Search PubMed⌕ Search

Biomedical subjects

A Kroeger

Publications and source records attributed to A Kroeger.

At least 37 records · Page 2Linked to original sources
PubMed1995

Insecticide-impregnated bed nets for malaria control: varying experiences from Ecuador, Colombia, and Peru concerning acceptability and effectiveness.

Between 1991 and 1994, an intervention program with permethrin- and lambdacyhalothrin-impregnated bed nets was carried out over a period of nine months in each of five endemic, malarious areas of Ecuador, Peru, and Colombia. This program was evaluated through household surveys, blood sampling, in-depth longitudinal studies, and entomologic analysis. Eighty-four communities (including approximately 35,000 individuals) were paired according to malaria incidence, size, and coverage with bed nets and then randomly allocated to intervention and control groups. The results showed that peoples' acceptance of the measure was related to their perception of an immediate protective effect against insects. The effectiveness of the bed nets, measured as a reduction of malaria incidence in intervention communities as against control communities, showed large variations between and within the study areas. The protective efficacy varied between 0% and 70% when looking only at the postintervention differences between intervention and control groups. The average protection was 40.8% when considering a four-month incidence of clinical malaria attacks and 28.3% when considering a two-week malaria incidence. Important factors for the success of the bed net program were insect susceptibility to pyrethroids, high coverage with impregnated bed nets, high malaria incidence, good community participation, high mosquito densities when people go to bed, and a high proportion of Plasmodium falciparum. In one area, where DDT spraying in the control communities was executed, the effectiveness of bed net impregnation was slightly better than that of spraying.

Adolescent↗
PubMed1995

Community based dengue control in Columbia: people's knowledge and practice and the potential contribution of the biological larvicide Bti (Bacillus thuringiensis israelensis).

A study on dengue control was undertaken in a poor urban area in Cúcuta, Colombia. The first objective was to describe people's knowledge, attitudes and practices regarding dengue fever, the transmission of the disease and possible preventive measures. The second objective was to analyse the infestation of the community with Aedes aegypti larvae, and the third objective to test the efficacy of Bti (Bacillus thuringiensis israelensis) with respect to the level and duration of reduction of Ae. aegypti larvae in water tanks. It was found that people had a very fragmentary knowledge about dengue and about the necessary protective measures which did not lead them to any action. The infestation of water containers, particularly the larger tanks, was very high (house index = 61; Breteau index = 96). The application of Bti in water tanks led to satisfactory results: For one month and longer, the water tanks treated with Bti were free of mosquito larvae. The effect was reduced by a lower dose, washing the tanks and a less potent formulation. People's acceptance of Bti was higher than that of temephos. Further studies are necessary to confirm the utility of Bti in dengue control.

Aedes↗
PubMed1994

The socioeconomic impact of malaria in Colombia and Ecuador.

In-depth studies in three communities of Colombia and Ecuador, over a period of two to three months in each, were the basis of the economic analysis presented in this paper. In Santa Cruz, located at the rio Naya in Colombia, the average cost per case of malaria was US$17.30 (indirect costs US$15.80 and direct costs US$1.50); the loss corresponded to 20.1% of a minimum monthly wage (1986) or to a value of 5.6 days' work. In Perla de Sade, in the Cant6n Quininde of Ecuador, the average cost per case of malaria amounted to US$10.40 (indirect costs US$5.90 and direct costs US$4.50); the losses corresponded to 20.8% of a minimum monthly wage (1989) and to a value of 5.7 days' work. In Calder6n in the Cant6n of San Lorenzo in Ecuador, the average cost per case of malaria was US$4.80 (indirect costs US$3.50 and direct costs US$1.30); the losses corresponded to 16.0% of a minimum monthly wage (1991) with a value of 4.4 days' work. The results in these three communities, and in four additional ones, showed that the major economic impact of malaria is in the reduction of the labour force of families (indirect costs), and less so in the direct costs of care and cure. This emphasizes the economic importance of malaria because the rural familes with economies at subsistence level depend for survival particularly upon the maintenance of their labour force.

Adolescent↗
PubMed1994

[Community educational interventions against inappropriate drug use].

In the present study, which was carried out in peri-urban areas of Lima and Chimbote, Peru, and La Paz, Bolivia, the household survey method was used to investigate the manner in which drugs are used in treating the most common diseases in each locality. The objectives were to detect inappropriate practices, correct them through educational interventions, and determine the interventions' effectiveness. Simple random sampling was used to select the residences surveyed, which were then divided into study groups and control groups. A preliminary survey determined that the most frequent illnesses were the common cold, diarrhea, and dietary deficiency diseases and that their treatment often involved the inappropriate use of drugs. Educational interventions of varying duration were carried out, and subsequently a second survey was performed using the same instrument in order to determine the effectiveness of the interventions. Although there was an increased tendency not to treat the aforementioned diseases, the responses directly related to the use of drugs did not reveal any significant changes in behavior. Various factors were identified that influence the consumption of drugs.

Bolivia↗
PubMed1993

Prevalence of enteropathogenic and enterotoxigenic Escherichia coli in children with and without diarrhoea in Esteli, Nicaragua.

In Esteli, Las Segovias, Nicaragua, the frequency of isolations of enteropathogenic (EPEC), and enterotoxigenic E. coli (ETEC) was investigated in 100 children with (n = 50) and without diarrhoea (n = 50). EPEC was found to be significantly (p < 0.05) more frequent in diarrhoeal (16%) than in healthy children (4%). Detailed analyses revealed that 6 serotypes of E. coli were involved. Isolation of ETEC was not statistically significantly different (p > 0.05) in diarrhoeal (28%) and healthy children (16%). Determination of the susceptibility of isolated E. coli indicated a high level of resistance to common antimicrobial drugs. These resistant strains of E. coli might become a health problem in this part of Nicaragua.

