To estimate the frequency of infectious gastroenteritis across Australia, and to identify risk factors, we conducted a national telephone survey of 6087 randomly selected respondents in 2001-2002. The case definition was three or more loose stools and/or two or more vomits in a 24-hour period in the last 4 weeks, with adjustment to exclude non-infectious causes and symptoms secondary to a respiratory infection. Frequency data were weighted to the Australian population. Multivariate logistic regression was used to assess potential risk factors including season, region, demographic and socioeconomic status. Among contacted individuals, 67% responded. The case definition applied to 7% of respondents (450/6087) which extrapolates to 17.2 million (95% CI 14.5-19.9 million) cases of gastroenteritis in Australia in one year, or 0.92 (95% CI 0.77-1.06) cases/person per year. In the multivariate model, the odds of having gastroenteritis were increased in summer and in the warmest state, in young children, females, those with higher socioeconomic status and those without health insurance.
There are an estimated 277,000 cases of campylobacteriosis in Australia each year, most of which are thought to be sporadically acquired. To explore causes for these infections, we conducted a multi-centre case-control study of patients and community controls across five Australian States during 2001-2002. A total of 881 campylobacter cases and 833 controls aged 5 years were recruited into the study. Crude logistic analyses were conducted within various food and non-food exposure groups. A final most parsimonious multivariable logistic regression model was developed and adjusted odds ratios (aOR), 95% confidence intervals (95% CI) were derived together with adjusted population attributable risks (PAR). Consumption of undercooked chicken (aOR 4.7, 95% CI 2.6-8.4) and offal (aOR 2.0, 95% CI 1.0-4.0), ownership of domestic chickens aged<6 months (aOR 12.4, 95% CI 2.6-59.3) and domestic dogs aged<6 months (aOR 2.1, 95% CI 1.1-4.2) were found to be independent risk factors for illness in the final model. The PAR proportions indicate that eating chicken meat, either cooked or undercooked may account for approximately 30% of campylobacter cases that occur each year in Australia. These results justify the continued need for education of consumers and foodhandlers about the risks associated with the handling of raw chicken and the potential for cross-contamination.
There is a clear independent effect of ethnicity above and beyond the effect of socioeconomic status on overweight and obesity in children. Further research is required to explore the mediators of this gradient.
Recent advances have enabled quite accurate estimation by spectrophotometry of the density of cutaneous melanin. The relation between skin cancers and this objective measure of skin phenotype is examined here. For this purpose, a population-based case-control study of subjects aged 20-59 years of northern European ancestry was conducted in Tasmania, Australia. Cases (n = 244) of cutaneous malignant melanoma during 1998-1999, and a sample of cases of basal cell carcinoma (n = 220) and squamous cell carcinoma (n = 195) of the skin were identified from cancer registrations. Controls (n = 483) were selected from a comprehensive population listing. Melanin at the upper inner arm was estimated from skin reflectance of light of 400 and 420 nm wavelengths. For melanoma, basal cell carcinoma, and squamous cell carcinoma, respectively, the odds ratios comparing the least with the highest of four melanin categories were 6.2 (95% confidence interval (CI): 2.3, 16.6), 6.3 (95% CI: 2.6, 15.1), and 4.2 (95% CI: 1.7, 10.8) for men and 1.9 (95% CI: 1.0, 3.7), 1.4 (95% CI: 0.7, 3.0), and 0.7 (95% CI: 0.3, 1.7) for women. The gender differences were not due to disparities in site of occurrence or (for melanoma) in thickness of the lesion. The authors conclude that, particularly for men, cutaneous melanin density at the upper inner arm is a strong predictor of risk of skin cancer.
The very low level of ciprofloxacin resistance in C. jejuni isolates likely reflects the success of Australia's policy of restricting use of fluoroquinolones in food-producing animals.
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