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Prospective, community-based surveillance systems for measuring birth, death, and population movement rates may have advantages over the 'gold-standard' retrospective household survey in humanitarian contexts. A community-based, monthly surveillance system was established in South Kivu, Democratic Republic of the Congo, in partnership with a local implementing partner and the national ministry of health. Data were collected on the occurrence of births, deaths, arrivals, and departures over the course of one year, and a retrospective survey was conducted at the end of the period to validate the information. Discrepancies between the two approaches were resolved by a third visit to the households with discordant records. The study found that the surveillance system was superior in terms of its specificity and sensitivity in measuring crude mortality and birth rates as compared to the survey, demonstrating the method's potential to measure accurately important population-level health metrics in an insecure setting in a timely, community-acceptable manner.

Background The domestic rabbit is a common pet species, but limited research exists on the health of pet rabbits. This study aimed to characterise common disorders of pet rabbits and reasons for mortality as recorded by veterinary practices in England. Methods This cross-sectional study covered anonymised clinical records of 6349 rabbits attending 107 primary veterinary care clinics. Results The median age was 3.2 years (interquartile range (IQR) 1.6–5.1), and the median adult bodyweight was 2.1 kg (IQR 1.7–2.6). The most common breed types were domestic (n=2022, 31.9 per cent), lop (1675, 26.4 per cent) and Netherland dwarf (672, 10.6 per cent). For those rabbits that died during the study period, the median age at death was 4.3 years (IQR 2.1–7.0). The most common causes of death were recorded as myiasis (prevalence 10.9 per cent, 95 per cent confidence interval (CI): 7.4 to 15.2), anorexia (4.9 per cent, 95 per cent CI: 4.0 to 10.4), recumbency/collapse (4.9 per cent, 95 per cent CI: 4.0 to 10.4) and ileus (4.3 per cent, 95 per cent CI: 3.5 to 9.5). The most prevalent specific disorders recorded were overgrown claw/nails (16.0 per cent, 95 per cent CI: 14.5 to 17.5), overgrown molar(s) (7.6 per cent, 95 per cent CI: 6.6 to 8.7), perineal soiling (4.5 per cent, 95 per cent CI: 3.7 to 5.4), overgrown incisor(s) (4.3 per cent, 95 per cent CI: 3.5 to 5.2) and ileus (4.2 per cent, 95 per cent CI: 3.4 to 5.0). Conclusions This study augments the limited evidence base on rabbit health and can assist veterinarians to better advise owners on optimal animal husbandry priorities.

Objective: The objective of the study is to investigate the relation between pretreatment depressive symptoms (DS) and the course of DS during the first year after cancer diagnosis, and overall survival among people with head and neck cancer (HNC). Methods: Data from the Head and Neck 5000 prospective clinical cohort study were used. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) pretreatment, at 4 and 12-month follow-up. Also, socio-demographic, clinical, lifestyle, and mortality data were collected. The association between before start of treatment DS (HADS-depression > 7) and course (never DS, recovered from DS, or persistent/recurrent/late DS at 12-month follow-up) and survival was investigated using Cox regression. Unadjusted and adjusted analyses were performed. Results: In total, 384 of the 2144 persons (18%) reported pretreatment DS. Regarding DS course, 63% never had DS, 16% recovered, and 20% had persistent/recurrent/late DS. People with pretreatment DS had a higher risk of earlier death than people without DS (hazard ratio (HR) = 1.65; 95% confidence interval (CI) 1.33-2.05), but this decreased after correcting for socio-demographic, clinical, and lifestyle-related factors (HR = 1.21; 95% CI 0.97-1.52). Regarding the course of DS, people with persistent/recurrent/late DS had a higher risk of earlier death (HR = 2.04; 95% CI 1.36-3.05), while people who recovered had a comparable risk (HR = 1.12; 95% CI 0.66-1.90) as the reference group who never experienced DS. After correcting for socio-demographic and clinical factors, people with persistent/recurrent/late DS still had a higher risk of earlier death (HR = 1.66; 95% CI 1.09-2.53). Conclusions: Pretreatment DS and persistent/recurrent/late DS were associated with worse survival among people with HNC.

Background Studies of sheep mortality or cause-specific mortality, in Ireland or internationally, are relatively scarce but are important in presenting baseline levels and changing trends of endemic disease. This study assessed sheep mortality and cause-specific mortality in 33 sentinel sheep flocks in Ireland. Methods Sentinel flocks were requested to submit carcases of all sheep that died to the regional veterinary laboratories (RVLs) of the Department of Agriculture, Food and Marine during a calendar year (2016). Postmortem examinations were performed on 1247 submissions to Athlone, Kilkenny and Sligo RVLs. Results The median overall submission rate was 13.8 per cent (range 2.5 per cent–35.8 per cent) per adult female sheep in the flock in January 2016. The median fetal, perinatal, lamb and adult submissions per adult female sheep in the flock in January 2016 were 2.1 per cent (0.0 per cent–15.2 per cent), 3.5 per cent (0.0 per cent–20.0 per cent), 3.0 per cent (0.0 per cent–12.4 per cent) and 2.8 per cent (0.8 per cent–7.1 per cent), respectively. The frequency of detection of categories of postmortem diagnoses in fetuses, perinates, lambs and adults are presented. Conclusions Comparisons with existing passive surveillance findings reflect some differences in the relative frequency of detection of certain categories of disease suggesting that sentinel flock surveillance could usefully supplement existing passive animal disease surveillance activities for ovine disease.

