Question

salmonella in the Caribbean: A case study

1. Was there any bias noted? Describe

2. Any confounding variables? Describe

Answer 1

Salmonella in the carribean: A case study

Was there any bias noted?

Salmonella is a gastrointestinal illness caused by bacteria from the genus salmonella.the illness is characterized by the sudden onset of headache ,abdominal pain,diarrhea,nausea.and some times vomiting.fever is almost always present.the illness typically lasts for 5- 7 days and usually does not required treatment unless the patient become severly dehydrated or the infection spread from the intestines. In the immunocompromised host or an overwhelming infection in a normal host salmonella may spread to the blood stream and other body sites and can cause death unless treated promptly with antibiotics.

Salmonella In the Caribbean As early as the mid 1980 ,salmonella become a pathogen of public health concern in the Caribbean when it is caused an increasing number of cases and outbreaks of diarrhea involving local and turist populations. The communicable disease surveillance system in place at the time ,how ever did not support in the timely detection of these outbreaks or the investigation of risk factors associated with infection. As a result ,the the incidence of salmonella continue to grow.

There is growing evidence for a positive association between malaria and invasive nontyphoidal salmonella ( iNTS) disease.

However ,case - control studies conducted within health care facilities also report inverse associations. This may due to berkson ' s bias a selection bias that acts when both exposure and outcome are associated with hospital attendance and study participants are slected among attendees only .this study describes the effects of Berk son's bias on the malaria - iNTS association and provides a less biased effect estimate.

The study highlights how a selection bias may reverse results unsuitable control group us used an adds further evidence on the malaria iNTS disease association.

2. Describe any confounding variables ? Describe?

Weakness;

* Reporting of communicable disease to the system is incomplete 40% and lacks sensitivity.

* Lack of laboratory conformation means that reported cases have a low positive productive value.

* Lack of subtyping inhibits the systems ability to detect outbreaks.

require laboratory conformation ; of disease which laboratory testes / culture are necessary for a definitive diagnosis eg sallmonellosis. Laboratory conformation will increase the positive productive value of the system.

Streamline the flow of information ; and speed of transmission of report to the final recepiant send reports on a daily basis where possible instead of batching holding them.