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Biomedical subjects

D Yach

Publications and source records attributed to D Yach.

At least 127 records · Page 7Linked to original sources
PubMed1988

Crowding and alcohol abuse as risk factors for tuberculosis in the Mamre population. Results of a case-control study.

As part of a community health programme, a population-based case-control study was undertaken to determine whether crowding and alcohol are risk factors for tuberculosis in Mamre. Forty notified cases of tuberculosis were compared with 84 randomly selected controls. Cases and controls were group-matched for age and sex. Seventy-six per cent of dwellings had a housing density ratio greater than 100%. There was no association between crowding and tuberculosis, but cases lived in houses that were significantly older than those of controls (odds ratio, 4,8, 95% confidence interval 1,5-15,6). There was an association between alcohol problems in the household and tuberculosis (odds ratio adjusted for employment status 2,2, 95% confidence interval 1,3-3,8). Further studies using refined methods are needed to evaluate the role of crowding in tuberculosis. The need for alcohol intervention campaigns in conjunction with tuberculosis control programmes directed at high-risk groups should be considered.

Adolescent↗
PubMed1988

Mortality in Mamre, 1981-1987.

Mortality statistics for Mamre were extracted from the Regional Services Council records for 1981-1987. The standardised mortality ratios were 0,70 for males and 0,55 for females. The age-specific mortality rates, including the infant mortality rate (23.6/1,000 live births), were lower than the national rates for coloureds. Non-natural causes of death were well above the national level. The high proportion of non-natural deaths is reflected in potential years of life lost (PYLL) for this cause--58% among males and 43% among females. Diseases of the circulatory system accounted for 19% and 17% of PYLL, and carcinomas for 7% and 14%.

Black or African American↗
PubMed1988

An introduction to clinical epidemiology.

Clinical epidemiology is defined and its influence on methods of diagnosing and treating patients assessed. A plea is made for the wider application of such methods.

Clinical Competence↗
PubMed1988

Smoking and health in South Africa.

In 1984 smoking rates among adults in South Africa were highest in coloureds (41.1%), followed by whites (34.9%), Asians (29.0%), and blacks (27.7%). With increased urbanisation, income, and education, black and coloured smoking rates are likely to rise. Current trends suggest that the proportion of smoking-related disease mortality and morbidity among coloureds and blacks will increase. Studies in South Africa and elsewhere have shown that smokers run an increased risk of coronary artery disease, lung, oesophageal, and cervical cancer, respiratory disease, gastrointestinal ulcers, and leukoedema. Non-smokers exposed to 'involuntary smoking' are also at risk, and smokeless tobacco is not a safe alternative to smoking. The evidence for smoking-induced health damage is so compelling that action against smoking is urgently needed. Surveys of smoking habits among specific groups show the importance of peer and role model example, and suggest guidelines for the targeting of health education.

Adolescent↗
PubMed1988

Deaths related to smoking in South Africa in 1984 and projected deaths among coloureds and blacks in the year 2000.

Using a World Health Organization/International Agency for Research on Cancer classification of causes of death, we found that 34.5% of deaths among whites were attributable to smoking-related causes in 1984. The comparable figures for Asians, coloureds and blacks were 24.5%, 14.5% and 3.9% respectively. Age- and sex-specific death rates in 1984 for 35- to 64-year-olds among coloureds were greater than those among whites. Taking into account the expected ageing of the black population and the increased use of tobacco by blacks, smoking-related deaths are expected to increase by between 140 and 1,200% by the year 2000. Smoking-related diseases by 2000 will make a severe impact on the delivery of health services.

Adult↗
PubMed1988

Anti-smoking legislation--an international perspective applied to South Africa.

Legislation is an essential component of any effective anti-smoking programme, and is being used increasingly in many countries. Legislative measures may control or ban tobacco advertising, require that cigarette packets carry a health warning and contents statement, limit the tar and nicotine content of cigarettes, restrict sales, impose taxes on tobacco products, restrict smoking in public places and workplaces, make health education mandatory or provide for the establishment of a national anti-smoking agency. A major objective is to establish non-smoking as the norm. We recommend that the government of South Africa introduces a comprehensive anti-smoking programme that will include the following steps: (i) putting extra taxes on cigarettes to fund health education, (ii) prohibiting the sale of cigarettes to minors, (iii) making health warnings and contents labelling on both cigarette packets and advertisements prominent, and (iv) encouraging public and private sector involvement in protecting non-smokers' rights and helping smokers to stop smoking.

Health Education↗
PubMed1988

Infant mortality rates in urban areas of South Africa, 1981-1985.

National infant mortality rates (IMRs) for South Africa are at present based on guestimates. There is no reliable national black IMR estimate. A study was undertaken to determine the IMR for 10 large urban areas (where records are available) for 1981-1985 and to use these to estimate a national black IMR. Considerable variability in the IMR was found for blacks both between cities and years. An overall national IMR estimate for blacks of between 94 and 124 deaths per thousand live births was obtained. This is about twice as high as the national figure of 51.9 for coloureds. The coloured non-urban rate was 2.6 times the urban rate of 25.9 while the Asian and white rates were similar in urban and non-urban areas (17.9 and 12.3 respectively).

Black or African American↗
PubMed1988

Tuberculosis patient compliance in the western Cape, 1984.