This study was conducted in a commercial 1000-sow herd facing recurrent exudative epidermitis (EE) outbreaks during the nursery period and assessed the efficacy of autogenous vaccination in controlling such outbreaks. The vaccine was produced using three Staphylococcus hyicus isolates recovered from affected pigs shortly before the onset of the study. All of those isolates were positive for the exhB gene, which encodes the exfoliative toxin type B (ExhB). From four consecutive farrowing batches of sows, two batches were vaccinated (V) against S hyicus at five and two weeks before farrowing, and two sow batches remained non-vaccinated (NV). Vaccination efficacy was primarily determined by the levels of metaphylactic antimicrobial usage, and the morbidity and mortality data for the pigs of the V and NV sows. The total amount of antimicrobials used metaphylactically against EE in pigs among the V and NV farrowing batches was 39,600 and 88,550 mg, respectively. The used daily dose pig to animal daily dose pig ratio for the V and NV batches were 1.31 and 1.79, respectively (a ratio of 0.8 to 1.2 is indicative of correct dosing). The morbidity and mortality rates were V=6.50 and NV=14.36 (P=0.008), and V=2.59 and NV=5.02 (P=0.000), respectively. To conclude, autogenous vaccination of the sows with a vaccine based on exhB-positive S hyicus isolates reduced metaphylactic treatment with antimicrobials as well as the morbidity and mortality rates in weaned pigs compared with pigs from NV sow batches.

The objective of this study was to evaluate cancer mortality in pulp and paper industry workers exposed to chlorinated organic compounds. We assembled a multinational cohort of workers employed between 1920 and 1996 in 11 countries. Exposure to both volatile and nonvolatile organochlorine compounds was estimated at the department level using an exposure matrix. We conducted a standardized mortality ratio (SMR) analysis based on age and calendar-period-specific national mortality rates and a Poisson regression analysis. The study population consisted of 60,468 workers. Workers exposed to volatile organochlorines experienced a deficit of all-cause [SMR = 0.91; 95% confidence interval (CI), 0.89-0.93] and all-cancer (SMR = 0.93; 95% CI, 0.89-0.97) mortality, with no evidence of increased risks for any cancer of a priori interest. There was a weak, but statistically significant, trend of increasing risk of all-cancer mortality with increasing weighted cumulative exposure. A similar deficit in all-cause (SMR = 0.94; 95% CI, 0.91-0.96) and all-cancer (SMR = 0.94; 95% CI, 0.89-1.00) mortality was observed in those exposed to nonvolatile organochlorines. No excess risk was observed in cancers of a priori interest, although mortality from Hodgkin disease was elevated (SMR = 1.76; 95% CI, 1.02-2.82) . In this study we found little evidence that exposure to organochlorines at the levels experienced in the pulp and paper industry is associated with an increased risk of cancer, apart from a weak but significant association between all-cancer mortality and weighted cumulative volatile organochlorine exposure.

Objectives: To investigate mortality trends in a cohort of people admitted to a regional head injury unit with all severities of injury in the calendar year 1981. Methods: A computerised database with details of 1919 admissions was compared with deaths registered by the NHS Central Register, Scotland for the years 1981 to mid-2002. Death certificate information for matches was analysed. Results: The 1919 admissions referred to 1871 individuals, comprising 93 severe, 205 moderate, and 1573 minor injuries according to Glasgow coma scale criteria. There were 57 deaths (42 severe head injuries, eight moderate, seven minor) during the initial admission, and 340 (six severe, 33 moderate, 301 minor) in the subsequent years. Substance abuse, principally alcohol, was a factor in 37 deaths, suicide accounted for 20, and accidents for 25. The great majority of these latter deaths were in people under the age of 70 years. Conclusion: Premature deaths after predominantly minor head injury are commonly alcohol related or the result of suicide or accidents.

To assess possible health risks associated with the manufacture of paper, we carried out a retrospective analysis of mortality among 4,242 men and women employed at a Scottish paper mill between 1955 and 1992. During follow-up to 1994, 959 subjects had died giving an SMR of 0.85 (95% CI 0.80-0.90) in comparison with the national population. Mortality from all cancer (SMR 0.77, 95% CI 0.68-0.88) and particularly from lung cancer (SMR 0.64, 95% CI 0.50-0.81) was lower than expected. An excess of lymphatic and hematopoietic cancer (11 deaths, SMR 2.17) was observed in the making department. These findings do not support an occupational hazard of lung cancer as suggested by several earlier studies. The excess of lymphatic and hematopoietic cancer in the making department was unexpected, and may be a chance occurrence.

Three hundred and ninety one male employees aged 35-65 in a Swedish pulp and paper company were followed up for 22 years; 151 deaths were recorded by 31 December 1983. On the basis of data from 1961, indices for job decision latitude, job support, and other work related psychosocial factors were constructed as were five indices for non-work related social network factors. All indices were checked by life table analysis in respect of mortality. Job decision latitude and a combined index for job decision latitude and job support showed significant associations with mortality. These two indices were investigated by multivariate analysis with scale for evaluation of neuroticism and known somatic risk factors such as smoking, cholesterol, and systolic and diastolic blood pressure. Age, educational level, occupational status, physically heavy work, and general health state were also included in the multivariate analysis. Age, systolic blood pressure, the combined index for job decision latitude and job support, smoking, and neuroticism were shown to be independent predictors of mortality.