Synopsis for November 25, 2005

The MMWR is embargoed until Wednesday, 12 PM EST.

1. Screening HIV-Infected Persons for Tuberculosis – Cambodia, January 2004-February 2005
2. Prevalence of Mobility Limitations Among Persons Aged Greater Than 40 Years With and Without Diagnosed Diabetes and Lower Extremity Disease – United States, 1999-2002
3. Dental Visits Among Dentate Adults with Diabetes – United States, 1999 and 2004
4. Conclusions and Recommendations of the Advisory Committee on Polio Eradication – Geneva, Switzerland, October 2005

Screening HIV-Infected Persons for Tuberculosis – Cambodia, January 2004-February 2005

According to data released today by CDC, simple, locally designed interventions can significantly increase tuberculosis (TB) screening in HIV-positive people, which is critical since TB is the most common cause of death for HIV-infected individuals worldwide.

Assessing data from a joint pilot project to enhance TB screening in HIV-positive individuals, the Cambodia Ministry of Health, CDC and USAID found that many HIV-positive patients, such as children, semi-skilled or skilled workers, and those who did not report feeling ill when they presented to the clinic were not often being screened for TB, although TB was common among these groups. Efforts to incorporate information about TB into HIV counseling, along with enhanced provider and patient education, increased TB screening of HIV positive individuals from 37 percent to 61 percent. HIV and tuberculosis are diseases that continue to plague not only Cambodia, but the world. Researchers note that it is essential to remember the importance of screening for and treating TB in HIV-infected individuals worldwide.

Prevalence of Mobility Limitations Among Persons Aged Greater Than 40 Years With and Without Diagnosed Diabetes and Lower Extremity Disease – United States, 1999-2002

Adults with diabetes and lower extremity disease are significantly more likely to report mobility limitations than those without these conditions.

As the U.S. population ages and the prevalence of diabetes increases, lower extremity disease (LED) and its health consequences such as chronic ulcers of the foot/leg, amputations and mobility limitations will become an increasing public health concern. In this MMWR, we analyzed data from National Health and Nutrition Examination Survey (NHANES) 1999—2002 for adults aged greater than 40 years. The results clearly showed that, in this nationally representative sample, adults who had diagnosed diabetes or LED were more likely to report mobility limitation than those without these conditions. Adults with both diagnosed diabetes and LED had an even higher prevalence of mobility limitation. The prevalence of mobility limitation among them was almost 3 times greater than those with neither condition (39 percent and 14 percent, respectively).

Dental Visits Among Dentate Adults with Diabetes –
United States, 1999 and 2004

Efforts are needed to encourage people with diabetes to have an annual dental examination. This is important because people with diabetes are at high-risk for periodontal (severe gum) disease. Regular dental visits provide an opportunity for prevention, early detection, and treatment of periodontal disease. Although states are making progress, disparities were found by race, income level, education level, health insurance status, smoking history, and whether the person had ever taken a diabetes management class.

This BRFSS analysis shows that states are making progress in getting closer to the Healthy People 2010 objective of having 71 percent of people with diabetes have a dental visit each year. Seven states have reached this national objective, and four states plus the District of Columbia made significant gains since 1999. According to this analysis, in 2004, 65 percent of people who have diabetes had a dental visit during the preceding year.

Conclusions and Recommendations of the Advisory Committee on Polio Eradication – Geneva, Switzerland, October 2005

Maintenance of a high index of suspicion for CRS in infants with compatible clinical signs, along with rubella vaccination of susceptible persons, will prevent the transmission of rubella.

Rubella was declared to be no longer endemic in the United States by an independent panel convened by the CDC in 2004. This article describes a public health investigation around an imported case of congenital rubella syndrome (CRS) in an infant born in New Hampshire to refugee parents. Rubella remains endemic in other parts of the world. Therefore, CRS should be considered in infants with compatible clinical signs, particularly in those born to mothers who resided in countries without rubella elimination programs or with recently implemented programs. Since rubella virus can be shed by an infant with CRS up to one year after birth, prompt diagnosis of CRS, along with rubella vaccination of susceptible persons, will prevent the transmission of rubella.

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