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Biomedical subjects

A Hall

Publications and source records attributed to A Hall.

At least 469 records · Page 26Linked to original sources

Admissions to a provincial psychiatric hospital: the effects of opening a second in-patient facility.

Until 1955, the Saskatchewan Hospital, North Battleford, was the only facility designated for in-patient psychiatric treatment of the northern half of Saskatchewan's population. In that year the University Hospital's 39-bed psychiatric unit was opened in Saskatoon, but the number of Saskatoon patients referred to North Battleford have continued to increase.A statistical study of changes in the annual admission rates (patients/1000 population) to the Saskatchewan Hospital shows that the opening of the University Hospital unit has reduced the rate of intake of Saskatoon residents to the Saskatchewan Hospital. This decrease is related to specific diagnostic groups. There have also been changes in methods of referral.

Adolescent↗

Patients' views of routine hospital follow-up: a qualitative study of women with breast cancer in remission.

OBJECTIVE: To investigate the experience of specialist hospital follow-up among 109 women with breast cancer in remission. METHODS: Qualitative interviews explored views of follow-up at an outpatient clinic. RESULTS: Continuity of care and an unrushed consultation were considered to be both desirable and efficient. There were concerns that discontinuity led to a lack of personal and case familiarity and communication difficulties. Access to cancer expertise, the availability of diagnostic tests and specialist facilities were valued features of hospital follow-up, and further analysis indicated that this was particularly important in the early stages of follow-up. DISCUSSION: A preference for continuity of care may suggest that GP follow-up would be preferred, but access to specialist services is valued and may be of particular importance during the early stages of follow-up. The diversity of patients' needs during follow-up must be recognised when formulating policy.

Adult↗

Diagnosis of Giardia duodenalis infection in Bangladeshi infants: faecal antigen capture ELISA.

An enzyme-linked immunosorbent assay (ELISA) to detect antigens of Giardia duodenalis in faeces was evaluated as a diagnostic tool by testing faecal samples collected during a cohort study of 229 infants living in an urban slum in Dhaka, Bangladesh. Faecal samples had been collected at enrollment, on a routine monthly basis, and repeatedly during episodes of diarrhoea and infection with Giardia, and a portion of all samples was frozen in saline. A direct smear of all had been examined by microscopy and again after concentrating cysts by ether sedimentation. A total of 2121 of the 4936 samples stored during the 22 months study were tested by the ELISA. After excluding non-specific binding, the sensitivity of the assay was 94.2% and the specificity was 98%. The presence of other parasites, including flagellated protozoa, was not linked to false positive ELISA results. There was a correlation between the number of Giardia cysts present and the ELISA optical density. Assuming that the ELISA is 100% sensitive, microscopy detected 92.4% of the infections detected by the ELISA.

Animals↗

Albendazole as a treatment for infections with Giardia duodenalis in children in Bangladesh.

Albendazole, a broad spectrum anthelmintic recently shown to be active in vitro against Giardia duodenalis, was given at 4 different dosages and compared with metronidazole in the treatment of children in Bangladesh infected with Giardia. Three stools were collected over 10 d after treatment and examined microscopically. Albendazole was found to be effective: single doses of either 600 mg (n = 103) or 800 mg (n = 114) successfully treated 62% and 75% of infections, respectively; 400 mg given either once a day for 3 d (n = 116) or for 5 d (n = 115) successfully treated 81% and 95% of all infections, respectively. Albendazole given daily at 400 mg for 5 d was as effective as metronidazole, which cured 97% of infections (n = 230). Albendazole may thus be an alternative treatment for infections with Giardia, while the moderate efficacy of single doses may provide a benefit in addition to its effects on several species of intestinal helminths.

Albendazole↗

Strongyloides stercoralis in an urban slum community in Bangladesh: factors independently associated with infection.

Stool samples from 880 residents in an urban slum in Dhaka, Bangladesh, were collected on 3 occasions over one year, and examined for intestinal parasites. Information on many potential risk factors for infection was obtained by questionnaire from a respondent in each household studied. In a crude univariate analysis of the data, several of the factors were found to be significantly associated with Strongyloides stercoralis infection. Most of these factors were co-variate with one another, and with poverty generally. Using Mantel-Haenszel chi 2 tests to control for confounding effects of each variable individually, the following 4 factors remained independently associated with S. stercoralis infection: respondent's use of a community latrine rather than a private latrine, living in a house with an earth floor rather than a cement floor, being of Bihari ethnicity, and being 7-10 years of age. Implications of these results for the epidemiology and control of strongyloidiasis are briefly discussed.

