona community health centre. The rural area where Te’ne lives is not accessible by vehicle so she escorts local villagers needing healthcare and especially pregnant women, to the community health centre through difficult terrain which can take over an hour by foot. Margaret Gyapong (Ghana) – Gyapong is currently a Medical Anthropologist at the University of Health and Allied Science in Ghana. Until March 2017, she was the Deputy Director for Research and Development in the Ghana Health Service. Gyapong has also helped turn the Dodowa Health Research Centre into an institution of international repute. Emmah Kariuki (Kenya) – As a Service Delivery Officer with Jhpiego in Kenya, Kariuki works to bring low cost health innovations to disadvantaged communities. This entails providing technical support for service delivery in family planning reproductive health. Kariuki also provides training to healthcare providers, develops training materials, coordinates research activities and supports the Ministry of Health in the implementation of family planning and reproductive activities. Kwanele Asante (South Africa) – Patient activist, lawyer and bioethicist, Asante serves as Chair of the Ministerial Advisory Committee on Cancer and has founded and led an effort to end disparities in global cancer. Asante works to ensure that the voice of patients facing barriers to care is elevated to give them a greater chance at prolonging their life. Dr. Aula Abbara (Greece) – Dr. Abbara is the project lead in Greece for the Syrian American Medical Society Global Response, which provides primary healthcare to refugees together with the Greek authorities and International Non-Governmental Organisations. The range of services provided includes: pediatric and maternal health and delivering a Teaching Recovery Techniques program with the Children and War Foundation. Dr. Abbara also teaches healthcare workers in Turkey on topics related to infectious disease. Samalie Kitooleko (Uganda) – Kitooleko is a nurse in charge of the Uganda Rheumatic Heart Disease Registry. She takes care of patients with chronic cardiovascular illnesses such as congenital heart disease, myocardial infarction and rheumatic heart disease (RHD). She realized an increasing number of RHD patients, especially young women, lacked knowledge about their illness and were dying due to preventable complications which inspired her to champion for patient education. Louise Nilunger Mannheimer (Sweden) – Mannheimer is Head of Unit at the Health and Sexuality Unit at the Public Health Agency of Sweden where she is currently leading a team responsible for the national coordination of sexual and reproductive health and rights. Her work also includes HIV prevention of young adults, LGBT rights and tackling male violence against women. With these awards, Women in Global Health, GE Healthcare and our partners aim to celebrate the contributions of women leaders in global health, whose work is championing better health in their communities. We worked closely with our partner organisations to identify women who have made an impact in categories listed above. This list is by no means comprehensive and we are aware that there are many more women out there making great achievements and advances to improve global healthcare at all ends of the spectrum. The focus of this honor is telling the stories of those women who are making an impact at the local, grassroots level and in traditionally under-represented communities. Recognizing the need for these untold stories to reach beyond Geneva, GE Healthcare will be previewing a new documentary that follows three of these women from sunrise to sunset to answer one question: how have these individuals made an impact on the disparity that exists in global health in a way much of the world is still striving to do? Premiering in June, Heroines of Health takes us from South Sulawesi, Indonesia, where Mrs. Rohani wakes up at 4 a.m. for her morning prayer so she can walk pregnant mothers to the nearest health center; to Lwala, Kenya, where Mercy Owuor educates her community about health issues; to Chennai, India, where Dr.. Sharmila Anand is enabling young women to gain employment through a radiology training program. Three women. Three countries. Three stories untold. Until now. Watch the trailer at https://www.youtube.com/watch?v=Iy6YJHcPr8I. GE Healthcare provides transformational medical technologies and services to meet the demand for increased access, enhanced quality and more affordable healthcare around the world. GE (NYSE: GE) works on things that matter - great people and technologies taking on tough challenges. From medical imaging, software & IT, patient monitoring and diagnostics to drug discovery, biopharmaceutical manufacturing technologies and performance improvement solutions, GE Healthcare helps medical professionals deliver great healthcare to their patients. For more information about GE Healthcare, visit our website at www.gehealthcare.com. Women in Global Health (WGH) is a global movement that brings together all genders and backgrounds to achieve gender equality in global health leadership. We believe that everyone has the right to attain equal levels of participation in leadership and decision-making regardless of gender. WGH creates a platform for discussions and collaborative space for leadership, facilitates specific education and training, garners support and commitment from the global community, and demands change for Gender Transformative Leadership. WGH is a virtually based network, registered in California, USA. 1 WHO, Spotlight on statistics: A fact file on health workforce statistics. Gender and health workforce statistics, Issue 2, February 2008. Available online at: http://www.who.int/hrh/statistics/spotlight_2.pdf 4 United Nations: We can end poverty: Millenium development goals and beyond 2015. http://www.un.org/millenniumgoals/bkgd.shtml.


