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This study explored ethnic inequalities in dental caries among adults and assessed the role of socioeconomic position (SEP) in explaining those inequalities. We analysed data on 2013 adults aged 16-65 years, from the East London Oral Health Inequality (ELOHI) Study, which included a random sample of adults and children living in East London in 2009-10. Participants completed a questionnaire and were clinically examined for dental caries at home. Dental caries was measured using the number of decayed, missing and filled teeth or DMFT index. Ethnic inequalities in dental caries were assessed in negative binomial regression models before and after adjustment for demographic (sex and age groups) and SEP measures (education and socioeconomic classification). White Eastern European and White Other had higher DMFT, whereas all Asian (Pakistani, Indian, Bangladeshi and Other) and all Black (African, Caribbean and Other) ethnic groups had lower DMFT than White British. Similar inequalities were found for the number of filled and missing teeth, but there were no differences in the number of decayed teeth between ethnic groups. This study showed considerable disparities in dental caries between and within the major ethnic categories, which were independent of demographics and SEP. The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Schistosomiasis in returning travellers is one of the most common imported tropical infections with potentially serious complications, which are preventable if diagnosed early. A review was undertaken of consecutive cases of schistosomiasis presenting at the Hospital for Tropical Diseases, London, UK from 1997 to 2012. All 1020 schistosomiasis cases were from Africa and Schistosoma haematobium was the predominant species in those with microscopy confirmed schistosomiasis (74.2%, 204/252). The number of cases of imported schistosomiasis is decreasing steadily as a proportion of travellers seen. The majority of cases were in travellers originating from non-endemic settings (81.8%, 707/864). The most common symptom was of genitourinary complaints (22.6%, 230/1020), predominantly haematuria (17.8%, 181/1020); 36.1% (368) of cases were asymptomatic. Overall 42% had eosinophilia, and 62% of ova positive S. haematobium cases had haematuria on urine dip. Thus, no single screening tool was sufficient to identify or rule out schistosomiasis when used alone. Serology testing was a more sensitive tool in travellers than in other patients (p=0.007). The prevalence of schistosomiasis in presenting travellers is decreasing. The predominant presenting species has shifted from S. mansoni to S. haematobium. No single test can reliably diagnose schistosomiasis, with eosinophilia and urine dip having low sensitivity. Clinicians need to continue to undertake a wide spectrum of diagnostic tests to ensure cases of schistosomiasis are not missed. The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2ff7e9595c
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