Adolescent↗

A randomized controlled trial comparing mebendazole and albendazole against Ascaris, Trichuris and hookworm infections.

The efficacies and side effects of single dose treatments with 500 mg mebendazole (Janssen Pharmaceutica) and 400 mg albendazole (SmithKline Beecham) against intestinal nematodes were compared in a single-blind, randomized controlled trial among 2294 children aged 6 to 12 years on Pemba Island, Zanzibar, among whom infections with Ascaris, hookworms and Trichuris were highly prevalent. Both drugs were highly effective against Ascaris, with cure rates of over 97%. The cure rates for Trichuris were low, but mebendazole was significantly better than albendazole and produced a greater reduction in the geometric mean egg count. Mebendazole was inferior to albendazole in curing hookworm infections and in reducing the geometric mean egg count. There was no difference in the frequency of side effects reported by heavily infected children treated with either drug. In a trial on 402 children, 500 mg mebendazole (Janssen) was compared with a generic version of the drug, 500 mg mebendazole (Pharmamed). No difference was apparent in the efficacies of the 2 treatments against any of the 3 parasites studied.

Albendazole↗

Enzyme polymorphisms in Ascaris lumbricoides in Bangladesh.

Fourteen enzymes of Ascaris lumbricoides were analysed electrophoretically on cellulose acetate plates; 8 stained well and 3 were found to be polymorphic. Allelic and genotypic frequencies at the 3 polymorphic enzyme loci, Mpi, Pgi and 6-Pgd, were determined in a sample of 117 worms from 8 children living in different houses in an urban slum in Bangladesh. Allele frequencies in samples of parasites from the different children were compared to test for the possibility of non-random distribution of parasite genotypes between people. No strong evidence of differences was found. Diploid genotype frequencies did not deviate significantly from those expected from the Hardy-Weinberg equilibrium. Significant linkage disequilibrium was observed in one of 3 pairs of enzyme loci tested, which might suggest that some genetic subdivision exists in the local A. lumbricoides population, although no strong interference should be made from this single result. Overall, the results suggest that the worms sampled formed part of a single population which appears to be randomly mating.

Alleles↗

Albendazole and infections with Ascaris lumbricoides and Trichuris trichiura in children in Bangladesh.

Two hundred and forty-five children infected with Trichuris trichiura, 143 of whom were also infected with Ascaris lumbricoides, were treated with albendazole as follows: single doses of either 600 mg or 800 mg, or daily doses of 400 mg for either 3 d or 5 d. Three stools were examined over a period of 10 d after treatment and again after nearly 40 d, using a quantitative microscopical technique. Albendazole appeared to act slowly against A. lumbricoides but within 10 d all dosages had cured about 92% of infections. In contrast, albendazole appeared initially to inhibit egg production by T. trichiura, which was then resumed. The single doses gave poor cure and egg reduction rates for T. trichiura of less than 30% each, and 400 mg of albendazole for 3 d was required to achieve a cure rate of 80%. The implications of these results are briefly discussed.

Albendazole↗

Rate of reinfection with intestinal nematodes after treatment of children with mebendazole or albendazole in a highly endemic area.

The comparative efficacy of albendazole and mebendazole in the treatment of intestinal nematode infections were compared 3 weeks after treatment in a randomized trial among schoolchildren on Pemba Island, Tanzania. Egg counts were compared 3 weeks, 4 months and 6 months after treatment of 731 children seen on each occasion. Differences in the efficacies were apparent with some nematodes 21 d after treatment, but these were no longer apparent 4 months after treatment, and by 6 months intensities of infection were similar to pre-treatment levels. These findings suggest that treatment of schoolchildren every 4 months may be necessary in this highly endemic area in order to have an impact on the intensity of intestinal nematode infections sufficient to be likely to reduce morbidity.

Albendazole↗

Household aggregation of Strongyloides stercoralis infection in Bangladesh.

Strongyloides stercoralis infections were shown to be aggregated in households in an urban slum community in Dhaka, Bangladesh. Parasitological data on 880 residents living in 280 households were analysed statistically using 3 different tests, each of which yielded significant evidence of household aggregation of S. stercoralis infection. One test was applied to the data after stratification for 4 variables were previously shown to be independently associated with infection. Evidence of household aggregation of infection remained after stratification, suggesting that aggregation is due not only to shared risk factors, but also to either familial genetic predisposition to infection or close contact person to person transmission of infection within households.

Adolescent↗

Measles, polio and tetanus toxoid antibody levels in Gambian children aged 3 to 4 years following routine vaccination.