Child, Preschool↗
PubMed1992

Sociomedical aspects of malaria control in Colombia.

A household interview survey combined with a serological survey on the incidence of malaria attacks and prevalence of antibodies has been carried out in rural and urban areas of the pacific coast of Colombia. Additional information on people's knowledge, attitudes and behaviour towards malaria was collected by means of participant observation and informal interviews. The results show that people incorporate modern and traditional elements into their concepts of the disease and treatment strategies. The deficiencies of the official control programmes are shown from the people's point of view. Some human factors which influence malaria transmission are discussed and an estimate of the accuracy of self-diagnosis presented.

Colombia↗
PubMed1992

Helminthiasis and cultural change in the Peruvian rainforest.

The objective of this study was to identify the impact of cultural and ecological change on intestinal helminth infections in traditional indigenous communities in the Peruvian rainforest and to identify the ways of transmission of helminth eggs. A remote indigenous settlement was compared with a more developed mestizo town. Stool specimens as well as soil, dust, air and water were examined for Ascaris and Trichuris eggs. A significantly lower infection intensity of Ascaris and Trichuris could be demonstrated for the traditional Indian community. Here the hygienic conditions were found to be better than in the town. The mestizo teacher and his family, who had come from the town to the Indian settlement, showed poorer hygienic standards and higher levels of Ascaris and Trichuris egg excretion than the Indian dwellers. The distribution of Ascaris and Trichuris eggs in the soil, house dust and in the air suggests that the contaminated dust from defaecation sites was distributed through the whole community by feet, animals (chickens) and wind. It was observed that many traditional habits that contributed to the good hygiene of the native population were being abandoned in the process of cultural change.

Animals↗
PubMed1992

Soil contamination with Ascaris lumbricoides eggs as an indicator of environmental hygiene in urban areas of north-east Brazil.

The objective of this study was to detect the pathways of transmission of Ascaris lumbricoides eggs in low-income households of two Brazilian cities. An inexpensive flotation technique for egg isolation was applied for the determination of soil contamination in 227 households. The median contamination levels were 0.8 (indoor), 0.3 (backyard) and 0.6 (defaecation site) eggs per gram soil. The contamination levels showed no significant correlation with the presence or quality of latrines or flush toilets. Houses with flush toilets were found to be sources of faecal contamination of the neighbourhood due to the absence of an adequate sewage system. Households with small children were more often contaminated than those without. The keeping of pigs was correlated with an increased yard contamination. The faecal egg excretion showed a significant correlation with the soil contamination in the backyard. Embryonated eggs, which represent the 'older' eggs, constituted 37% of all eggs. In the dry season significantly fewer Ascaris eggs were found in the soil than during the rainy season. The usefulness of the soil contamination with Ascaris lumbricoides eggs as an indicator of the efficacy of hygiene programmes is discussed.

Animals↗
PubMed1991

[Popular conceptions regarding cutaneous leishmaniasis in Colombia and their applicability in control programs].

A study was carried out to obtain information on prevailing popular ideas and attitudes about cutaneous leishmaniasis and its treatment in an isolated endemic area on the Colombian Pacific Coast. Interviews were conducted with a representative sample of individuals from the community and with health agents. The formal survey covered 736 households, 332 of them in a rural area (where leishmaniasis is endemic) and 404 in the city of Buenaventura (where there is no transmission of the disease.) The results showed that cutaneous leishmaniasis is well known in the rural area. The people have names for it (ya-te-vi or bejuco), have an understanding of its etiology (although their interpretation differs from that accepted by the scientific community), and have developed methods for preventing and treating it. The popular understanding of the disease results in behavior directed toward its prophylaxis and treatment that shares many characteristics with Western medicinal practices. The traditional treatments should be taken into account in the application of measures to control the disease in that area.

Adolescent↗
PubMed1983

[Drug-resistant malaria in East Africa].

Two tourists from Kenya with falciparum malaria had an R1-resistance against chloroquine (WHO-extended field test, no in-vitro test). In addition, one of them was resistant against pyrimethamine-sulfadoxine (Fansidar), however sensitive against quinine and mefloquine. In a third tourist, from Tanzania, a diagnosis of chloroquine-resistance had been made too early and drug medication had been changed. These observations document the necessity of early species diagnosis. It is recommended to consider also in patients from East Africa the possibility of multiple resistances of falciparum malaria and to change medication if required.

Adult↗
PubMed1983

Health interview surveys in developing countries: a review of the methods and results.

Health interview surveys are carried out to gain knowledge of people's perceived morbidity, their use of different kinds of health services, and their perceived need for health care. Many of such studies in less developed countries (LDCs) have failed to consider the methodological improvements which have been developed in health care research in recent years. In the first part of this paper the research on methodological issues is summarized and the inherent problems in health interview surveys are stressed. Some specific requirements for cross-cultural research are described. The second part deals with health interview surveys carried out on a national, provincial and local level in LDCs. Recommendations for a standardization of the methodology are given.

Communication↗
PubMed1982

Participatory evaluation of primary health care programmes: an experience with four Indian populations in Ecuador.

A seminar with primary health care workers from four Indian groups in Ecuador serves as an example for the participatory evaluation of primary health care (PHC) programmes. Discussions in small groups, interpretation of visual aids, derived from research data on health care utilization, and practical evaluation exercises helped participants understand the opportunities and limitations which exist in the PHC schemes. The main topics of discussion were: health impacts of sociocultural change, community support of health workers, links with the hierarchy of the health care system, differential use of traditional and modern medicine and planning of future programmes. The final discussion with health officials was important for the mutual respect and understanding. The need for the involvement of communities and PHC workers in the evaluation of their own programmes is stressed.

Ecuador↗