Search PubMed⌕ Search

Biomedical subjects

G Burnham

Publications and source records attributed to G Burnham.

31 records · Page 2Linked to original sources
PubMed1995

Ivermectin treatment of onchocercal skin lesions: observations from a placebo-controlled, double-blind trial in Malawi.

To determine effects of ivermectin on skin lesions of onchocerciasis, a placebo-controlled, double-blind trial was carried out in the Thyolo highlands of Malawi involving 70 persons over a 32-month period. Assessment was made using both a clinical numeric grading system and sequential photographs. Among both ivermectin and placebo recipients, there was a significant reduction in both the severity and extent of papular skin lesions. Persons with edematous or lichenified skin lesions of onchocerciasis who received ivermectin showed significantly more improvement than those receiving placebo. Twelve months after the placebo group received ivermectin, their skin lesions were similar to those of the ivermectin group. Changes were most evident for those persons with more severe skin disease in both the ivermectin and placebo groups. Annual ivermectin treatment for onchocercal skin lesions is probably inadequate, and treatment three or four times a year may be required, although the optimum regimen has not been established.

Adolescent↗
PubMed1995

Malaria, an unclear but present danger.

Malaria is an ever present danger to those who travel in endemic areas. Falciparum malaria may be a life-threatening condition, even when treated promptly and appropriately. It is important that practitioners be aware that international travelers are at risk for malaria. It is also important to advise patients to seek expert advice on malaria prevention before they travel to malarious areas.

Critical Care↗
PubMed1994

Assessing and planning home-based care for persons with AIDS.

The HIV/AIDS pandemic continues to gather momentum in many developing countries, increasing the already heavy burden on health care facilities. As a result, donors, implementing partners and communities are beginning to create home-based care programmes to provide care for persons with HIV/AIDS. This paper recommends reorienting this home care provision as a service founded in, and coming from, the community rather than the health system. A methodology, in the form of an assessment matrix, is provided to facilitate the assessment of a community's capacity to provide care for people with AIDS. The focus is on rapid assessment methods using, where possible, readily available information to clearly and systematically define current circumstances. The matrix created for a specific community is then used in the development of an action plan with interventions prioritized and tailored to local needs. A case study from a hypothetical developing country, where HIV/AIDS is a significant problem, is used to illustrate the process.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Knowledge and attitudes toward onchocerciasis in the Thyolo highlands of Malawi.

In preparation for mass distribution of ivermectin to control onchocerciasis in the Thyolo highlands of Malawi a survey was conducted to determine knowledge and attitudes toward onchocerciasis which could assist in developing educational messages. Since onchocerciasis is not known by a specific name in the Thyolo highlands, information was sought about individual perceptions of common symptoms of infection. Itching, skin thickening, nodules, or depigmentation (leopard skin) were reported by 95% of those interviews. Effective treatment was often thought by the community to be available when actually it was not. Traditional healers were not thought to be an important source for treatment of lesions associated with onchocerciasis. None of those interviewed associated Simulium damnosum s.l. with any symptoms other those related to the actual bite. Based on the information gathered, various options for ivermectin educational messages are discussed.

Adult↗
PubMed1994

In vivo sensitivity of Plasmodium falciparum to chloroquine, amodiaquine and sulfadoxine-pyrimethamine in western Uganda.

In an in vivo study of antimalarial sensitivity in Kabarole District, Western Uganda, 82% of asymptomatic malarial infections and 86% of symptomatic infections were chloroquine sensitive. Of persons with symptomatic malaria, 88% were sensitive to sulfadoxine-pyrimethamine (Fansidar). Amodiaquine cleared parasites in all persons in whom it was used. Over the course of the past five years, there appears to be no substantial increase in the extent of chloroquine resistance in Western Uganda.

Adult↗
PubMedDate not supplied

Quality assurance management methods applied to a local-level primary health care system in rural Nigeria.

