Sefer Aycan

Prevalence of Epilepsy in Turkish Children Between the Ages of 0 and 16 Years

The aim of this cross-sectional study was to determine the prevalence of epilepsy in Turkey among children between the ages of 0 and 16 years. The study population consisted of 24,773,569 children living in Turkey. Because the prevalence of childhood epilepsy is reported to be 0.001 to 1% in the literature, the sample size was determined as 48,260, with 0.05 error type I and 0.10 error type 2 (power 0.90), and the effect size was 2. With the cluster sampling method, samples were selected from cities, towns, districts, and villages, and 46,813 (97%) children were reached. The study questionnaire contained sections with individual informational questions and questions for the selection of suspected epilepsy cases and physical examination results. The epilepsy classification was designed according to the classification of the International League Against Epilepsy (ILAE). The prevalence of epilepsy was determined as 0.8%; 55.2% of the subjects with epilepsy were grouped as generalized, 39% as partial, and 5.8% as unidentified. Age, place of residence, route of delivery, place of delivery, and social and economic status had no statistically significant effect on the development of epilepsy. Male gender, preterm, and post-term delivery increased the risk of developing epilepsy. Early diagnosis and treatment of epilepsy, as well as the education of health workers and families, are very important. (J Child Neurol 2004;19:271-274).

Measles Epidemiology and Elimination Strategies in Turkey

In Turkey, 15,000-30,000 measles cases have been reported annually since the 1990s. Epidemics occur every 3-4 years, and >/=90% of cases are <15 years old. The high incidence is due to inadequate vaccination coverage (nationally 84% in 2001) and immunity provided by the first dose of vaccine administered at age 9 months. The second dose, which has been recommended for first grade students since 1998, has been insufficient to provide the herd immunity necessary to control measles. The Ministry of Health launched a comprehensive program for 2002-2010 targeting measles elimination. This plan calls for a national vaccination campaign among all children aged 9 months to 14 years and routine two-dose vaccination coverage will be increased to >/=95% or follow-up campaigns will be conducted in areas not achieving high coverage levels. Also, all military recruits in 2002-2009 will be vaccinated and case-based, laboratory supported surveillance will be initiated.

Water usage habits and the incidence of diarrhea in rural Ankara, Turkey

This aim of this study was to determine water usage behavior and incidence of diarrhea during the summer months among people in rural areas of Turkey. Information was collected using a questionnaire during face-to-face interviews with people aged 18 years and over in their homes. Diarrhea was detected in 31.7% of the 543 households included in the study in the summer of 2003. The percentage of those living in the study area experiencing at least one bout of diarrhea was 10.0%. The diarrhea episode rate was 18.7%. A logistic regression model of factors that could influence the incidence of diarrhea showed that the reported distance between the septic tank and the well, the total monthly household income and water shortages of longer than 12h had a significant effect on diarrhea incidence (P<0.05). The fact that water shortages are the biggest risk factor for diarrhea points to the need for (i) health education to raise awareness and (ii) the supply of equipment to enable households to use both the first running water after a water shortage and the water they have collected during the shortage as drinking water.

Prevalence of insomnia symptoms: results from an urban district in Ankara, Turkey

Objective. Characteristics of insomnia symptoms in Turkey are not well established. The goal of this study was to determine the prevalence of insomnia and related symptoms in an urban district of Turkey. Method. The study was carried out in Ankara, in an urban district with a population of 2665. Out of the 1332 people in the sample, 1034 in the 15–65 age range were included in the study. Interviews were conducted according to the “Sleep Disorders Assessment Questionnaire” developed by the researchers. The Insomnia Severity Index (ISI) was also given to the subjects with a sleep problem to measure the subjective quality and quantity of insomnia symptoms. Results and conclusion. A total of 29.4% of all participants reported a sleep problem, out of which 23.7% defined one or more of the insomnia symptoms which included difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), non-restorative sleep (NRS) and sleep deprivation (SD). Insomnia risk was found to be significantly increased with age, female sex, smoking and chronic medical illness. A total of 75.9% of participants who reported insomnia symptoms did not seek medical help for their complaint. According to the ISI, among the subjects with insomnia symptoms, 79 (32.2%) had subthreshold insomnia, 43 (17.6%) had clinical insomnia, 12 (4.9%) had severe clinical insomnia, while 88 (35.9%) did not score in the range indicating insomnia. The findings are discussed in the light of previous research and in relation to sociocultural factors emphasizing the need for public education on sleep disorders as medical conditions.

