Search PubMed⌕ Search

Biomedical subjects

J M Klopper

Publications and source records attributed to J M Klopper.

At least 19 recordsLinked to original sources
PubMed1992

Epidemiology of acute leukaemia in the Cape Province of South Africa.

Of 535 consecutive cases of acute leukaemia diagnosed in the Cape Province between 1978 and 1985, demographic data are incomplete in 75 black patients and they have had to be excluded from the spatial analysis. Of the remaining 460 cases, 223 (48.5%) occurred in white patients and 237 (51.5%) in those of mixed ancestry, classified as coloureds according to the Population Registration Act No. 30 of 1950. The average incidence was 2.12, 1.37 and 0.58/100,000 for whites, coloureds and blacks respectively. There was no temporal trend in the incidence of acute leukaemia between the three race groups. The median age for whites was 30 years and for the coloureds was 15 years, which is comparable to the 16 years for the black patients. The two-peak age distribution for leukaemia was seen in the white group, but was absent in the other two groups. This is accounted for by a different distribution in non-lymphoblastic as opposed to lymphoblastic subtypes. Furthermore, there was a disproportionately high frequency of acute progranulocytic leukaemia in the black patients, whereas the white and coloured groups were similar. There was a single, clearly defined macro-scale cluster restricted to white patients in Statistical Region 17 (SR-17). This exploratory study provides the first epidemiologic data for acute leukaemia in the Cape Province. It needs to be extended in order to verify these observations under more controlled circumstances and to seek evidence for some environmental factors that may account for the geographical cluster.

Acute Disease↗
PubMed1991

A methodology for resource allocation in health care for South Africa. Part IV. Application of South African Health Resource Allocation formula.

The primary concern of this concluding article in a series is the application of the South African Health Resource Allocation (SAHRA) formula proposed in the previous article (SAMJ 1990; 77: 456-459). Target allocations based on this formula are compared with current budgets to estimate the extent of geographical maldistribution of health care resources. Under the present health service structure, the direction of redistribution of these resources should be from the provinces to 'homelands'. A number of refinements to the crude formula, such as the introduction of a more rational regionalisation policy and accounting for the teaching commitments of academic hospitals, are considered and their effects illustrated. Despite data deficiencies and the wide range of possible technical modifications to SAHRA, the concept of basing resource allocation decisions on an internationally applied formula is worthy of public debate.

Education, Medical↗
PubMed1991

Urbanisation and women's health in Khayelitsha. Part I. Demographic and socio-economic profile.

Demographic and socio-economic data and information on migration patterns and urban/rural links was collected from 722 households in the formal housing area and the serviced and the unserviced site areas of Khayelitsha; 659 women and 61 men were interviewed. Thirty-eight per cent of the population were aged under 15 years and 77% under 35 years. There was a predominance of females in the 5-35-year age group. There was a mean of 4.9 persons per household, and 93.5% of sites contained 1 dwelling. Of the 659 female respondents, 7% had received no formal education, 39% had primary school education, and 54% had secondary school education. Unemployment among women was 45%. Domestic service accounted for 66.2% of formal employment. Of all women 86% were unskilled, 71.9% had been born in a 'homeland', and 69.7% had migrated to an urban area before 1985. Ties to the rural areas were strong, particularly in the 'shack' areas. 'New arrivals' to an urban area were young, mostly unemployed, and lived in the worst environmental conditions. In the unserviced 'shack' areas, 47.5% of women had migrated to an urban area in the last 5 years. There are important target areas for a study of the health effects of urbanisation and for possible interventions. This study tends to confirm the 'quadruple' oppression of women in Khayelitsha, on the basis of race, social class and gender and as new arrivals in an urban environment.

Adolescent↗
PubMed1991

Urbanisation and women's health in Khayelitsha. Part II. Health status and use of health services.

A study was conducted among women in Khayelitsha to determine the relationship between urbanisation, health status and use of health services; 722 households were visited, and 659 female respondents provided information on acute and chronic illness for the 3,229 individuals who were members of their households. In addition, they provided information concerning their reproductive health, AIDS awareness, knowledge of cervical smears and use and knowledge of health services. Acute illness was reported for 4.3% of the study population, the commonest complaints being diarrhoea, abdominal pain and upper respiratory infections; 4.4% reported chronic illness, the commonest complaints being hypertension and tuberculosis; 16.2% of women reported gynaecological illness; 86% had of heard of AIDS (although their knowledge of transmission and prevention was poor); and 45% had heard of cervical smears. Patterns of illness and knowledge and use of health services vary in the different areas of residence of Khayelitsha. This appears to be related to urbanisation, age, and environmental and socio-economic factors.

Black or African American↗
PubMed1990

A methodology for resource allocation in health care for South Africa. Part II. The British experience and its relevance to South Africa.

This second article in the series on resource allocation in health care, argues for a formula-based method of resource allocation in South Africa. The model employed in England since 1976 and its application in a number of developed and developing countries is reviewed. The international experience is related to South African conditions and the principal elements necessary for a formula to achieve greater spatial equity in South African health-resource distribution are discussed.

Delivery of Health Care↗
PubMed1990

A methodology for resource allocation in health care for South Africa. Part III. A South African health resource allocation formula.

A formula to calculate the proportion of the public sector budget that should be allocated to various geographical regions of South Africa is described. The formula is broadly classified into curative and preventive components. Using data that are routinely available, indices of need are calculated for each of these components. It is concluded that resource allocation on a macro level should closely approximate regional population distribution if cross-border flow of patients and additional teaching-hospital expenditure are ignored.

