Hart, D. E., Rojas, L. A., Ros?rio, J. A., Recalde, H. and Rom?, G. C. (1994), Childhood Guillain-Barr? syndrome in Paraguay, 1990 to 1991. Ann Neurol., 36: 859?863. doi: 10.1002/ana.410360609 Abstract
During 1990 to 1991, through a national surveillance program for poliomyelitis, the Paraguayan Ministry of Health received reports of 50 children with incident acute flaccid paralysis (< 15 years old). On the basis of established criteria, 37 were diagnosed with Guillian-Barr? syndrome. The average annual incidence rate for 1990 to 1991 was 1.1/100,000 children. The clinical course was more benign than reported in other pediatric series. There were low rates of hospitalization (57%), respiratory compromise (8%), and intubation (5%). The overall severity, however, was similar to that described in previous reports, with a 3% case-fatality rate and an 81% total recovery rate at 12 months. Seventy-six percent of patients had symptom onset during January to April, the warmest months of the year. Thirty percent of patients had definite or possible exposure to organophosphate pesticides, and the peak use coincides with the peak incidence of Guillian-Barr? syndrome There was no correlation between occurrence of Guillian-Barr? syndrome and prior immunization.
During 1990 to 1991, through a national surveillance program for poliomyelitis, the Paraguayan Ministry of Health received reports of 50 children with incident acute flaccid paralysis (< 15 years old). On the basis of established criteria, 37 were diagnosed with Guillian-Barr? syndrome. The average annual incidence rate for 1990 to 1991 was 1.1/100,000 children. The clinical course was more benign than reported in other pediatric series. There were low rates of hospitalization (57%), respiratory compromise (8%), and intubation (5%). The overall severity, however, was similar to that described in previous reports, with a 3% case-fatality rate and an 81% total recovery rate at 12 months. Seventy-six percent of patients had symptom onset during January to April, the warmest months of the year. Thirty percent of patients had definite or possible exposure to organophosphate pesticides, and the peak use coincides with the peak incidence of Guillian-Barr? syndrome There was no correlation between occurrence of Guillian-Barr? syndrome and prior immunization.
Arch Environ Health. 2004 Nov;59(11):575-80.
Guillain-Barre syndrome in a rural farming district in South Africa: a possible relationship to environmental organophosphate exposure.
London L1, Bourne D, Sayed R, Eastman R.
Author information
Abstract
Although organophosphate (OP) insecticides have been recognized as having neuropathic potential, a relationship with Guillain-Barre syndrome (GBS) has not been previously confirmed. A cluster of 7 cases of GBS was noted over an 11-yr period in an isolated farming region in the Northern Cape Province of South Africa, an area subject to intensive aerial application of OP insecticides. Observed cases were more than 4 times higher than expected based on a Poisson probability distribution. Four cases were clustered in an area where the topography showed a marked hollow, and where spray drift of aerial OP insecticides was anticipated. The rate of GBS in this subcluster was more than 14 times higher than expected. The authors explored the hypothesis that aerial OP insecticide application was related to the raised incidence of GBS in this area and made suggestions for future research.
PMID: 16599005 [PubMed - indexed for MEDLINE]
Guillain-Barre syndrome in a rural farming district in South Africa: a possible relationship to environmental organophosphate exposure.
London L1, Bourne D, Sayed R, Eastman R.
Author information
Abstract
Although organophosphate (OP) insecticides have been recognized as having neuropathic potential, a relationship with Guillain-Barre syndrome (GBS) has not been previously confirmed. A cluster of 7 cases of GBS was noted over an 11-yr period in an isolated farming region in the Northern Cape Province of South Africa, an area subject to intensive aerial application of OP insecticides. Observed cases were more than 4 times higher than expected based on a Poisson probability distribution. Four cases were clustered in an area where the topography showed a marked hollow, and where spray drift of aerial OP insecticides was anticipated. The rate of GBS in this subcluster was more than 14 times higher than expected. The authors explored the hypothesis that aerial OP insecticide application was related to the raised incidence of GBS in this area and made suggestions for future research.
