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Biomedical subjects

G Hussey

Publications and source records attributed to G Hussey.

At least 37 records · Page 2Linked to original sources
PubMed1999

Risk factors for meningococcal disease in Cape Town.

OBJECTIVE: To determine the risk factors associated with meningococcal disease among children living in Cape Town. DESIGN: A case-control study was conducted from October 1993 to January 1995. SETTING: The study population consisted of all children under the age of 14 years who were resident in the Cape Town metropolitan region. Cases and controls were selected from Red Cross War Memorial Children's Hospital. RESULTS: A total of 70 cases and 210 controls were interviewed. Significant risk factors for meningococcal disease included being breast-fed for less than 3 months (adjusted odds ratio (OR) 2.4); overcrowding (adjusted OR 2.3); and age less than 4 years (adjusted OR 2.3). Exposure to two or more household members who smoked was also a risk factor, but only in the presence of a recent upper respiratory tract infection (adjusted OR 5.0). CONCLUSION: This is the first case-control study in South Africa examining risk factors for meningococcal disease. It provides further evidence for reduction of smoking, reduction of overcrowding and promotion of breast-feeding as important public health measures.

Adolescent↗
PubMed1997

Managing measles.

Explore the source record for details and available documents.

Antibiotic Prophylaxis↗
PubMed1997

Epidemiology of post-neonatal bacterial meningitis in Cape Town children.

Bacterial meningitis is a major cause of childhood morbidity and mortality in South Africa. However, comprehensive regional or national epidemiological data, essential for rational public health interventions, are lacking. The purpose of this 1-year prospective study, from 1 August 1991 to 31 July 1992, was to define the magnitude of the problem of childhood bacterial meningitis in Cape Town. The study group consisted of all children, aged > 1 month to < 14 years, who presented with proven bacterial meningitis at all the hospitals in the Cape Town metropolitan area. During the year 201 cases were identified: 101 (50.2%) were due to Neisseria meningitidis, 74 (36.8%) were due to Haemophilus influenzae and 26 (12.9%) were due to Streptococcus pneumoniae. The overall incidence rate (95% confidence interval) for children less than 14 years, 5 years and 1 year was 34 (30-40), 76 (65-88) and 257 (213-309) per 100,000 children, respectively. The rate was highest in black infants, 416 (316-545)/100,000. This was 2 times greater than the rate in coloured infants and about 4.5 times greater than the rate in white infants. The median age of all the children was 10 months. The ages of children with haemophilus and pneumococcal meningitis were similar, 9 and 7.5 months respectively (P = 0.43), while children with meningococcal meningitis were significantly older (22 months) than the others (P < 0.01). The overall case fatality rate was 5%, and 12.9% of survivors had significant neurological sequelae (disability) on discharge.

Adolescent↗
PubMed1997

Vitamin A status, other risk factors and acute respiratory infection morbidity in children.

OBJECTIVE: This study evaluated the association between vitamin A status and the severity of acute respiratory infections (ARIs) in children, controlling for the influence of other known ARI risk factors. DESIGN: Case control study. SETTING: Ambulatory and hospital-based study. PATIENTS: Severe cases (N = 35) were children with ARI who were admitted to hospital for inpatient treatment, while mild cases (N = 32) were children with ARI who were treated as outpatients. The control group (N = 54) was selected from children with non-infectious diseases attending the outpatient department. Cases and controls were matched for age and area of residence. MAIN OUTCOME MEASURES: Serum vitamin A levels and analysis of ARI risk factors. RESULTS: The mean (SD) vitamin A levels were 22.09 (7.27) micrograms/dl for the controls, 20.27 (11.11) micrograms/dl for the mild cases and 13.79 (7.60) micrograms/dl for the severe cases. All pairwise comparisons of levels of the three patient groups achieved statistical significance-severe and mild (P < 0.01), severe and control (P < 0.001) and mild and control (P = 0.03). After vitamin A levels were dichotomised, the odds ratios (and 95% confidence intervals) for severe versus mild cases were 2.1 (0.8-5.6), for mild versus controls 2.9 (0.8-10.5) and for severe versus controls 6.0 (2.0-19.4). A chi 2 for trend across the three groups was 13.2 (P = 0.001). Risk factors significantly associated with disease status included a history of hospital admission in the preceding 6 months, absence of a clinic card, poor housing and lack of electricity for indoor fuel use. Factors associated with poor vitamin A status included low weight for age, previous diarrhoeal disease and poor housing. Vitamin A status was independently associated with disease status in logistic regression modelling. CONCLUSION: Vitamin A status has a strong association with severity of infection. The gradient of that association suggests a dose-response effect. The multifactorial nature of ARI severity and vitamin A status highlights the need for a comprehensive approach to public health programmes to address ARI. The role of vitamin A supplementation for at-risk groups is supported by this study, but needs to be clearly defined within a broader approach to health.