Pettersson J.H.-O.,Uppsala University | Golovljova I.,National Institute for Health Development | Vene S.,Public Health Agency of Sweden | Jaenson T.G.T.,Uppsala University
Parasites and Vectors | Year: 2014

Background: In northern Europe, the tick-borne encephalitis virus (TBEV) of the European subtype is usually transmitted to humans by the common tick Ixodes ricinus. The aims of the present study are (i) to obtain up-to-date information on the TBEV prevalence in host-seeking I. ricinus in southern and central Sweden; (ii) to compile and review all relevant published records on the prevalence of TBEV in ticks in northern Europe; and (iii) to analyse and try to explain how the TBE virus can be maintained in natural foci despite an apparently low TBEV infection prevalence in the vector population. Methods. To estimate the mean minimum infection rate (MIR) of TBEV in I. ricinus in northern Europe (i.e. Denmark, Norway, Sweden and Finland) we reviewed all published TBEV prevalence data for host-seeking I. ricinus collected during 1958-2011. Moreover, we collected 2,074 nymphs and 906 adults of I. ricinus from 29 localities in Sweden during 2008. These ticks were screened for TBEV by RT-PCR. Results: The MIR for TBEV in nymphal and adult I. ricinus was 0.28% for northern Europe and 0.23% for southern Sweden. The infection prevalence of TBEV was significantly lower in nymphs (0.10%) than in adult ticks (0.55%). At a well-known TBEV-endemic locality, Torö island south-east of Stockholm, the TBEV prevalence (MIR) was 0.51% in nymphs and 4.48% in adults of I. ricinus. Conclusions: If the ratio of nymphs to adult ticks in the TBEV-analysed sample differs from that in the I. ricinus population in the field, the MIR obtained will not necessarily reflect the TBEV prevalence in the field. The relatively low TBEV prevalence in the potential vector population recorded in most studies may partly be due to: (i) inclusion of uninfected ticks from the 'uninfected areas' surrounding the TBEV endemic foci; (ii) inclusion of an unrepresentative, too large proportion of immature ticks, compared to adult ticks, in the analysed tick pools; and (iii) shortcomings in the laboratory techniques used to detect the virus that may be present in a very low concentration or undetectable state in ticks which have not recently fed. © 2014 Pettersson et al.; licensee BioMed Central Ltd.


Dahl V.,Karolinska Institutet | Dahl V.,Public Health Agency of Sweden | Peterson J.,University of California at San Francisco | Fuchs D.,Innsbruck Medical University | And 5 more authors.
AIDS | Year: 2014

Objective and design: Though combination antiretroviral therapy reduces the concentration of HIV-1 RNA in both plasma and cerebrospinal fluid (CSF) below the detection limit of clinical assays, low levels of HIV-1 RNA are frequently detectable in plasma using more sensitive assays. We examined the frequency and magnitude of persistent low-level HIV-1 RNA in CSF and its relation to the central nervous system (CNS) immune activation. Methods: CSF and plasma HIV-1 RNA were measured using the single-copy assay with a detection limit of 0.3 copies/ml in 70 CSF and 68 plasma samples from 45 treated HIV- 1-infected patients with less than 40 copies/ml of HIV-1 RNA in both fluids by standard clinical assays. We also measured CSF neopterin to assess intrathecal immune activation. Theoretical drug exposure was estimated using the CNS penetration-efficacy score of treatment regimens. Results: CSF HIV-1 RNA was detected in 12 of the 70 CSF samples (17%) taken after up to 10 years of suppressive therapy, compared to 39 of the 68 plasma samples (57%) with a median concentration of less than 0.3 copies/ml in CSF compared to 0.3 copies/ml in plasma (P<0.0001). CSF samples with detectable HIV-1 RNA had higher CSF neopterin levels (mean 8.2 compared to 5.7 nmol/l; P=0.0085). Patients with detectable HIV-1 RNA in CSF did not differ in pretreatment plasma HIV-1 RNA levels, nadir CD4+ cell count or CNS penetration-efficacy score. Conclusion: Low-level CSF HIV-1 RNA and its association with elevated CSF neopterin highlight the potential for the CNS to serve as a viral reservoir and for persistent infection to cause subclinical CNS injury. © 2014 Wolters Kluwer Health- Lippincott Williams & Wilkins.