PMID: 16599005 [PubMed - indexed for MEDLINE]
BMC Public Health. 2009 Jul 6;9:219. doi: 10.1186/1471-2458-9-219.
Pesticide-related illness reported to and diagnosed in primary care: implications for surveillance of environmental causes of ill-health.
Rushton L1, Mann V.
Author information
Abstract
BACKGROUND:
In Great Britain (GB), data collected on pesticide associated illness focuses on acute episodes such as poisonings caused by misuse or abuse. This study aimed to investigate the extent and nature of pesticide-related illness presented and diagnosed in Primary Care and the feasibility of establishing a routine monitoring system.
METHODS:
A checklist, completed by General Practitioners (GP) for all patients aged 18+ who attended surgery sessions, identified patients to be interviewed in detail on exposures and events that occurred in the week before their symptoms appeared.
RESULTS:
The study covered 59320 patients in 43 practices across GB and 1335 detailed interviews. The annual incidence of illness reported to GPs because of concern about pesticide exposure was estimated to be 0.04%, potentially 88400 consultations annually, approximately 1700 per week. The annual incidence of consultations where symptoms were diagnosed by GPs as likely to be related to pesticide exposure was 0.003%, an annual estimate of 6630 consultations i.e. about 128 per week. 41% of interviewees reported using at least one pesticide at home in the week before symptoms occurred. The risk of having symptoms possibly related to pesticide exposure compared to unlikely was associated with home use of pesticides after adjusting for age, gender and occupational pesticide exposure (OR = 1.88, 95% CI 1.51 - 2.35).
CONCLUSION:
GP practices were diverse and well distributed throughout GB with similar symptom consulting patterns as in the Primary Care within the UK. Methods used in this study would not be feasible for a routine surveillance system for pesticide related illness. Incorporation of environmental health into Primary Care education and practice is needed.
PMID:19580646 [PubMed - indexed for MEDLINE] PMCID: PMC2718882 Free PMC Article
Pesticide-related illness reported to and diagnosed in primary care: implications for surveillance of environmental causes of ill-health.
Rushton L1, Mann V.
Author information
Abstract
BACKGROUND:
In Great Britain (GB), data collected on pesticide associated illness focuses on acute episodes such as poisonings caused by misuse or abuse. This study aimed to investigate the extent and nature of pesticide-related illness presented and diagnosed in Primary Care and the feasibility of establishing a routine monitoring system.
METHODS:
A checklist, completed by General Practitioners (GP) for all patients aged 18+ who attended surgery sessions, identified patients to be interviewed in detail on exposures and events that occurred in the week before their symptoms appeared.
RESULTS:
The study covered 59320 patients in 43 practices across GB and 1335 detailed interviews. The annual incidence of illness reported to GPs because of concern about pesticide exposure was estimated to be 0.04%, potentially 88400 consultations annually, approximately 1700 per week. The annual incidence of consultations where symptoms were diagnosed by GPs as likely to be related to pesticide exposure was 0.003%, an annual estimate of 6630 consultations i.e. about 128 per week. 41% of interviewees reported using at least one pesticide at home in the week before symptoms occurred. The risk of having symptoms possibly related to pesticide exposure compared to unlikely was associated with home use of pesticides after adjusting for age, gender and occupational pesticide exposure (OR = 1.88, 95% CI 1.51 - 2.35).
CONCLUSION:
GP practices were diverse and well distributed throughout GB with similar symptom consulting patterns as in the Primary Care within the UK. Methods used in this study would not be feasible for a routine surveillance system for pesticide related illness. Incorporation of environmental health into Primary Care education and practice is needed.
PMID:19580646 [PubMed - indexed for MEDLINE] PMCID: PMC2718882 Free PMC Article
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