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Biomedical subjects

D Yach

Publications and source records attributed to D Yach.

144 records · Page 8Linked to original sources
PubMed1987

Tuberculosis deaths in South Africa, 1980.

Tuberculosis is the most common notifiable disease in the RSA and accounts for considerable morbidity, especially in black and coloured populations. The estimated number of deaths from tuberculosis vary according to the source of information used. The impact of registered tuberculosis deaths at different age groups and in all four population groups is compared. Tuberculosis mortality exerts a major impact in blacks and coloureds between 15 and 64 years of age accounting for about 7% of all deaths. Deaths from tuberculosis represent a failure of case-finding and/or case-holding. It is suggested that discrepancies between registered and notified deaths for tuberculosis be removed and that greater attention be paid to improving the management of tuberculosis in South Africa.

Adolescent↗
PubMed1987

Village health workers are able to teach mothers how to safely prepare sugar/salt solutions.

In the predominantly rural Hewu district of Ciskei 54% of infant deaths are diarrhoea-related. The aim of this study was to determine whether village health workers (VHWs) could teach mothers to safely prepare homemade sugar-salt solutions (SSS). VHWs from 11 villages were selected for training while 11 randomly selected villages acted as controls. VHWs selected for training were taught to prepare SSSs and to teach mothers with children under 5 years about the use of such solutions. A card illustrating the main points was given to all mothers. Six weeks after training, randomly selected mothers in control villages (n = 320) and experimental villages (n = 327) were interviewed and asked to prepare SSS. Experimental and control villages had similar children's diarrhoeal disease rates (using a 2 week recall period). In experimental villages 81.5% of mothers compared to 29.7% in control villages had received SSS cards (i.e. been visited). Of recently occurring diarrhoeal-episodes 76.6% were initially treated with a SSS (correct formula used in 81% of cases) in experimental villages compared to 50.5% (correct formula used in 48% of cases) in control villages (P less than 0.05 for SSS use). Greater use of enemas and home remedies occurred in control villages (P less than 0.05). Of solutions made in experimental villages 7% had sodium concentrations over 100 mmol/litre compared to 36% in control villages. Results show that VHWs can effectively train mothers to safely prepare SSS and the VHW program has been expanded to other areas.

Child, Preschool↗
PubMed1986

The impact of smoking in developing countries with special reference to Africa.

The health effects of smoking have been well documented in developed countries. This article highlights the impact of smoking and tobacco production on health and agricultural production in Africa. It shows that smoking represents an important current and future health risk to people in Africa, which will place stresses on the development of their health services. Tobacco production is shown to be associated with food imports, deforestation, and an economic dependence on transnational corporations. Possible solutions are proposed.

Adolescent↗
PubMed1985

Mseleni joint disease in 1981: decreased prevalence rates, wider geographical location than before, and socioeconomic impact of an endemic osteoarthrosis in an underdeveloped community in South Africa.

Mseleni joint disease (MJD), an endemic osteoarthrosis, was first described in 1970, localized to Kwa Zulu, South Africa. In 1981 another survey was conducted (1) to see whether prevalence had changed, (2) to estimate the prevalence in areas not previously surveyed and (3) to estimate its socioeconomic impact. A 5% stratified random sample of homesteads was selected and five local interviewers surveyed 333 kraals, interviewing 333 individuals, obtaining information on 3368 live members of these homesteads. Overall prevalence rates were 7.4% in 1566 females and 3.0% in 1179 males (age or sex unknown in 623). The previously affected area still had the highest prevalence rates, but they were significantly lower than before, even if only residents of at least ten years' duration were considered. These consistently lower age-specific prevalence rates are compatible with a decline in incidence rate, possibly because of disappearance of an environmental causal agent. Prevalence rates for females in some areas not previously surveyed were between 5 and 10%, suggesting that a larger area than stated before is affected. The proportions of severely disabled individuals are the same as reported in 1973 but greater in number considering the larger area affected. Of these, an estimated 67% of males and 47% of females are not receiving disability grants. Fifty per cent of children (aged 6-25 years) of affected parents have had no schooling compared with 30% of children of unaffected parents. This study also highlighted several methodological problems unique to rural research. It is suggested that while aetiological research should continue, the existing prevalence of MJD has major social, economic and health care implications, for which solutions should be researched as a high priority.

Adolescent↗
PubMed1985

A respiratory epidemiologic survey of grain mill workers in Cape Town, South Africa.