Age Factors↗
PubMed1989

A methodology for resource allocation in health care for South Africa. Part I. Rationale and prerequisites.

A strategy for the equitable allocation of health care resources is needed in South Africa. The existing health administrative structures are obstacles to achieving this goal. An attempt is made to describe a framework in which the prerequisites for the equitable allocation of resources are a major restructuring of health services into a number of regional health authorities in a unified health service, and to establish a formula which is adapted from the RAWP (Resource Allocation Working Party) model used in the UK.

Health Care Rationing↗
PubMed1989

Birth defects surveillance. A pilot system in the Cape Peninsula.

A pilot birth defects surveillance system was established in 1982 as part of an epidemiological baseline study pertaining to potential changes in water quality in the Cape Peninsula. The methodology used for reporting birth defects for two information systems, one hospital-based and the other population-based, utilizing statutory notifications of births, is described. Preliminary birth defect rates by cause are presented for a hospital-based system and are consistent with rates reported internationally. The system based on statutory notifications showed gross under-reporting.

Congenital Abnormalities↗
PubMed1988

Morbidity profile of the Mamre community.

Various morbidity parameters in Mamre, a village of 4,623 residents in the western Cape, are described. Acute morbidity (either injury or illness) occurring in the 2 weeks before the survey was reported by 4% of respondents. Investigation of several chronic conditions for which people said that they were receiving treatment yielded rates of 57/1,000 for hypertension, 29/1,000 for 'nerves', 13/1,000 for diabetes and 19/1,000 for tuberculosis; 9.9% of respondents reported disability. Reported morbidity increased with age, was commoner in women than in men, and agreed with perceptions of individuals' health. Tuberculosis, inadequate sewerage and water facilities, alcohol abuse and dusty roads were perceived to be the main health problems by the community. The morbidity profile and the relatively high rate of pscyhosocial problems found are consistent with a process of urbanisation in a predominantly working-class community.

Adolescent↗
PubMed1988

Mamre Community Health Project--rationale and methods.

The overall aim of the Mamre Community Health Project is to improve the health status of the people of Mamre and to develop an approach to health promotion which may be applicable to other similar areas. Integral to this is the establishment of a surveillance system to monitor changes longitudinally with particular reference to the effects of interventive programmes and the rural-urban transition that the community is experiencing. A multidisciplinary approach that also involves both postgraduate and undergraduate students will be utilised. This article outlines the methodology employed in the first phase of the project, which was concerned with the collection of the baseline data to determine priorities, plan interventions and establish a suitable surveillance system. Approximately 1,000 households were visited and 5,000 residents interviewed by 10 trained interviewers who were selected from the community. Sampling was not used. Methodological issues addressed include the methods used to gain the co-operation and participation of the community, development of an appropriate questionnaire, selection and training of interviewers, supervision of field-work, coding of data and steps taken to ensure the reliability and validity of information collected. Thorough planning with meticulous attention to detail ensured that the Mamre Community Health Project was completed on target with fairly smooth implementation of the data collection phase. Future research will focus on refining epidemiological methods, especially aspects of study design, case definition and exposure status.

Data Collection↗
PubMed1988

Morbidity patterns from general practice in Cape Town. A pilot study.

A pilot survey of morbidity patterns reflected in general practice was undertaken by a panel of physicians in Cape Town during 1984-1985. Acute upper respiratory tract infections, bronchitis and bronchiolitis were the commonest reasons for contact. A definite pattern of contacts by day of week was noted. The age distribution of the contacts closely matched that of the suburb in which the practice was situated.

Adolescent↗
PubMed1987

The health and wealth of South Africa.

The per capita gross national product (GNP) in South Africa is examined as it relates to life expectancy and the infant mortality rate. Despite South Africa's relative wealth in per capita GNP terms, life expectancy at birth is 63-65 years and the national infant mortality rate according to Unicef, is unlikely to reach the target of 50/1,000 live births by the year 2000. The distribution of expenditure on health is contrasted between the former provincial administrations, the major local authorities, the national states and the homelands. The health resources allocation distribution is unlikely to ensure health for all by the year 2000.

Developing Countries↗
PubMed1987

South African health care expenditure, 1975-1984.

South African health care expenditure is reported for the period 1975-1984 and analysed for the public and private sectors. Approximately 5.9% of South Africa's gross national product was devoted to health care in 1984-1985. This proportion appears to be increasing. Real per capita expenditure on health increased by 13% during the period under review. Trends of health care expenditure during the decade are discussed as well as some underlying causes of the increases in health care expenditure in South Africa. Precise expenditure data and outcome information are required in order to ensure appropriate resource allocation.

Financing, Government↗
PubMed1987

Privatisation.

Explore the source record for details and available documents.

Cost Control↗
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

Variations in mortality of the coloured, white and Asian population groups in the RSA, 1978-1982. Part V. Hypertensive diseases.

An analysis was undertaken of mortality from hypertensive disease in the RSA between 1978 and 1982 among whites, coloureds and Asians. The age-specific mortality rates for each group are presented and comparisons are also made between these groups based on age-standardised mortality rates. As with a similar study undertaken for the period 1969-1971, marked variations are seen between the various population groups. The rates for Asians exceeded those for coloureds substantially, and both these groups had far higher rates than whites. These results demonstrate an interesting variation when compared with mortality from ischaemic heart disease and recent prevalence studies of hypertension. The possibility that this variation is due to better control of hypertension in whites or is a result of a different ratio of risk factors in each group studied is considered.

Adult↗