Bordetella pertussis Seroprevalence Among Vaccinated School Children in Ankara, Turkey

Pertussis is an acute infectious disease caused by Bordetella pertussis occurring world wide [1]. It is highly contagious in the early catarrhal stage and the secondary attack rate can increase up to 80–90% with household contact [1, 2]. Antibodies against pertussis toxin (PT) have been correlated with clinical protection against pertussis in humans [3]. Pertussis affects susceptible individuals of every age and is especially severe in children [1, 2]. Adolescents and adults are important reservoirs for B. pertussis and are frequent sources of infection for infants in particular [1, 4, 5]. In Turkey, infants are vaccinated with whole cell pertussis as a triple vaccine including Tetanus and Diphteria at the second, third, and fourth months with a booster at 18 months of age according to the national vaccination schedule. No pertussis vaccination is given afterward. Neither immunity nor vaccination protects against the disease long-term and it has been reported that the number of pertussis cases in adolescents and adults has been increasing since the 1990s [4, 6–13]. Pertussis is a notable disease in Turkey and continues to be one of the important childhood infections [14]. The National Standard Diagnosis and Surveillance Guide is put into use since January 1st, 2005, and cases are started to be reported as probable cases or definite cases from all health facilities [15]. Due to the new surveillance system, the number of clinically confirmed cases were 200 and laboratory confirmed cases were 72 with an overall incidence of 0.01/1,000,000 population [16]. The low number of cases reported may likely to be due to the low awareness of the clinicians both in diagnosis and in reporting. Laboratory verification is not usually obtained because of not including the disease in their prediagnosis list or lack of required laboratory infrastructure. In this study, we aimed to determine the pertussis seroprevalance rate in four dosage vaccinated school children aged 6–14 years through the assessment of anti PT IgG antibodies.

Associations between obesity and the radiographic phenotype in knee osteoarthritis

BACKGROUND/AIM Investigation of the association between obesity and the distinction of radiographic patterns in knee osteoarthritis. MATERIALS AND METHODS Seven hundred and thirty-four women underwent weight-bearing antero-posterior knee radiography. Osteophytes and joint space narrowing (JSN) were graded according to the OARSI atlas. Each subject was assigned to one of the following groups with respect to the maximum score: osteophyte-dominant, indeterminate, JSN-dominant, and radiographically normal. RESULTS Obese patients had a significantly more frequent osteophyte-dominant pattern compared to nonobese subjects (74.5% and 38%, respectively, P < 0.001). Logistic regression analysis demonstrated that obesity had a stronger association with an osteophyte-dominant pattern compared to a JSN-dominant pattern (OR and 95% CI = 7.16 (3.15-16.26) and 1.63 (0.96-2.78), respectively). Age had a very weak effect on the distinction to an osteophyte-dominant pattern and no effect on JSN dominance (OR and 95% CI = 1.1 (1.06-1.15) and 1.02 (0.99-1.05), respectively). CONCLUSION There might be an association between obesity and the radiographic phenotype in patients with knee osteoarthritis. The findings suggest that the association between obesity and the osteophyte formation is stronger than that of JSN.

Medical Waste Survey in a University Hospital: Do Intern Doctors and Emergency Nurses Know and Pay Attention to Segregation of Wastes?

Medical wastes are of public health concern in both developed and developing countries being costly in disposal and carry risks of infection or physical injury and of exposure to potentially harmful pharmaceuticals. This study aimed to determine the knowledge and attitudes of intern doctors and emergency nurses in a university hospital and conducted in Gazi University Hospital in April 2006. One hundred and thirty one intern doctors and 27 emergency nurses are targeted to be reached for March–April 2006 period. A questionnaire form was filled out for each participant. Nurses have undergone training programs on medical wastes and waste segregation (50.0%) significantly more than the intern doctors (19.3%). The knowledge of the medical wastes that must be disposed in “red coloured plastic sacks” were known by almost all (98.6% of intern doctors, 100.0% of emergency nurses) participants (p > 0.05). Wastes which must be disposed in “blue coloured plastic sacks” and “black coloured plastic sacks” were known better by nurses (85.0 and 85.0%) than intern doctors (60.5 and 58.2%) (p < 0.05). Intern doctors and emergency nurses are found as a group of high risk and the appropriate training programs in terms of timing and content will be effective.

The 5-Year Incidence of Type 2 Diabetes Mellitus in Women Older Than 15 Years in Ankara, Turkey: A Population-Based Study

Background Type 2 diabetes mellitus (DM) is a significant cause of morbidity and premature mortality especially in adults. In Turkey, there are few studies on DM incidence. This study aimed to determine the incidence of type 2 DM in women 15 years or older in Turkey. Methods This prospective cohort study was performed from December 2002 to May 2003. Preliminary population-based screening was performed in 1997 and 1998 on women 15 years or older living in 4 villages in the Gölbaşı, Ankara province. Five hundred sixty-three women who were considered nondiabetic in the first study comprised the population for the present study. Data collection was accomplished by using a questionnaire and randomly measuring the blood glucose levels of the women. The χ2 and Fisher exact tests were used to analyze the risk factors for DM. Results The 5-year incidences of type 2 DM, impaired glucose tolerance, and impaired fasting glucose were 2.3%, 0.4%, and 0.7%, respectively. The 5-year incidence of type 2 DM increased with age (P < 0.05). The DM incidence was 6.2% in those with mixed-type hypertension and 4.0% in those with a body mass index of 30 kg/m2 or higher. At 5-year follow-up, age (≥35 years), hypertension, and body mass index (≥30 kg/m2) were the risk factors for incidence of abnormal glucose metabolism (P < 0.05). Conclusions The incidence of abnormal glucose metabolism in this study is in accord with that in the literature. Our results will contribute to our understanding of the incidence of DM in women in Turkey.