Search PubMedSearch

Biomedical subjects

M W Borgdorff

Publications and source records attributed to M W Borgdorff.

6 recordsLinked to original sources

The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania.

OBJECTIVE: To determine the prevalence of HIV-1 infection and to identify the most important risk factors for infection. DESIGN: A cross-sectional population survey carried out in 1990 and 1991 in Mwanza Region, Tanzania. METHODS: Adults aged 15-54 years were selected from the region (population, 2 million) by stratified random cluster sampling: 2434 from 20 rural villages, 1157 from 20 roadside settlements and 1554 from 20 urban wards. Risk factor information was obtained from interviews. All sera were tested for HIV-1 antibodies using enzyme-linked immunosorbent assay (ELISA); sera non-negative on ELISA were also tested by Western blot. RESULTS: The response rate was 81%. HIV-1 infection was 1.5 times more common in women than in men; 2.5% of the adult population in rural villages, 7.3% in roadside settlements and 11.8% in town were infected. HIV-1 infection occurred mostly in women aged 15-34 years and men aged 25-44 years. It was associated with being separated or widowed, multiple sex partners, presence of syphilis antibodies, history of genital discharge or genital ulcer, travel to Mwanza town, and receiving injections during the previous 12 months, but not with male circumcision. CONCLUSION: This study confirms that HIV-1 infection in this region in East Africa is more common in women than in men. The results are consistent with the spread of HIV-1 infection along the main roads. There is no evidence that lack of circumcision is a risk factor in this population.

Adolescent

Cost and output of mobile clinics in a commercial farming area in Zimbabwe.

Mobile clinics may be useful to improve the geographic accessibility of health services, but their cost may be higher than that of static clinics. In this paper it is determined to what extent mobile clinics in a commercial farming area in Zimbabwe improve geographic accessibility. The opportunity cost of mobile clinics, comprising cost of staff time and transport is estimated. Staff time appears to be more efficiently utilized in mobile clinics than in static clinics. The cost of transport comprises the cost to the health service and that to the population using the service. The consequences of two extreme assumptions are determined. If the first assumption (outreach does not increase coverage) were true, total transport cost would increase if outreach were discontinued. If the second assumption (outreach increases coverage by the number of attendances at mobile clinics) were true, a substantial increase in coverage would be obtained in particular for growth monitoring, immunizations and child spacing, without increasing the cost per contact. It is concluded that outreach clinics should continue in this commercial farming area. The sites of the mobile clinics are being reconsidered as a result of this study.

Agriculture

Estimating vaccination coverage: routine information or sample survey?

The manager of a district immunization programme needs to regularly assess vaccination coverage. This case study from Zimbabwe describes how routine information can be used for this purpose. The number of children and their location in the district was estimated from several sources using a variety of methods. This suggested that under-enumeration at the 1982 census was probably as high as a third and was a particular problem among children aged under 1 year. Routinely collected figures of the number of vaccinations were then used to calculate coverage levels for different health unit catchment areas within the district. These levels varied considerably and were lowest in areas with significant numbers of Apostolics, a group who often reject immunization on religious grounds. Comparisons between estimates of coverage obtained from routine information and a sample cluster survey raised several issues. These included accuracy of routine information, precision of sample surveys, estimating differential coverage in the district, management uses of estimates and the cost of data collection.

Adolescent