Vogt H.,Linköping University | Braback L.,Sundsvall Hospital | Kling A.-M.,Unit for Statistics and Surveillance | Grunewald M.,Public Health Agency of Sweden | Nilsson L.,Linköping University
Pediatrics | Year: 2014

BACKGROUND AND OBJECTIVES: Childhood immunization may influence the development of asthma, possibly due to lack of infections or a shift in the T-helper cell type 1/T-helper cell type 2/regulatory T cells balance. We therefore investigated whether pertussis immunization in infancy is associated with asthma medication in adolescence.METHODS: After 14 years of no general pertussis vaccination, almost 82,000 Swedish children were immunized for pertussis in a vaccination trial between June 1, 1993, and June 30, 1994. In a follow-up analysis of almost 80,000 children, their data were compared with those of ∼100,000 nonvaccinated children, born during a 5-month period before and a 7-month period after the vaccination trial. Data for the main outcome variable (ie, dispensed prescribed asthma medication for each individual in the cohort during 2008-2010) were obtained from the national prescription database. Multivariate regression models were used to calculate the effect size of vaccination on dispensed asthma medication (odds ratios [OR], 95% confidence intervals [CI]). Approaches similar to intention-to-treat and per-protocol methods were used.RESULTS: The prevalence rates of various asthma medications for study patients at 15 years of age differed between 4.6% and 7.0%. The crude ORs for any asthma medication and antiinflammatory treatment in pertussis-vaccinated children after intention-to-treat analysis were 0.97 (95% CI: 0.93-1.00) and 0.94 (95% CI: 0.90-0.98), respectively. Corresponding adjusted ORs were 0.99 (95% CI: 0.95-1.03) and 0.97 (95% CI: 0.92-1.01). Similar ORs were found after per-protocol analysis.CONCLUSIONS: Pertussis immunization in infancy does not increase the risk of asthma medication use in adolescents. Our study presents evidence that pertussis immunization in early childhood can be considered safe with respect to long-term development of asthma. Copyright © 2014 by the American Academy of Pediatrics.


Romild U.,Public Health Agency of Sweden | Volberg R.,Gemini Research Ltd | Abbott M.,Auckland University of Technology
International Journal of Methods in Psychiatric Research | Year: 2014

Swelogs (Swedish Longitudinal Gambling Study) epidemiological (EP-) track is a prospective study with four waves of data-collection among Swedish citizens aged 16-84 years at baseline. The major objectives of this track are to provide general population estimates of the prevalence and incidence of problem and at-risk gambling and enable comparisons with the first Swedish national study on gambling and problem gambling (Swegs) conducted in 1997/1998. The overall study (Swelogs) comprises three tracks of data collection; one epidemiological, one in-depth and one follow-up. It is expected to provide information that will inform the development of evidence-based methods and strategies to prevent the development of gambling problems. This paper gives an overview of the design of the epidemiological track, especially of its two first waves. The baseline wave, performed between October 2008 and August 2009, included 8165 subjects, of whom 6021 were re-assessed one year later. A stratified random sampling procedure was applied. Computer-supported telephone interviews were used as the primary method. Postal questionnaires were used to follow-up those not reached by telephone. The response rate was 55% in the first wave and 74% in the second. The interview and questionnaire data are supplemented by register data. © 2014 The Authors. International Journal of Methods in Psychiatric Research published by John Wiley & Sons Ltd.