A nation-wide cross-sectional survey of 816 children 3-4 years old was carried out in The Gambia between September 1990 and July 1991 to assess the seroprevalence of antibodies against 3 diseases included in the expanded programme on immunization: measles, poliomyelitis and tetanus. Among 689 children whose records were available, 94.5% were fully immunized. Measles vaccine was administered to 97% of the children and 91% of these had detectable antibodies at the time of the survey. Antibodies against type 1 and type 3 polioviruses, after up to 6 doses of oral polio vaccine, were present in 88.1% and 89.3% of the children respectively. Ninety-seven percent of the children who had received 4 doses of diphtheria-pertussis-tetanus vaccine (DPT) and 91% of those who received 3 doses had detectable tetanus toxoid antibodies at the age of 3-4 years. This study shows that serological responses to EPI vaccines given in infancy persist at very satisfactory levels throughout early childhood.

Administration, Oral↗

Selective approaches to basic neurobehavioral testing of children in environmental health studies.

To identify neurotoxic effects in children living near hazardous waste sites, the Agency for Toxic Substances and Disease Registry (ATSDR) has designed a basic Pediatric Environmental Neurobehavioral Test Battery (PENTB) for children 1 through 16 years of age. It emphasizes tests appropriate to the stages of a child's development. These stages were fundamental factors in selecting tests for the PENTB, which includes both informant- and performance-based assessment procedures. Assessment of children under 4 years of age is restricted to four informant-based instruments, to evaluate as many functions as possible while minimizing testing time and the professional expertise needed in the test setting. The assessment of children 4 through 16 years of age includes 10 performance-based tests to evaluate key functions within the cognitive, motor, and sensory domains analogous to functions affected by neurotoxic chemicals in adults. In all age groups, it is crucial to also assess family, cultural, economic, and other potentially confounding variables.

Child↗

Predicting the impact of school-based treatment for urinary schistosomiasis given by the Ghana Partnership for Child Development.

Mathematical models can be used to predict the impact of interventions to control infectious diseases. In this paper, an epidemiological model is used to predict the impact of chemotherapy of school-age children infected with Schistosoma haematobium, in a programme conducted by the Ghana Partnership for Child Development in the Volta Region, Ghana. Existing data were used to validate the predictions of the model, demonstrating convincingly the ability of the model to make correct predictions. Predictions of trends in mean egg count, infection prevalence and prevalence of heavy infection (> 50 eggs/10 mL urine) were then made for the period 1997-1999, and will be compared to the data collected in the programme in the future.

Adolescent↗

Alternatives to bodyweight for estimating the dose of praziquantel needed to treat schistosomiasis.

Data on age, height and mid upper-arm circumference (MUAC) from nearly 6000 schoolchildren in Ghana, Tanzania and Malawi (not MUAC) were used to examine their power to predict bodyweight and thus the dosage of praziquantel required to treat schistosomiasis. Height was found to provide a simple and reasonably accurate estimate of weight, and about 75% of children would have been given a dosage of praziquantel within the range normally given using bodyweight at a dosage of 40 mg/kg bodyweight. The upper and lower ranges in dosage did not exceed dosages of praziquantel which have been used before or are currently recommended to treat schistosomiasis. A pole marked with the number of tablets could thus be used as a simple way to determine the dose of praziquantel to treat children in school-based health programmes.

Adolescent↗

The distribution of Ascaris lumbricoides in human hosts: a study of 1765 people in Bangladesh.

The Ascaris lumbricoides expelled by 1765 people in a poor urban community in Bangladesh were recovered and counted after the subjects had been treated with pyrantel pamoate. The subjects were divided into 22 classes by age and sex (mean n = 80) to examine how prevalence, mean worm burdens and measures of aggregation of worms varied with age and between the sexes, and to see how a measure of aggregation, k, calculated in 3 ways (by maximum likelihood, from moments, or from the percentage uninfected) compared with an empirical aggregation index (the percentage of subjects who expelled an arbitrary 80% of all worms) and with the proportion who were moderately to heavily infected (defined as > or = 15 worms). The prevalence of infection ranged from 64% to 95%, mean worm burdens ranged from 7 to 23 worms, and k ranged from 0.3 to 1.2. There were significant differences between adult males and females in the prevalence of infection, mean worm burdens and measures of aggregation, differences which are probably driven more by behaviour than immunity. The parameter k was better described in terms of the proportion who were moderately to heavily infected (linear; range 0.15-0.58) than by the empirical aggregation index (non-linear; range 0.30-0.49).

Adolescent↗