https://www.um.edu.mt/library/oar/handle/123456789/33876 2026-04-04T18:51:26Z https://www.um.edu.mt/library/oar/handle/123456789/50201 Title: The epidemiology of meningococcal disease in Malta. Abstract: Objectives 1. To examine trends and epidemiological characteristics of meningococcal disease in Malta particularly in the light of the recent upsurge. 2. To compare these characteristics and trends with those obtained in other countries in recent years. 3. To consider the public health implications of recent trends in reported incidence. 4. To examine the relationship between reported incidence and climatic factors. Design - Data collection from routine health records 1994-1999 with retrospective analysis. Setting - The Maltese islands. Subjects - Maltese residents living in Malta. Main outcome measure - Notified cases of meningococcal disease to the Department of Public Health and laboratory reports. Results - A significant increase in the reported incidence of meningococcal disease particularly in the young adult population. Different serogroups were identified with serogroup B being the predominant strain followed in frequency by serogroup C. Cases of meningococcal disease were consistently reported in every quarter from 1997 onwards. Conclusion - An increase in the number of cases is occurring at a time when some other European countries are experiencing similar trends. The importance of close surveillance, particularly to monitor any changes in the serogroup of the meningococci causing disease, cannot be overemphasised. With the availability of vaccines against serogroup B meningococci, vaccination will become of major importance in preventing meningococcal disease in Malta. Meanwhile, the main methods of control remain the early treatment of cases and the prevention of secondary cases. Description: M.SC.PUBLIC HEALTH 2000-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/42517 Title: The value of ICPC disease coding and morbidity in general practice. Abstract: Description - Data relating to morbidity in General Practice in Malta is rare to come by. General Practitioners record much information on morbidity in the course of their routine work, and General Practice records reflect more closely the true relative frequencies of most diseases than do hospital or mortality records. The diagnostic information available in General Practice depends on the type of records maintained, but on the whole the data are free from the biases that arise from selective referral and admission of patients to hospital. Although in Malta doctors are not responsible for a defined list of people, the author has been using an electronic database for maintaining patient records since 1994. The system used is custom made for the author and includes the ICPC2 classification of diseases, widely used in General Practice and recommended by WONCA, the World Organisation of National Colleges, and Associations of Family Medicine. Aims and objectives - Encounters for all patients attending the author's clinic have been documented on electronic records since 1994. Data on 593 encounters for different disorders were examined. Although that due to a lack of good denominator data, these cannot be readily converted into morbidity rates, the relative frequency of disease presentation in General Practice in Malta can be studied and a list of the commoner diagnoses is very informative. The results may be compared to morbidity rates in General Practice in other countries. Method - Data relating to 593 consecutive clinic encounters performed during the first quarter of 1994 were analysed based on the diagnosis code. A disease profile was compiled and relative frequency of disease presentation worked out for each body system. Prevalence Rates of disease presentation in General Practice in Holland between 1985 - 1994 are available through the Transition Project, an electronic patient record keeping system based also on ICPC-2. Although not strictly comparable, data from the two studies were examined to see whether there are any similarities between disease presentation in General Practice in Malta and Holland. Description: M.SC. PUBLIC HEALTH 2000-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/42516 Title: Epilepsy in Maltese children. Abstract: Purpose: To determine the point prevalence of active childhood epilepsy in Malta with the primary objective of health service planning in this population. The study also aimed at verifying the applicability of the ILAB classification of seizures, and epilepsies / syndromes in this group of children. Methods: A cross-sectional descriptive survey of children 0-15 years with "active" epilepsy was carried out among residents of Malta. Children with a diagnosis of epilepsy (recurrent unprovoked seizures) who had experienced a seizure or who had received antiepileptic medication in the preceding 5 years were considered to be active prevalence cases. The age- and sex-specific prevalence rates of epilepsy, type of seizures, epilepsies and recognisable epileptic syndromes were determined using the latest ILAB International Classification of Epileptic Seizures (ICES, 1981) and Epilepsies and Epileptic Syndromes (ICE, 1989). Results: Two hundred and five children fulfilled the criteria of active epilepsy giving a prevalence rate of 2.4211 ,000 population in children from birth through 15 years of age (95 % Cl = 2.1-2.79) on January 1, 1999. The proportion of boys to girls was 1.3: 1. According to ICES / ICE, seizures were classifiable with certainty in 99% of cases and epilepsy syndromes in 70% of cases. Among the syndromes, cryptogenic and symptomatic partial syndromes occurred in 35%, other generalized idiopathic epilepsies in 11%, childhood absence in 7%, Lennox Gastaut in 6%,West syndrome in 5% and benign childhood epilepsy with centrotemporal spikes (BECT) in 4%. Epilepsy was intractable in 26% of all cases and correlated significantly with symptomatic aetiology, early onset of epilepsy, as well as with additional neuroimpairments. The aetiology was regarded to be remote symptomatic in 39%, cryptogenic in 22% and idiopathic in 32%. Perinatal asphyxia, trauma and brain malformations were the three most common aetiological factors identified accounting for half of the cases with remote symptomatic epilepsy. Almost all children (91%) were on anticonvulsant medication; 70% were on monotherapy while 21 % were on polytherapy. Additional neuroimpairments were present in 106 (52%) of children. Learning disability was the commonest identified neuroimpairment with 36% of children functioning within the mental retardation range. Conclusions: The ILAE classification for seizures (ICES) was found satisfactory in the large majority of cases. However, since a considerable number of cases fell into the heterogeneous non-specific categories of the ICE, the value of present epilepsy/syndrome classification is limited in terms of prediction of prognosis, and indication for special investigations in individual cases. Although epilepsy appears to be a low prevalence condition it is more often associated with the burden of other neuroimpairments, particularly learning difficulties. This often has a considerable impact on children and their families. Health care service is but one of the network of services proposed to meet the needs of children with epilepsy. Children with epilepsy require optimal treatment with the minimal use of drugs, careful educational monitoring, realistic expectations from parents and teachers and close liaison between doctors, parents and schools. Key Words: Epilepsy - Epileptic syndromes - Prevalence - Classification - Children Description: M.SC. PUBLIC HEALTH 2000-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/41442 Title: Cheers! Drink to everyone's health : attitudes of young people towards alcohol consumption. Abstract: The objective of this study was to research alcohol consumption patterns in young people and their attitudes towards alcohol drinking. The results are· intended to help create "positive" messages promoting low risk drinking. Three research tools were used in this study, a questionnaire, a focus group and interviews. This methodology was based on the concept of triangulation. The questionnaire was completed by 347 University of Malta students, aged 18 to 22 years. The focus group was carried out with young people also within this age group. The interviews consisted of face-to-face interviews with 3 bartenders. The results showed that the participants of this study tended to consume alcohol frequently. Beer and spirits were the commonest alcoholic beverages. The rate of alcohol consumption, binge drinking, drunkenness and the perceived level of drunkenness were found to increase with age. Drink driving also appeared to be quite a common practice. Sixty nine point eight percent of the respondents thought that there was a drinking problem among young people in Malta. This study indicated that alcohol drinking and related problems might constitute a public health problem among university students. In developing preventive interventions, the drinking patterns and the social-psychological perspective of this practice should be taken into consideration. Description: M.SC. PUBLIC HEALTH 2000-01-01T00:00:00Z