Acute Disease↗
PubMed1994

Epidemiology of invasive Haemophilus influenzae infections in Cape Town, South Africa.

The full spectrum of invasive Haemophilus influenzae disease has not been documented previously in Africa. This 1-year prospective study was designed to determine the epidemiology of invasive Haemophilus influenzae disease in Cape Town children. During this period, 142 children with invasive disease were hospitalized; 85 (59.9%) presented with meningitis, 35 (24.6%) with pneumonia and 22 (15.5%) with other diseases. No cases of epiglottitis were seen. Sixty per cent of cases were male and 40% female. The median age of the children was 9 months, with a range of 1-144 months, and 65.5% were aged < 12 months. Neurological dysfunction was noted in 40% and 18% of children with meningitis on admission and discharge, respectively. The overall case fatality rate (95% confidence intervals) was 9.2% (4.9-15.7), and for meningitis, pneumonia and septicaemia it was 4.7% (1.2-16.4), 14.3% (4.6-31.8) and 40% (8-78.1), respectively. Serotype b accounted for 86.5% of all cases, 97.3% of cases of meningitis, 71.4% of cases of pneumonia, 50% of cases of septicaemia, all cases of arthritis and cellulitis and none of mastoiditis. The incidence rates (95% confidence intervals) for all invasive type b infections were 169 (122-198) and 47 (39-57) per 100,000 population for children < 1 and < 5 years, respectively. For meningitis the rates were 112 (84-148) and 34 (25-40) per 100,000, respectively. Rates for mixed race and white children were similar, but those for black children were more than double those rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Distribution↗
PubMed1994

Serotypes and antimicrobial susceptibility of Haemophilus influenzae.

During a one year prospective study of Haemophilus influenzae infections in patients treated in hospitals in the metropolitan area of Cape Town. H. influenzae type b accounted for 81.7% of 126 invasive isolates, whereas 86.1% of the 280 non-invasive isolates were non-typeable. Ampicillin resistance was detected among 10.8% of strains of which all but one produced beta-lactamase. All strains were susceptible to cefotaxime as were more than 95% to chloramphenicol, rifampicin, tetracycline but 20.4% were resistant to co-trimoxazole and 87.2% to erythromycin.

Adult↗
PubMed1994

An audit of the use of antibiotics in presumed viral meningitis in children.

The antibiotic management of 139 consecutive patients with presumed viral meningitis evaluated during a 6-month period was examined. The presumptive diagnosis of viral meningitis was made in retrospect by consensus among the authors, using clinical and routinely available laboratory information. Sixty-eight (51.9%) of 131 patients with complete records were treated with antibiotics after diagnosis, 25 for 2 days or less and 43 for longer than 2 days. Antibiotic treatment was retrospectively judged to be unjustified in 35 (81.4%) of the 43 patients treated for longer than 2 days. When compared with untreated patients antibiotic treatment was started in younger female children with lower cerebrospinal fluid glucose values and longer duration of symptoms. There was no difference between the two groups in other cerebrospinal fluid values, peripheral white blood cell count or history of preceding antibiotics. In contrast no associations were found with treatment beyond 2 days, compared with treatment for 2 days or less. Thus the decision to stop antibiotic treatment early did not appear to be made according to consistent clinical criteria. This apparent lack of consistent criteria suggests the need to develop clinical guidelines for such decisions, both to aid clinicians and to provide standards for medical audit.

Anti-Bacterial Agents↗
PubMed1994

Eradication of poliomyelitis in South Africa.

An international campaign under the leadership of the World Health Organisation is underway to eradicate polio from the world by the year 2000. South Africa may already be free of polio. However, to ensure eradication we need to move from a polio control programme to a polio eradication programme. This necessitates the institution of a surveillance programme for acute flaccid paralysis (AFP) and improvement of the delivery of polio vaccine. All children with AFP (including those with suspected Guillain-Barré syndrome) should be investigated with stool culture to exclude polio. Primary care services need strengthening so that oral polio vaccine coverage greater than 90% is achieved in all regions by all authorities. Outbreak response activities need to be developed. Consideration needs to be given to national immunisation days and mopping-up activities.

Child↗