Study protocol for enhanced CJD surveillance in the 65+ years population group in Scotland: an observational neuropathological screening study of banked brain tissue donations for evidence of prion disease.

Introduction: Creutzfeldt-Jakob disease (CJD) is a human prion disease that occurs in sporadic, genetic and acquired forms. Variant CJD (vCJD) is an acquired form first identified in 1996 in the UK. To date, 178 cases of vCJD have been reported in the UK, most of which have been associated with dietary exposure to the bovine spongiform encephalopathy agent.

High accuracy of home-based community rapid HIV testing in rural Malawi.

Objective: To assess the performance of rapid HIV antibody tests when used as part of a home-based community wide counseling and testing strategy in northern Malawi.

Design: A cross-sectional population survey of HIV infection, 2007 to 2008.

Methods: Adults aged 15 years or older in a demographic surveillance area were counseled and then offered an HIV test at their home by government-certified counselors.

Variant Creutzfeldt-Jakob disease in the United Kingdom: a countrywide or local risk?

Background: The aim of this study was to identify factors that may have augmented local risks for variant Creutzfeldt-Jakob disease (vCJD).

Methods: A descriptive study was conducted of local investigations of UK cases of vCJD, who had lived close together at some point since 1980. The main outcome measures were domestic, educational, occupational, healthcare associated, social and recreational links between cases; common dietary, iatrogenic and other possible routes of exposure to vCJD infection; and locally elevated vCJD risk.

Potential of environmental models to predict meningitis epidemics in Africa.

Objectives: Meningococcal meningitis is a major public health problem in Africa. This report explores the potential for climate/environmental models to predict the probability of occurrence of meningitis epidemics.

Methods: Time series of meningitis cases by month and district were obtained for Burkina Faso, Niger, Mali and Togo (536 district-years).

Environmental risk and meningitis epidemics in Africa.

Epidemics of meningococcal meningitis occur in areas with particular environmental characteristics. We present evidence that the relationship between the environment and the location of these epidemics is quantifiable and propose a model based on environmental variables to identify regions at risk for meningitis epidemics. These findings, which have substantial implications for directing surveillance activities and health policy, provide a basis for monitoring the impact of climate variability and environmental change on epidemic occurrence in Africa.

Geographic Information System mapping of snakebite incidence in northern Ghana and Nigeria using environmental indicators: a preliminary study.

Snakebite is an important health problem in many parts of rural West Africa where the carpet or sawscaled viper, Echis ocellatus, is responsible for most of the morbidity and mortality. Marked seasonal and geographical variation in the incidence of snakebite suggests an association with environmental factors that could potentially identify high-risk areas and inform health care decision making. This preliminary investigation describes a Geographic Information System (GIS) approach to risk mapping that identifies environmental variables potentially associated with variation in snakebite incidence rates at a number of health facilities in northern Ghana and Nigeria and which has been used to create a preliminary risk map of the potential probability of high snakebite incidence for West Africa.

Where is the meningitis belt? Defining an area at risk of epidemic meningitis in Africa.

Mapping an area at risk of epidemics of meningococcal meningitis in Africa has significant implications for their prevention and case treatment, through the targeted development of improved surveillance systems and control policies. Such an area was described using information obtained from published and unpublished reports of meningitis epidemics between 1980 and 1999 and cases of meningococcal disease reported by surveillance systems to WHO. The Sahel bore the greatest epidemic burden, with over two-thirds of documented outbreaks and high attack rates.