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Biomedical subjects

A Degrémont

Publications and source records attributed to A Degrémont.

At least 19 recordsLinked to original sources
PubMed1991

Community-based questionnaires and health statistics as tools for the cost-efficient identification of communities at risk of urinary schistosomiasis.

Self-administered questionnaires, distributed by existing administrative channels to village party chairmen, head-teachers and schoolchildren, showed good diagnostic performance for the qualitative assessment of urinary schistosomiasis endemicity. At a cost 34 times below that of the WHO-recommended parasitological screening strategy, the schoolchildren's questionnaire allowed the screening of 75 out of 77 schools of a rural Tanzanian district in six weeks, and the exclusion of schools not at high risk for urinary schistosomiasis with over 90% confidence. The headteacher and party questionnaires made it possible to assess the perceived importance of a spectrum of diseases and symptoms, among which was schistosomiasis. The priority rank of schistosomiasis control was strongly correlated with the prevalence rate of the disease in the community. The questionnaires also looked for the prioritization of health among other community issues and thus contributed important information for planning at district level. Standardized monthly disease reports, sent by all primary health services, were also analysed. They allowed a zonal schistosomiasis endemicity classification.

Adolescent↗
PubMed1990

Hepatic capillariasis in a 1-year-old child.

We described the 2nd European case of hepatic capillariasis. The diagnosis of this parasitosis caused by Capillaria hepatica was made by needle biopsy of the liver in a 1-year-old girl who presented with a triad of persistent fever, hepatomegaly and hypereosinophilia. The child recovered completely after treatment with thiabendazole (Mintezol, Merck, Sharp and Dohme, Hoddeston, UK).

Animals↗
PubMed1990

[Imported diseases in Switzerland: development and perspectives].

During the last years, imported diseases have become more frequent in Switzerland. This is easily explained by the enormous increase of tourism to tropical and subtropical countries. Immigration from these countries has equally seen an important augmentation. The principal imported diseases are still malaria and gastrointestinal infections. Viral infections are rarely diagnosed, with the exception of hepatitis and HIV infection. The prevalence of sexually transmitted diseases is most certainly underestimated. The differential diagnosis of imported skin diseases is still difficult. Rare tropical diseases will probably become more frequent in the coming years as travellers leave more and more the traditional tourist paths. Practitioners have to look out for such problems, and continuous training programmes for them will have to take these new problems into account. Referral centres of infectious diseases should be established in all regions of Switzerland. High priority should be given to the prevention of imported diseases.

Communicable Diseases↗
PubMed1990

[Imported diseases: information, communication and continuing education].

With the increase of international travel and immigration, imported diseases have become more important in recent years in Switzerland. Diagnosis and therapy of imported diseases were simplified over the last years, whereby prophylaxis is still a complex problem, i.e. difficult to standardize. The article analyses information problems and presents what is done in Switzerland in this regard for each concerned group (travellers, practitioners and chemists, vaccination centers). Written information and courses for continuing education are generally available and adequate, but their impact is insufficient, perhaps because of the time constraints they impose. Electronic communication systems are not yet efficient due to their low access quota (spreading and standardization of the equipment), but the situation in regard to information as well as to continuing education will be better, as soon as these systems are accessible to the large public and well adapted, easy to use programmes will have been developed.

Communicable Disease Control↗
PubMed1987

Longitudinal study on the health status of children in Kikwawila village, Tanzania: study area and design.

The paper describes the study area and the project design of a longitudinal study on the health status of children undertaken in Kikwawila village in southeastern Tanzania from 1982 to 1984. This rural village is situated in the Kilombero river plain (270 m above sea level) and extends over 50 km2. A census in 1982 (repeated in 1984) revealed that 1152 (1406) people lived in 260 (299) households of the nucleated roadside settlements of the sectors Kikwawila and Kapolo. The vital statistics showed an infant mortality rate estimate of 198/1000 which was far above the regional (140%) and the national (137%) averages. Over 30 tribes were recorded but 6 tribes formed 84% of the population. The population was predominantly muslim (75%). Most adult inhabitants (90%) were subsistence farmers cultivating an average of 3.7 acres per household. Rice, maize and cassava were the main crops of the area. At the beginning of the study, the village had no village health post, dispensary or health centre and it lacked an adequate and safe water supply. A great proportion of the population (67%) had to rely on water from unprotected hand dug wells and from rivers for domestic purposes. Only half of the households had a simple pit latrine. Even when latrines were present, they collapsed after heavy rains due to loose, unconsolidated soils, termites and the high water table. These difficulties affected the sustained success of sanitation campaigns. The study area represented a typical settlement of the Kilombero valley and was, with regard to most demographic, ethnic, agricultural and health characteristics, considered a suitable pilot area. A primary health care programme based on village health workers was implemented in parallel with complementary community based studies on the causes, interrelations and control measures of the major health problems faced by the community, and possible control measures.

