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ABSTRACT: Our study aimed to determine anti-HBc total (IgG+IgM) seroprevalence in the adult population aged ≥ 15 and to compare the cost of testing for HBsAg and anti-HBs in only anti-HBc positive+ subpopulation to that in the whole population for HBV screening. The study involved a face-to-face survey and peripheral blood sampling from 452 adult subjects for HBV tests. HBV-DNA PCR was studied only in anti-HBc+ subjects. Of the 452 subjects anti-HBc total was positive in 192 (42.47%), of which: (a) 27 (14.06%) were HBsAg+, anti-HBs negative⁻, (b) 126 (65.62%) were HBsAg⁻, anti-HBs+, (c) 39 were HBsAg⁻, anti-HBs⁻. This last group (c) were tested for HBV-DNA PCR and six (15.38%) were positive. When we perform HBsAg and anti-HBs tests in all 452 subjects as in routine practice in blood banks, the cost is 3320 Euros. However, when all subjects are tested for anti-HBc total at first and then only anti-HBc total+ ones are tested for HBsAg and anti-HBs, the cost is 2929 Euros. The cost difference between the two methods is 391 Euros for 452 subjects. Accordingly, our HBV screening algorithm brings a financial saving of 11.78% and helps to identify the isolated anti-HBc total+ subjects who carry potential risk for spreading HBV.
Transactions of the Royal Society of Tropical Medicine and Hygiene 10/2010; 104(12):782-6. · 2.16 Impact Factor
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ABSTRACT: In this study, we aimed to determine behaviors of women over 40 years toward methods of breast cancer early detection in a rural region of Ankara, Turkey.
Of the 1277 women aged over 40 years, 910 (71.3%) participated in the study.
Not performing breast self-examination was 3.1 times more frequent in those aged 60 years and older (95% confidence interval [CI], 1.8-5.2), 2.1 times more frequent in those who could only read and write (95% CI, 1.5-2.9), and 2.5 times more frequent in housewives (95% CI, 1.5-4.3). The likelihood of clinical breast exam was 1.8 times less in women aged 60 years old and older compared with younger women. Primary school graduates had a 1.9 times (95% CI, 1.3-2.9) greater chance of not having had a mammography compared with those that been at least primary school graduates.
For women to change their behavior and adopt early methods of diagnosing breast cancer, it is necessary to reach priority target groups during the training provided by primary care institutions.
Journal of Cancer Education 02/2009; 24(2):127-8. · 0.76 Impact Factor
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ABSTRACT: To assess the drug preferences of primary care physicians for osteoarthritis (OA) in comparison with the current guidelines, and their reflections in the cost of prescriptions.
Data were collected from all primary health care centers in Bolu, Turkey, during November 2002 from patient polyclinic logbooks. Drugs prescribed were classified according to the Anatomical Therapeutic Chemical Classification system for comparison purposes. Gender, age, and health insurance of patients were analyzed for drug preferences and costs.
Forty-eight primary care physicians prescribed 1,047 drugs for 507 OA patients with total a cost of $10,254. Anti-inflammatory and antirheumatic products were the leading group accounting for 59.6% of the prescribed drugs, and 84.1% of the total expenditure. Paracetamol, the most commonly recommended in the guidelines, constituted 6.9% of all prescribed drugs and 0.9% of the total cost. Drug preferences showed a statistical difference among the health insurance types while drugs' cost showed statistical significance among the gender and health insurance types. Cyclooxygenase-2-specific inhibitors were the most commonly prescribed subgroup, constituting 23.2% of prescribed drugs and 62.6% of the total expenditure.
Paracetamol in practice was not the first-line drug preferred by primary care physicians. Drug prescription data showed that the preference of drugs was affected by health insurance types and the gender of patients in favor of expensive, new drugs. There is a need for improvement of drug prescriptions to reflect current recommendations and guidelines.
Saudi medical journal 01/2008; 28(12):1885-9. · 0.52 Impact Factor
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ABSTRACT: It is essential to evaluate the susceptibility of women in the reproductive age group to rubella virus in order to set strategies for the prevention of congenital rubella syndrome (CRS). Turkey began implementing measles-mumps-rubella vaccination as part of the national vaccination schedule for children (12 months, 6 years) and adolescents (14 years) in July, 2006, and there is an ongoing discussion of the need for a policy of vaccinating women of child-bearing age against rubella. The aim of this study was to determine the rubella seroprevalence among women in the reproductive age group in a rural district in Ankara and to provide data about rubella susceptibility for policymakers. Four hundred ninety of the women in the 15- to 49-year-old age group in the region who were targeted were reached (68.2%), and 467 (65.0%) of them who had a convenient serology were included in the study. Rubella IgG antibodies were quantified by the enzyme-linked immunosorbent assay method. Seropositivity was 95.5% for the total group and 96.2% among pregnant women. The seropositivity of this rural group of women was found to be high, but in order to rule out the need for a rubella vaccination program for women of child-bearing age, large-scale studies in different settings and studies that describe the CRS burden in Turkey are required.