Exposure to grain dust may induce acute and chronic respiratory, nasal, and ocular symptoms. The prevalence of respiratory symptoms, atopic status, and lung function changes, as measured by pulmonary function tests (PFT) over the week in 582 grain mill workers and 153 control subjects not exposed to grain dust were studied in Cape Town. Atopic status, smoking habits, and baseline PFT did not differ significantly between grain workers and control subjects. Grain workers showed significant deterioration in lung function values over the week, with forced expiratory volume in one second declining on average by 4.8% compared with an increase of 3.3% in control subjects (p less than 0.001). Forced expiratory flow during the middle half of the forced vital capacity declined by 14.8% in grain workers and by 0.8% in control subjects (p less than 0.0001). Grain workers had significantly higher prevalences than did control subjects of regular cough (46 versus 30%), expectoration (35 versus 17%), wheeze (25 versus 11%), and watery eyes (25 versus 10%) (p less than 0.01 for all). These symptoms were not related to the duration of employment. A dose-response relationship, independent of smoking habits, was demonstrated between reported dust exposure and symptoms as well as between dust exposure and PFT. These results have important implications for the grain mill industry in South Africa where there is insufficient legislation and worker compensation.

Adult↗
PubMed1982

Economic aspects of smoking in South Africa.

Costs and financial gains related to smoking and assessed in terms of health, financial, agricultural and social factors are presented. It is argued that the sum of the costs exceeds that of the financial gains. Methods of reducing the smoking rate by decreasing tobacco production as well as tobacco consumption are suggested.

Adult↗
PubMedDate not supplied

A century of smoke.

Tobacco kills 5 million people annually. By the mid 2020s, that figure will increase to about 10 million a year, with most of the deaths occurring in developing countries. This review explains how early technological and regulatory developments contributed to the epidemic, reveals the efforts of the tobacco industry to conceal its products' harmfulness, and stresses the role of the globalization of trade and marketing as a means of increasing consumption world-wide. The results of tens of thousands of studies published globally over the past 50 years point to an association between smoking and lung cancer and other adverse health effects, and the non-smoker's rights movement has exposed the wide-spread perils of 'secondhand' smoke. Yet, the tobacco industry continues its global expansion, and consumers in low- and middle-income countries are especially susceptible to its marketing tactics. This review ends by emphasising the need for a global public-health response, and identifies the Framework Convention on Tobacco Control as a significant effort. It stresses the need for accelerated action and innovative tobacco-control efforts, if the projected death toll is to be reduced in this century.

Advertising↗
PubMedDate not supplied

Environmental health impacts associated with rapid urbanisation in South Africa.

There is an urgent need for epidemiological assessments of environmental factors associated with rapid urbanisation in developing countries. Unlike the process in developed countries, urbanisation in the developing world is often associated with urban poverty, particularly on the periphery of the city where informal settlement areas develop. Population growth rates in these areas are frequently higher than in the city itself, and access to basic environmental amenities is frequently lacking. In Africa, ill-health conditions associated with rapid urbanisation, such as diarrhoea and acute respiratory infections, continue to be major causes of childhood deaths. An account is given of research being conducted in South Africa to address such problems, as well as problems related to inner-city decay, such as childhood lead exposure. There is a critical need for better inter-sectoral co-ordination between the health sector and other sectors such as housing and planning, in preventing negative health impacts associated with rapid urbanisation in the future.

Child↗
PubMedDate not supplied

'Health-for-All' in the twenty-first century: a global perspective.

Changes in the broad determinants of health since the Alma Ata Conference in 1978 necessitate a renewed examination of the underlying principles and focus of the Primary Health Care (PHC) strategy. The PHC approach has been adopted by most countries and has led to improved access to certain basic health services. However, the health gains in other areas are less encouraging. Some elements of the PHC approach, for example, the effective implementation of equity-oriented health policies and the need to improve management principles within health services, have yet to be fully implemented. Moreover, to address the underlying determinants of health status, the World Health Organization's (WHO) renewed global health policy will have to include certain issues that were not considered at Alma Ata. For example, the health impacts of global recession and globalization and the need for human-centered sustainable development strategies were not considered at Alma Ata. A renewed global health policy will also have to consider demographic, epidemiological, environmental and technological changes that have emerged since 1978. It is important that WHO's renewed policy be based on sound evidence, a commitment to ethical principles and broad use of partnerships for health at global, national and local levels. One implication of this new context of health development for the renewed health policy will be that 'thinking globally and acting locally' will have to complemented by stronger global action to protect local and national health.

Cross-Cultural Comparison↗