Age Factors↗
PubMed1987

Longitudinal study on the health status of children in a rural Tanzanian community: comparison of community-based clinical examinations, the diseases seen at village health posts and the perception of health problems by the population.

Standardised household interviews among adults and children, open-ended questionnaires, and clinical examinations administered during cross-sectional health status surveys, as well as the registers of village health posts (VHP), were used to assess the pattern of health problems of a rural community in southeastern Tanzania, and their results compared. All four approaches gave very similar results for the two major health problems (fever/malaria and abdominal pain or discomfort) which were mentioned by both children and adults. The parasitological data from the cross-sectional surveys also revealed hyperendemic P. falciparum malaria and a high prevalence and incidence for infections with hookworm (N. americanus), Strongyloides, and G. lamblia. However besides consistently revealing the two major health problems, each approach showed a distinct pattern for the additional health problems: household interviews and open-ended questionnaires resulted in a higher ranking of problems that had not yet been solved by the health care facilities available in the community at the time of the interview. This view was further biased by the fact that the interviews were done by people representing the health professionals. The statistics from the registers of VHP clearly reflected the types of treatment provided by this service. Malnutrition and various eye problems only became evident during the clinical examination of the population. However, the clinical examination did not identify the importance of the abdominal problems in the community. The cross-sectional survey (questionnaires, clinical examination) chiefly showed the health problems affecting the population around the time of the surveys (end of the dry season). Interestingly, the registers of the VHP did not show marked seasonal variations in the morbidity statistics for this community. Both questionnaire approaches and the registers of VHP showed a change in both the morbidity and the disease perception pattern that may reflect the effects of interventions launched at community level (activities of village health workers, mass-treatment against hookworm and G. lamblia). The study indicated that the individual ranking of the major health problems matched with data from health status surveys. It also pointed to the possibility that disease perception patterns could become a tool for community diagnosis and for the monitoring of health care programs.

Abdomen↗
PubMed1987

A longitudinal study on relations of retinol with parasitic infections and the immune response in children of Kikwawila village, Tanzania.

From 1982 to 1984 170 children of Kikwawila village (Kilombero district, Tanzania) were followed for nutritional (anthropometric measures, hematocrit, serum retinol, prealbumin, and zinc concentrations), parasitological (malaria parasitemia, urinary schistosomiasis, intestinal parasites) and immunological characteristics. Between 2.9% and 12.4% had serum retinol levels less than 100 micrograms/l which indicate deficiency. Retinol concentrations were correlated with age, hematocrits, prealbumin levels and mid upperarm circumferences. The latter correlation may be useful in nutritional surveys and primary health care programs for the identification of populations at risk of retinol deficiency. No association was found between average retinol levels and the presence of parasites, with the exception of malaria. Retinol levels were inversely correlated with malaria parasitemia in 1982, and directly correlated with antibody titers to synthetic sporozoite peptide in 1984. Since retinol, malaria parasitemia, and antisporozoite antibodies increased with age, confounding by age could not be excluded. Six months after administration of ornidazole in a single oral dose of 10 mg/kg, a significant effect on the prevalence of Giardia lamblia was found. Following treatment, average retinol levels were increased in persons with confirmed G. lamblia infections, but not in uninfected or untreated controls.

Adolescent↗
PubMed1986

Comparison of ultrasonography, intravenous pyelography and cystoscopy in detection of urinary tract lesions due to Schistosoma haematobium.

