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Biomedical subjects

A T Westwood

Publications and source records attributed to A T Westwood.

14 recordsLinked to original sources
PubMed2000

Bacterial infection in children with HIV: a prospective study from Cape Town, South Africa.

Invasive bacterial infection in children infected with the human immunodeficiency virus (HIV) is common. South African data on this problem are limited. Over 1 year we prospectively studied 108 HIV-infected children hospitalized for 136 presumed infective episodes. Blood culture was positive in 24.8% of episodes. Streptococcus pneumoniae predominated (14/30 positive blood cultures); one-third of isolates showed resistance to penicillin. Acute lower respiratory tract infection accounted for 44% of clinical diagnoses, a bacterial cause being established for 23.8% of these. Age and stage of HIV infection did not influence the likelihood of a positive culture. A high proportion of presumed infective episodes requiring hospitalization of young HIV-infected children have a bacterial cause. Blood culture appears to be a useful method of obtaining the microbiological information required to focus antibiotic therapy.

AIDS-Related Opportunistic Infections↗
PubMed2000

Children with cystic fibrosis in South Africa: an improving nutritional picture.

Nutritional status and growth play an important part in determining the prognosis in cystic fibrosis (CF). In South Africa, the median survival of patients with CF is 18 years. Using chart review, we studied the pattern of growth over time of a South African CF population. The percentages of expected weight-for-age, height-for-age and weight-for-height were determined for each patient in 1986 (n = 49) and 1996 (n = 63). Mean indices were the same in the two years. In 1996, mean weight-for-age of children aged 5-10 years was 94.2 per cent (SD 20.4), 14.3 per cent higher (p < 0.05, 95 per cent confidence intervals 3-25 per cent) than children of the same age in 1986. Improved growth of young children with CF has been achieved in a resource-poor country setting the scene for improved prognosis.

Adolescent↗
PubMed1999

Growth and nutrition in South African children with cystic fibrosis.

OBJECTIVES: To study nutritional status and its dietary correlates in a South African cystic fibrosis (CF) population. DESIGN: Cross-sectional survey. POPULATION: Thirty-eight children and adolescents attending the CF clinic at Red Cross War Memorial Children's Hospital, Cape Town. METHODS: Standard anthropometry and a 3-day weighted food record. RESULTS: Median percentage expected weight for height (WFH) was 93 (interquartile range 84-101). Sixteen per cent of patients were below the 5th percentile for height. The proportion of patients who were malnourished (WFH less than 90) was greater among those over 10 years of age (47% v. 14.3%, chi 2 = 4.33, P = 0.037). Sixty-eight per cent of patients consumed less than the recommended daily intake of energy. There was no correlation between WFH and energy intake. Fat intake represented 29.6% (interquartile range 27.5-33%) of daily energy intake. CONCLUSIONS: Young South African children with CF are growing well despite relatively low intakes of energy and fat. Greater attention needs to be given to overcoming malnutrition among older children.

Adolescent↗
PubMed1998

Lung function in South African children with cystic fibrosis.

OBJECTIVE: To determine the pattern of lung function in stable cystic fibrosis (CF) patients and to investigate the relationship of abnormal lung function to demographic variables, CF genotype and pulmonary colonisation with Pseudomonas aeruginosa (PA). DESIGN: A descriptive study done at the CF clinic at Red Cross War Memorial Children's Hospital in Cape Town. METHODS: Data were recorded and pulmonary function testing (PFT) was performed in 42 CF patients. RESULTS: 29 patients (69%) had mild disease, while 11 (26%) and 2 (5%) had moderate and severe disease respectively. Twenty-four patients (57%) demonstrated lower airway obstruction (LAO). Patients with moderate or severe disease were significantly older than those with mild disease (13.3 (3.7) years (mean (SD)) compared with 11.1 (3.0) years (t = 2.1; P = 0.04). PA colonisation status differed significantly with the pattern of lung function (chi 2 = 6.6; P = 0.04) and severity of lung disease (chi 2 = 12.6; P = 0.002). Nine (35%) of the 26 patients tested before and after bronchodilator therapy showed a positive response. CONCLUSION: The majority of patients had mildly impaired or normal lung function, with LAO predominating. A minority of patients were bronchodilator-responsive. PA colonisation may be associated with the development of abnormal lung function and more severe pulmonary disease.

Adolescent↗
PubMed1997

Surgery in cystic fibrosis--a 20-year review.

The surgical histories of 111 patients with cystic fibrosis (CF) seen between 1972 and 1991 were examined. Fifty-seven of these children underwent 154 operations; in 34 the surgery was directly related to CF and accounted for 84 operations. Meconium ileus and its complications were responsible for 26 of the 32 major abdominal CF-related procedures and there were 3 major CF-related thoracic operations. Only 1 child died within a month of operation. Complications occurred in 11.9% of general anaesthetics and post-operative complications in 9.2% of operations. Patients with CF are likely to need operative intervention and, when indicated, surgery should have a low morbidity and mortality.

Child↗
PubMed1996

The prognosis of cystic fibrosis in the Western Cape region of South Africa.

OBJECTIVE: To study the prognosis of cystic fibrosis (CF) in South Africa. METHODOLOGY: Retrospective chart review of 102 children with CF over 20 years. RESULTS: Survival at 18 years was 54% (95% confidence intervals 30-79). Prognosis was not influenced by gender or genotype but survival was noted to be worse for Cape Coloured children than for European children. This appeared mainly to be due to the death of eight Cape Coloured Infants, four of whom presented with oedema and anaemia, mimicking kwashiorkor. Infection with Pseudomonas aeruginosa occurred earlier in Cape Coloured children than European children (median, 1 vs 4 years) and they had a worse 5-year survival (58 vs 89%, P < 0.05) after infection. Of the 40 children born in the second decade studied, six Coloured and no European children died. CONCLUSIONS: Ethnic differences in prognosis exist for children with CF in South Africa and are probably related to underrecognition of CF and the socio-economic status of some patients.

Adolescent↗
PubMed1996

First report of CFTR mutations in black cystic fibrosis patients of southern African origin.

Cystic fibrosis (CF) is thought to be rare in the black populations of Africa who have minimal white admixture. Only a few cases have been reported but have not been studied at the molecular level. We report the detection of CFTR mutations in three southern African black patients. One was homozygous for the 3120 + 1G-->A mutation, while the other two were compound heterozygotes each with this mutation on one chromosome. The other mutations were G1249E and a previously unreported in frame 54 bp deletion within exon 17a involving nucleotides 3196-3249 (3196del54). The 3120 + 1G-->A mutation was first described in American black patients and has been shown to be a common mutation in this population (9-14% of CF chromosomes). It was also found in a black CF patient whose father, the 3120 + 1G-->A carrier, is from Cameroon. These data suggest that it is an old mutation which accounts for many of the CFTR mutations in African blacks.

Adult↗