Patient non-compliance is regarded as a major cause of treatment failure in tuberculosis. In view of the rising tuberculosis incidence rate in the western Cape it was decided to determine which factors were related to treatment compliance. Information about patients on treatment for tuberculosis was obtained from 75% of the 68 local authorities surveyed (representing 90% of the surveyed population). Patients who had received greater than or equal to 75% of their expected doses by the survey date were considered compliant. Overall compliance was 82.5%. The lowest rates were reported in teenagers, children under 5 years, blacks and unemployed patients. The results have implications for tuberculosis control strategies.

Adolescent↗
PubMed1988

Western Cape local authority compliance with tuberculosis policy, 1984.

Local authority compliance with the national tuberculosis regimen in 1984 was examined in 29 of the 32 largest local authorities in the western Cape. The variability in management practices was especially evident with respect to children. The effects of the relative lack of uniformity and deviations from recommended policy need to be determined.

Child↗
PubMed1988

Tuberculosis in the Western Cape health region of South Africa.

Tuberculosis (TB) is a major health problem in the Western Cape health region of South Africa. The incidence rate (based on notifications) is rising (particularly in coloureds) and the annual risk of infection is static in the highest risk group. Risk factors for infection, particularly as a result of overcrowding, and the number of infectious cases in the community are leading to an increase in the infectious pool. Potential risk factors for TB disease such as poor nutritional status, alcoholism, and unemployment are being exacerbated by the current political instability in the country. Poor patient compliance and several health service impediments have resulted in a large number of patients not being held on treatment until cure. There is a need to recognise that non-medical interventions are the key to a future successful TB control programme.

Black People↗
PubMed1988

The distribution of health needs and services in South Africa.

The authors recognize that social, economic and political factors play a larger role in determining public health policy than do epidemiological principles such as the analysis of needs, demand and supply. Nevertheless, demographic and mortality statistics, information from the 1983 registers of medical and dental practitioners, and that of nurses, as well as information on hospital beds were reviewed to describe health care requirements and resources in South Africa. The maldistribution observed in health needs and services closely parallel the divisions in South African society imposed by the apartheid policy. It is concluded that fundamental political change is required to reduce this maldistribution. The provision of preventive and promotive health services for children in African rural and peri-urban areas was identified as a health care requirement of high priority. It is thought that the need in these geographical regions might best be met by employing primary health care workers at a lower level of training than doctors with an accessible, supporting referral system. In addition, the quality of health care data being collected needs to be improved. It is suggested that both these problems be approached on a regional basis, and preferably under a single health authority, rather than the current fragmented health service.

Demography↗
PubMed1988

The impact of political violence on health and health services in Cape Town, South Africa, 1986: methodological problems and preliminary results.

Cape Town, South Africa experienced an upsurge in the level of political violence from May to July of 1986. To determine the impact of the political violence on health and health services, selected routinely available information was analyzed, a community survey was conducted of 1,540 randomly selected households in high, medium, and low impact areas (defined using police and community reports), and a survey of 162 nurses (75 per cent response rate) working in clinic and maternity services in Cape Town's townships was undertaken. Methodological problems were encountered in relation to sampling, interviewer allocation to areas, and access to routinely available information. Nevertheless, a consistent picture emerged from the studies that: demonstrated the impact of political violence on attendance at routine health service facilities (for hypertension, tuberculosis, immunizations, antenatal and postnatal services); highlighted the disruptions caused to basic services in high impact areas (water, street lighting, sanitation and transport); documented the problems experienced by nurses in performing their usual services and by patients obtaining access to their services; showed that high impact areas had three times higher rates of gunshot wounds than low impact areas during the period.

Adolescent↗
PubMed1987

Fatal head injuries in Cape Town.

Between 1 July 1983 and 30 June 1985 there were 563 cases of fatal head injuries in people over the age of 15 years recorded at the Salt River Police Mortuary, Cape Town. The demographic character of these cases was reviewed according to: (i) age, race and sex; (ii) date, day and time of injury; (iii) cause of death; and (iv) positive blood alcohol test. Assaults and transport-related accidents in association with a positive blood alcohol test in coloured males aged 40-60 years were a major characteristic.

Accidental Falls↗
PubMed1987

Use of indicators in achieving 'Health for All' in South Africa, 1987.

This review evaluates South Africa's performance in achieving health when measured against the World Health Organization's global indicators designed to achieve 'Health for All' by the year 2000. As this programme has not been implemented in South Africa, a need exists for this country to announce indicators and targets. South Africa meets the World Health Organization's targets in terms of health expenditure but available information on many of the other indicators suggest that a large segment of the population falls outside the targets set. Lack of immunisation and poor nutrition are reflected in unacceptably high infant mortality rates and relatively low life expectancies. As accurate data are needed for planning at both national and local levels a national health survey should be conducted.

Health Status Indicators↗
PubMed1987

Nutrition status of pre-school children in a Cape Town township.

An anthropometric study evaluated the nutritional state of pre-school children in the Site C squatter area of Khayelitsha township in Cape Town. A cluster sampling method was used and the weight for age, height for age, weight for height and mid-upper arm circumference of 872 children between the ages of 1 and 5 years were recorded. The National Centers for Health Statistics percentile charts were used as a reference standard. There was a low level of acute malnutrition with 13.7% of children below the 3rd percentile for weight for age. Acute severe malnutrition was not a problem with only 1.0% below the 3rd percentile weight for height. The figure of 47.2% below the 3rd percentile for height for age indicates high levels of chronic malnutrition. Only 42.2% of children had a 'Road to Health' card. The need for further research, nutritional surveillance and health care intervention is highlighted.

Body Height↗