The use of ultrasound in detecting urinary tract alterations by Schistosoma haematobium such as hydronephrosis and bladder calcifications was studied in 125 patients of the out-patients department of a district hospital in SE Tanzania, in an area highly endemic for this disease. Ultrasound was compared with plain abdominal X-ray (in 33 patients), intravenous pyelography (29), cystoscopy (31) and simple urine examination (125). Except for bladder calcifications which could not be demonstrated other than by X-ray, sonography compared favorably with IVP and cystoscopy and proved therefore to be a valuable tool in assessing S.h. related morbidity. In children moderate and advanced hydronephrosis were always associated with an irregular bladder wall and correlated strongly with the prevalence and intensity of S.h. infections as well as with haematuria and proteinuria. Important congestive pathology was observed in 1 out of 10 infected children and in 1 out of 20 examined adults.

Adolescent↗
PubMed1986

Community participation within a primary health care programme.

Based on experiences made in rural communities of Tanzania, aspects of community participation in schistosomiasis control within a primary health care (PHC) programme are discussed. Community participation is seen as prerequisite for PHC. Building up community participation can not be disease- or even symptom-orientated, it must be community problem-orientated. The assessment of village priorities as they are recognized by the community governs any control strategy based on PHC. As schistosomiasis is often not first ranking among community problems, schistosomiasis control must become part of a multisectorial approach to improve community health. This process can initiate and ensure community participation and may lead to cost-effective control measures within PHC.

Adolescent↗
PubMed1986

Monitoring and evaluating schistosomiasis control within a primary health care programme.

Approaches for monitoring and evaluation of schistosomiasis control within primary health care (PHC) programmes are discussed on the basis of experiences in rural Tanzania. Feedback is regarded as an essential element of evaluation. It ensures community participation and strengthens the PHC approach. Monitoring, evaluation and feedback depend on the type of control strategy chosen. The strategy in turn is governed by the epidemiological factors and the politico-socioeconomic situation of the setting where schistosomiasis control is envisaged. Simple methods for monitoring control activities at community level exist and are being tested on a long-term basis. They relate to epidemiologically relevant parameters, such as prevalence, incidence and morbidity, and they can be handled by members of a community, particularly village health workers and/or staff of a dispensary. Most of the data collected by the community or its segments allow immediate feedback and form the basis for new or adopted strategies.

Animals↗
PubMed1983

Studies on the epidemiology of schistosomiasis in Liberia: the prevalence and intensity of schistosomal infections in Bong County and the bionomics of the snail intermediate hosts.

Urine samples from 3548 individuals residing in six of the eight districts which comprise Bong County, Liberia, the project area of the Bong County Agricultural Development Project (BCADP), and fecal specimens from 3408 of these individuals were examined for schistosome ova. A total of 164 water sites, including rice paddies, were surveyed for schistosome vector snails and monthly changes in snail population density and infection rate were determined in selected water sites. Bulinus globosus was more widely distributed than Biomphalaria pfeifferi but the latter species showed a higher infection prevalence (12.3%) than the former one (10.3%). Snail population density and infection rate fluctuated with season, being higher in the dry season and lower during periods of heavy rainfall. Dessication and/or heat stress may have contributed to the contraction of snail population size at the end of the dry season. More water sites contained infected snails during December through February than at any other time of the year. In selected water sites examined at monthly intervals, mean snail density was higher in rice paddies than in other water contact sites but the latter showed a higher prevalence of infected snails than the former. The overall prevalence of Schistosoma mansoni (24.8%) was significantly higher than that of S. haematobium (22.7%) but the difference in prevalence rates of two species in school children was not statistically significant. The intensity of S. haematobium infection (13.2 means G) was significantly higher than that of S. mansoni (6.3 means G). Mixed infections in school children did not have a significant effect on egg output. The prevalence and intensity of S. haematobium showed a dramatic decline between the age groups 0-15 and 20-50 + years old; the differences between these age groups in S. mansoni infection were unremarkable. In Zota, Jorquelle and Kokoya Districts, prevalence rates of S. haematobium were higher than those of S. mansoni; the reverse was observed in Suakoko and Panta-Kpai Districts but relative prevalence rates varied according to specific locality in each district. A south to north stratification of schistosomal infection prevalence was observed similar to the west to east gradient reported by Saladin et al. (1980). New rice paddies developed during the three year operational period of the BCADP contained little or no vector snails and schistosomal infections in farm families of these paddies reflected the characteristic of the disease in corresponding localities.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