Stensvold C.R.,Statens Serum Institute | Beser J.,Public Health Agency of Sweden | Axen C.,National Veterinary Institute | Lebbad M.,Public Health Agency of Sweden
Journal of Clinical Microbiology | Year: 2014

Cryptosporidium meleagridis is a common cause of cryptosporidiosis in avian hosts and the third most common species involved in human cryptosporidiosis. Sequencing of the highly polymorphic 60-kDa glycoprotein (gp60) gene is a frequently used tool for investigation of the genetic diversity and transmission dynamics of Cryptosporidium. However, few studies have included gp60 sequencing of C. meleagridis. One explanation may be that the gp60 primers currently in use are based on Cryptosporidium hominis and Cryptosporidium parvum sequence data, potentially limiting successful amplification of the C. meleagridis gp60 gene. We therefore aimed to design primers for better gp60 subtyping of C. meleagridis. Initially,∼1,440 bp of the gp60 locus of seven C. meleagridis isolates were amplified using primers flanking the open reading frame. The obtained sequence data (∼1,250 bp) were used to design primers for a nested PCR targeting C. meleagridis. Twenty isolates (16 from human and 4 from poultry) previously identified as C. meleagridis by analysis of small subunit (SSU) rRNA genes were investigated. Amplicons of the expected size (∼900 bp) were obtained from all 20 isolates. The subsequent sequence analysis identified 3 subtype families and 10 different subtypes. The most common subtype family, IIIb, was identified in 12 isolates, represented by 6 subtypes, 4 new and 2 previously reported. Subtype family IIIe was found in 3 isolates represented by 3 novel, distinct subtypes. Finally, IIIgA31G3R1 was found in 1 human isolate and 4 poultry isolates, all originating from a previously reported C. meleagridis outbreak at a Swedish organic farm. Copyright © 2014, American Society for Microbiology. All Rights Reserved.


Soderlund-Strand A.,Laboratory Medicine Skane | Uhnoo I.,Public Health Agency of Sweden | Dillner J.,Karolinska Institutet
Cancer Epidemiology Biomarkers and Prevention | Year: 2014

Background: Organized human papillomavirus (HPV) vaccination was introduced in Sweden in 2012. On-demand vaccination was in effect from 2006 to 2011. We followed the HPV prevalences in Southern Sweden from 2008 to 2013.Methods: Consecutive, anonymized samples from the Chlamydia trachomatis screening were analyzed for HPV DNA for two low-risk types and 14 high-risk types using PCR with genotyping using mass spectrometry. We analyzed 44,146 samples in 2008, 5,224 in 2012, and 5,815 in 2013.Results: Registry-determined HPV vaccination coverages of the population in Southern Sweden increased mainly among 13-to 22-year-old women. Most analyzed samples contained genital swabs from women and the HPV6 prevalence in these samples decreased from 7.0% in 2008 to 4.2% in 2013 [- 40.0%; P < 0.0005 (%2 test)]. HPV16 decreased from 14.9% to 8.7% (- 41.6%; P < 0.0005) and HPV18 decreased from 7.9% to 4.3% (- 45.6%; P < 0.0005) among 13-to 22-year-old women. There were only small changes in vaccination coverage among 23-to 40-year-old women. In this age group, HPV18 decreased marginally (- 19.6%; P = 0.04) and there were no significant changes for HPV6 or HPV16. Two nonvaccine HPV types (HPV52 and HPV56) were increased among 13-to 22-year-old women, both in 2012 and 2013.Conclusions: A major reduction of HPV6,16, and 18 prevalences is seen in the age groups with a concomitant increase in HPV vaccination coverage. The minor changes seen for nonvaccine types will require further investigation.Impact: Monitoring of type-specific HPV prevalences may detect early effects of HPV vaccination. © 2014 American Association for Cancer Research.


Bremberg S.,Public Health Agency of Sweden | Bremberg S.,Karolinska Institutet
Acta Paediatrica, International Journal of Paediatrics | Year: 2015

Mental health problems increased in adolescents and young adults in Europe between 1950 and 1990, and the cause is largely unknown. Denmark, Finland, the Netherlands, Norway and Sweden form a relatively homogenous group of countries with favourable conditions for children. Our review examined the time trends for mental health problems in these countries between 1990 and 2010. Conclusion In general, there were only small changes in mental health problems in the countries studied. However, we did note a marked rising trend in mental health problems among adolescents in Sweden, which also has more issues with school achievement and unemployment rates. © 2015 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.

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