Introduction. Management of primary health care (PHC) systems in less developed countries is often impeded by factors such as poorly trained personnel, limited financial resources, and poor worker morale. This study explored the ability of local-level PHC supervisors in rural Nigeria to use quality assurance (QA) management methods to improve the quality of the PHC system. Methods. PHC supervisors from Bama Local Government Area were trained for 3 days in the use of QA methods and tools. The supervisors targeted the supervisory system and the health information system (HIS) for improvement. Health worker performance in diarrhoea case management was assessed, using a simulated case, to measure the impact of supervision. A HIS audit assessed data collection forms used by 17 PHC facilities. Gaps in quality were monitored over a 2-month study period and flaws in work processes were modified. Results. PHC supervisors introduced a checklist during monthly visits to facilities to monitor how workers managed cases of diarrhoea. Performance in history-taking, physical examination, disease classification, treatment and counselling improved over the evaluation period. The HIS audit found that a variety of reporting forms were used at PHC facilities. After HIS reporting was standardized, the number of health facilities using a daily disease registry significantly improved during the study period. Conclusions. QA management methods were used by PHC supervisors in Nigeria to improve supervision and the HIS. QA management methods are appropriate for improving the quality of the PHC in Nigeria and in other less developed countries where at least a minimal PHC infrastructure exists.

Developing Countries↗
PubMedDate not supplied

HIV seropositivity and tuberculosis in a rural Malawi hospital.

This study was undertaken to determine the extent to which human immunodeficiency virus (HIV) infection has increased hospital admissions for tuberculosis (TB) in a rural population of southern Malawi. The notes and chest X-rays of TB patients admitted to Malamulo hospital in 1983 and 1984, before the recognition of acquired immune deficiency syndrome (AIDS) in Malawi, were compared with those of patients admitted in 1987 and 1988. We found a 160% increase in TB admissions between the 2 periods. Extrapulmonary TB, especially pleural TB, was much commoner in 1987-1988 and occurred in a younger age group. HIV seroreactivity was measured in a third group of 152 tuberculosis patients admitted during 1988-1989. HIV seropositivity was found in 52% of all tuberculosis admissions and in 75% of those with extrapulmonary disease. There was no difference in clinical response to TB therapy between the HIV seropositive patients and those who were seronegative. Extrapulmonary TB should be considered in all HIV seropositive patients, especially in areas where the prevalence of TB is high. Health personnel involved in TB programmes where HIV and TB infections are prevalent should plan for a large increase in the TB case load secondary to the HIV pandemic.

Adult↗
PubMedDate not supplied

Emerging issues and future needs in humanitarian assistance.

During the past two decades, there has been tremendous investment in the ability to intervene in disaster settings, and significant barriers remain to providing appropriate services to populations affected by natural and man-made calamities. Many of the barriers to providing effective assistance exist within the NGO community, and illustrate emerging needs for international agencies. These emerging needs include improving methods of recipient participation to promote the local health system, developing improved methods for quality assurance, enhancing options for personnel development, and addressing long-term needs of reconstruction and rehabilitation. Relief agencies face challenges on all levels to develop sound practices in providing humanitarian assistance that can lead to long-term benefits to populations affected by disaster.

Altruism↗
PubMedDate not supplied

Demographic methods to assess food insecurity: a North Korean case study.

UNLABELLED: In complex emergencies, especially those involving famine and/or widespread food insecurity, assessments of malnutrition are critical to understanding the population's health status and to assessing the effectiveness of relief interventions. Although the Democratic People's Republic of Korea (DPRK) has benefited from some of the largest, most sustained appeals in the history of the World Food Program (WFP), the government in Pyongyang has placed restrictions on international efforts to gather data on the health and nutritional status of the affected population. QUESTION: Lacking direct means to assess the nutritional status of the North Korean populace, what other methodologies could be employed to measure the public health impacts of chronic food shortage? The paper begins with a review of methods for assessing nutritional status, particularly in emergencies; a brief history of the North Korean food crisis (1995-2001), and a review of the available nutritional and health data on the DPRK. The main focus of the paper is on the results of a survey of 2,692 North Korean adult migrants in China. Recognizing certain biases and limitations, the study suggests that sample households have experienced an overall decline in food security, as evidenced by both the decline in government rations from an average of 120 grams per person per day to less than 60 grams per day, and by the increase in the percentage of households relying on foraging or bartering of assets as their principal source of food. It also is apparent that the period 1995-1998 has been marked by elevated household mortality, declining fertility, and steadily rising out-migration. Taken together, the signs point toward famine, whether that is defined as a discrete event--that is, as a regional failure in food production or distribution leading to elevated mortality from starvation and associated disease--or as a more complex social process whose sub-states include not only elevated mortality, but declining fertility, eating of alternative 'famine foods', transfer of assets, and the uprooting and separation of families.

Adult↗