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author:("eberle, M W")
1.  Seroepidemiology of chlamydia in Costa Rica. 
Genitourinary Medicine  1990;66(3):182-188.
A population-based study of the sero-epidemiology of chlamydia was performed among a nationally representative sample of 760 Costa Rican women aged 25 to 59 years. Interviews and sera collection were completed between September 1984 and February 1985. The overall seroprevalence of chlamydial antibodies among these women was 56.1%. Women 25 to 39 years of age had a seroprevalence of 51.1%, while women 40 to 59 years of age had a seroprevalence of 64.2%. Women who reported no prior sexual activity had a seroprevalence rate of 48.6%, compared with a seroprevalence rate of 80.7% among women who reported three or more lifetime sexual partners. The geometric mean titre (GMT) of seropositive women ranged from 34.4 among the women who reported no prior sexual activity to 155.0 among the women with three or more lifetime sexual partners. Sero-positivity was more consistently associated with sexual activity than with age. Women with serological evidence of past Herpes simplex virus type 2 (HSV-2) or syphilis infection were more likely to be seropositive than were women without evidence of exposure to these sexually transmitted diseases, even when controlled for age and the number of lifetime sexual partners. The seropositivity among never sexually active women indicates the probable presence of Chlamydia pneumoniae infections, while the high seroprevalence of chlamydial antibodies among the sexually active women suggests that sexually transmitted Chlamydia trachomatis infections represent a public health problem not previously quantified in Costa Rica. Further seroepidemiological and/or culture studies are warranted to determine the incidence and prevalence of sexually transmitted chlamydial infection among men and younger women.
PMCID: PMC1194499  PMID: 2370061
2.  Preventing hepatitis B in people in close contact with hepatocellular carcinoma patients. 
Public Health Reports  1997;112(1):63-65.
OBJECTIVE: To determine the prevalence of testing for hepatitis B virus (HBV) infection in the clinical management of primary liver cancer (hepatocellular carcinoma). METHODS: The authors reviewed the records of 78 patients treated for hepatocellular carcinoma in hospitals in the Puget Sound area in 1988 and early 1989 and reviewed all 1990 U.S. death certificates on which primary liver cancer was listed. RESULTS: The records of 50 (64%) of 78 hepatocellular carcinoma patients contained no evidence that the patient's hepatitis B surface antigen (HBsAg) status had been determined. In addition, of 4353 people who died in 1990 for whom the diagnosis of primary liver cancer was listed on the death certificate, HBV infection was also listed for only 136 (3%), much less than expected based on case series. CONCLUSIONS: Many patients with hepatocellular carcinoma are not tested for HBV infection, suggesting that their close contacts are also not evaluated for HBV infection and the need for vaccination. Hepatitis B vaccination of close personal contacts of HBV-infected hepatocellular carcinoma patients is an important strategy for preventing HBV transmission.
PMCID: PMC1381841  PMID: 9018291
3.  The prevalence of selected risk factors for chronic disease among American Indians in Washington State. 
Public Health Reports  1996;111(3):264-271.
Despite great improvements in recent decades, the health status of American Indians continues to lag behind that of other Americans. Continued health improvement will depend largely on changes in individual behavior. Until recently, however, few data existed on health risk behaviors among American Indians. We conducted personal interviews among the adult population of an Indian Health Service Unit in Washington State to estimate the prevalence of some health risk behaviors. This analysis focuses on three of the many topics covered in the survey: tobacco use, alcohol consumption, and weight. Cigarette smoking was more prevalent among both men and women than it was in the general population in the same area with 43% of men and 54% of women among the American Indians interviewed reported that they currently smoked. However, they tended to smoke much less heavily than smokers in the general population. Smokeless tobacco use was concentrated among young men, with the overall prevalence similar to that found in the general population. Acute heavy drinking was found to be common with 40% of men and 33% of women reporting this behavior for the previous month. The prevalence of substantial overweight was 45% among men and 43% among women, considerably higher than in the general population. Tribal leaders and the Indian Health Service are using the findings to design disease prevention and health promotion activities. In addition to providing valuable information about the surveyed populations, the survey served as a pilot for similar studies of other American Indian groups.
PMCID: PMC1381771  PMID: 8643820

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