Japanese journal of infectious diseases 08/2007; 60(4):157-60. · 1.49 Impact Factor
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ABSTRACT: The aim of this study was to determine the seroprevalence of toxocariasis in adult asthmatics and to assess its relationship with risk factors. A total of 124 asthmatic and 60 control group subjects were included in the study. Of the asthmatic patients, 61 (49.2%) were atopic and 63 non-atopic (50.8%). The anti-Toxocara IgG (Toxocara IgG CELISA Cellabs, Australia) positivity rate for all asthmatic cases was 9.7%. There was no significant difference between the asthmatic cases and the control group regarding anti-Toxocara IgG positivity (P>0.05). When risk factors were analyzed, there was a statistically significant difference between the control group subjects and patients with non-atopic asthma and also between the atopic asthmatic patients and the patients with non-atopic asthma regarding pets being under veterinary control (P<0.05). The percentages of those who had their pets defecate indoors were 0, 15 and 8.6%, respectively, for the control subjects, patients with non-atopic asthma and those with atopic asthma. There was a statistically significant difference when the control group subjects were compared to the patients with atopic asthma (P<0.05).
Transactions of the Royal Society of Tropical Medicine and Hygiene 04/2007; 101(3):270-4. · 2.16 Impact Factor
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ABSTRACT: Training on breast health is required to increase awareness of early detection of breast cancer, especially in countries with limited resources.
Of the 784 invited women, 462 participated in the study (58.9%). The training included both theoretical and breast self-examination (BSE) training between preeducation and posteducation tests. Following the theoretical presentation, breast examination training was performed using a breast simulator. The competency of the participants on breast examination was assessed by an evaluation guide.
All breast cancer symptoms were stated at significantly higher rates compared to those before education (P < .05). The most commonly stated risk factor in both preeducation and posteducation tests was "no breast-feeding," with ratios of 15.2% and 56.3%, respectively. Early detection modalities for breast cancer were also stated more often in the posteducation test compared to the preeducation (P < .05). In the preeducation test, only 4.3% to 18.7% of the participant women could state most of the BSE steps. After BSE training, 85% to 92% of the participants were competent in BSE steps.
Theoretical education on breast cancer and BSE training in low-educated women, even illiterate, is highly effective.
Journal of Cancer Education 01/2007; 22(2):108-11. · 0.76 Impact Factor
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ABSTRACT: The objective of this study was to evaluate the effectiveness of inactivated influenza vaccine in preventing acute otitis media (AOM) and otitis media with effusion (OME) in children aged 6 to 60 months who attend day care.
This prospective, single-blind study was conducted in 8 day care centers in Ankara, Turkey. One hundred nineteen (61 vaccinated and 58 unvaccinated against influenza) healthy children were examined at study entry and at 6-week intervals for 6 months by the same 2 otorhinolaryngologists who were blinded about the vaccination status of the children. The frequency of AOM and OME is compared between the 2 groups and the effect of influenza season on frequency of episodes was evaluated. Based on national influenza laboratory data, the influenza season was determined to be the period between December 15, 2003, and January 31, 2004.
The frequencies of AOM, OME and total otitis media episodes in vaccinated children were 2.3%, 22.8% and 25.2%, respectively, and these frequencies were 5.2%, 31.1% and 36.3% in the unvaccinated group. The difference was statistically significant (P < 0.01). This difference was especially prominent in the influenza season (P < 0.05).
Influenza vaccine is effective in reducing AOM and OME episodes in 6- to 60-month-old day care children, especially during influenza season.
The Pediatric Infectious Disease Journal 06/2006; 25(5):401-4. · 3.58 Impact Factor
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ABSTRACT: The clinical value of an in-house cytomegalovirus nested polymerase chain reaction (CMV-PCR) and a commercial molecular assay hybrid capture CMV DNA assay (HCA) was evaluated in monitoring a group of renal transplant patients for six months follow up. In this study, the sensitivity, specificity, positive predictive value, and negative predictive value of nested CMV DNA PCR assay and HCA at the beginning of the study were 70, 42.9, 46.7, 66.7, and 60, 78.6, 66.7, and 73.3% respectively. After six months, they were 80, 66.7, 80, 66.7 for CMV PCR and 73.3, 88.9, 91.7, 66.7% for HCA respectively. These results indicate that in monitoring and predicting CMV infections in renal transplant recipients, not only qualitative but also quantitative assays must be used together in order to decide the preemptive strategies.
Memórias do Instituto Oswaldo Cruz 06/2005; 100(3):263-7. · 2.15 Impact Factor
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ABSTRACT: This study was designed to evaluate the age-specific varicella-zoster virus (VZV) seroprevalence in children less than 5 years old who presented at a healthy child outpatient clinic and to compare the results with the data from other countries. The study was a cross-sectional study determining the prevalence of serum IgG against VZV in children who presented to the Healthy Child Outpatient Clinic of the Gazi University Medical Faculty and who were aged between 9 months and 5 years, in the 3rd--97th percentile as regards height and weight, not suffering from any disease, and without a history of vaccination against varicella. The information on the children was obtained from a questionnaire, by physical examination, and from patient files. Serum samples were obtained from babies and children at 9, 15, 24, 36, 48, and 60 months. The 295 serum samples were kept at --20 degrees C following centrifugation until used for serologic analysis (ELISA). The 292 children of the study group consisted of 168 males (57.5 per cent) and 124 females (42.5 per cent). VZV antibodies were found to be positive in 65 children aged between 9 months and 5 years (22.3 per cent); 22.0 per cent in males and 22.6 per cent in females with no statistically significant difference between the sexes (p>0.05). The VZV seroprevalence was highest at the 48th and 60th months and this difference was statistically significant (p=0.000).
Journal of Tropical Pediatrics 06/2005; 51(3):141-4. · 1.39 Impact Factor
