CHICKENPOX IN DECLINE IN WALES

Consultation rates for chickenpox in Wales are declining except for pre-school children. Using data from the General Practice Surveillance of Infectious Diseases Scheme, which covers over 200 000 patients in Wales, researchers found that consultation rates remained stable in 0–4 year olds but declined in all older age groups. The authors suggest that either an overall decline in transmission or increased social mixing in children aged under 5 years old is the reason behind the decline, and furthermore that more research is necessary before universal varicella immunisation should be considered in the UK. (

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MOSAIC DOWN’S SYNDROME PREVALENCE

The overall minimum prevalence of Down’s syndrome in Northern Ireland is around 1 in every 595 births, slightly higher than previously reported. Researchers performed a retrospective observational study for the period between 1997 and 2001 and found a total of 208 postnatal diagnoses of Down’s syndrome, of which 197 were trisomy cases, three were translocation, and eight mosaic. According to the authors the marginally higher prevalence may be attributable to the higher incidence of mosaic cases, which often lack dysmorphic features and are therefore harder to diagnose. (

TYPE 2 DIABETES IN UK CHILDREN

Children in the United Kingdom still have a low prevalence of type 2 diabetes, according to a recent survey of all paediatric diabetes centres in the country. Of 112 children reported to the survey, 25 had type 2 diabetes and 20 had maturity onset diabetes of the young (MODY). Children of South Asian origin are at increased risk of having type 2 diabetes, with a relative risk of 13.7 compared with white UK children. Diagnosis of non-type 1 diabetes in white UK children is as likely to be MODY as type 2 diabetes, despite the fact that the latter is characterised by insulin resistance and is distinct from both the former and type 1 diabetes. (

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SWEDISH SUBSTANCE MISUSE

A strong association exists between substance abuse and violent crime in Sweden. Researchers cross referenced data from the Swedish national crime register and the hospital discharge register for 1988–2000 and found that over 125 000 people were discharged from hospital with diagnoses of substance misuse. Over a tenth of all violent crimes in Sweden were committed by patients diagnosed as having misused drugs, and 16% were committed by people who had hospital discharge diagnoses of alcohol misuse. The authors suggest that treatment services aimed at alcohol and drug misusers could potentially reduce violent offending. (

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MORE ON SCOTTISH HEART DISEASE

Socioeconomically deprived patients in Scotland are 44% more likely to develop heart failure than affluent patients, but are 23% less likely to see their doctor on a regular and ongoing basis. Data from the Scottish continuous morbidity recording project showed that age and sex standardised incidence of heart failure increased with greater deprivation from 1.8 per 1000 population in the most affluent stratum to 2.6 per 1000 in the most deprived. No relation was found between prescribing practice and socioeconomic status, and the authors suggest that socioeconomically deprived patients may have poorer outcomes because they have less ongoing contact with their general practitioner. (

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OLD PROBLEMS, MODERN CHALLENGES

Simpler and cheaper point of care screening tools are urgently required to help control Sexually transmitted infections (STIs) in developing countries. STIs are a huge health and economic burden on developing countries and their importance is more widely recognised since the advent of the HIV/AIDS epidemic. Previous evidence suggests that control of STIs can lead to reduced HIV transmission. According to the authors, such control can only be effective when a combination of interventions are used and are backed by real political and financial commitment. (

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HRT AND FALSE POSITIVES

The risk of false positive recall in the NHS breast screening programme—when patients are recalled after mammography for further assessment without subsequent cancer diagnosis—is much higher in current and recent users of hormone replacement therapy (HRT). After studying data on over 85 000 postmenopausal women screened at 10 NHS programme centres between 1996 and 1998, researchers found that current HRT users had a relative risk of 1.64 for false positive recall compared with women who had never used it, and recent users a relative risk of 1.21. These findings therefore disagree with recent research that suggests high rates of false positive recall can be avoided if women cease use of hormones weeks or months before mammography. (

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LEARNING FROM BIG TOBACCO

More tobacco control resources should be directed towards working class women if they are to be sufficiently protected from the tobacco industry. Using selected keywords to systematically search internal company documents of the largest cigarette manufacturers, researchers found that the tobacco industry regards working class young adults to be a critical market segment to promote growth of key brands. Furthermore, differences in smoking prevalence by sex are decreasing, giving rise to concerns that women in particular will be targeted by Big Tobacco. The internal company documents can be found online at http://legacy.library.ucsf.edu/ (

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