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N J Beeching

Publications and source records attributed to N J Beeching.

At least 37 records · Page 2Linked to original sources
PubMed2002

Zoonotic species of Cryptosporidium are as prevalent as the anthroponotic in HIV-infected patients in Thailand.

The epidemiology of chronic diarrhoea in adults with late-stage HIV infection was investigated in a prospective study in Bangkok, Thailand. During this investigation, 34 Cryptosporidium isolates were obtained from the faeces of 36 patients, with mean CD4(+) counts of only 14 x 10(6) CD4(+) cells/litre (range = 2 x 10(6) - 53 x 10(6)/litre), who had symptomatic cryptosporidiosis. Genotyping of these isolates, by RFLP analysis and DNA sequencing of the hypervariable region of the 18S rRNA gene, indicated that only 17 (50%) were of the C. parvum human genotype. The rest were of C. meleagridis (seven), the C. parvum 'bovine' genotype (five), C. felis (three) and C. canis (two). Extensive genotypic heterogeneity was observed among the C. parvum isolates, and two other isolates, one of C. meleagridis and the other of C. felis, produced atypical restriction patterns and were only identified by sequencing. This appears to represent the first report of C. canis and the 'bovine' genotype of C. parvum in HIV-infected Thai patients.

Adult↗
PubMed2001

Enumeration of non-communicable disease in rural South Africa by electronic data linkage and capture-recapture techniques.

Non-communicable diseases (NCDs) are becoming increasingly common and important in developing countries, yet their enumeration is problematic. We have attempted to enumerate NCD patients in a rural district of KwazuluNatal, South Africa, using the techniques of electronic data linkage and capture-recapture (CR). We examined four major NCDs (hypertension, diabetes, asthma and epilepsy). Basic patient details were recorded onto EpiInfo software over a 6-week period, from the main hospital clinic at Hlabisa, as well as the 10 outlying peripheral health clinics. Using electronic data linkage of lists from the main hospital, the peripheral clinics, and repeat prescription cards, a district NCD register was produced of 2455 patients. The mean age was 51 +/- 16 years (1 SD) and 76% were female. Of the total NCD patients, 62% had hypertension (age 57 +/- 12 years, 82% female), 16% epilepsy (age 35 +/- 17 years, 49% female), 13% asthma (age 45 +/- 19 years, 60% female) and 12% diabetes (age 54 +/- 13 years, 61% female). Estimated population crude prevalence rates for known NCD cases on the register were 7.4% for hypertension, epilepsy 0.2%, asthma 0.2% and diabetes 0.2%. We also attempted a CR analysis to assess completeness of data, by comparing overlap between patients attending peripheral clinics, and the central Hlabisa Hospital clinic. Matching by name, age, and diagnosis proved feasible, but there was little overlap, and CR calculations were invalid because of the relative independence of sources. We conclude that NCDs are common in rural Africa, and that a simple NCD district register is a potentially feasible and inexpensive option. Capture-recapture analysis is feasible, but requires suitable lists with acceptable overlap of patients.

Adolescent↗
PubMed2001

A case-control study of lifestyle risk factors associated with tuberculosis in Liverpool, North-West England.

The aim of this study was to identify the subtle influences of exposure and individual lifestyles on the risk of developing tuberculosis. A retrospective case-control study (with matching by sex, age, postcode and ethnicity) of all tuberculosis cases notified over a 7-yr period in Liverpool, UK, was carried out. Multiple logistic regression showed that, before diagnosis, cases were 7.4 times more likely to have had visitors from abroad; 4.0 times more likely to have been born abroad; and 3.8 times more likely to have lived with someone with tuberculosis. Subtle socioeconomic factors were also evident with cases 4.0 times less likely to have additional bathrooms. Lifestyle factors emerged with cases 2.3 times more likely to have smoked for at least 30 yrs, 3.8 times less likely to eat dairy products every week and 2.6 times less likely to have had high blood pressure. At interview, these factors were still evident, but cases, unlike controls, had reduced their smoking and alcohol consumption and were less likely to go out of the home or exercise than before their illness. Within individuals, lifestyle consequences of tuberculosis lead to a "healthier" lifestyle on the one hand (less smoking and alcohol consumption), but a reduced quality of life (social activity) on the other.

Case-Control Studies↗
PubMed2001

Capture recapture as a method of determining the completeness of tuberculosis notifications.

Notification of tuberculosis cases is often incomplete but combining data from several sources can provide a more accurate estimate of the number of cases. Data for the city of Liverpool were collected over an eight-year period from three sources: notifications, microbiological records and in-patient discharge coding data. Capture-recapture (CR) techniques were used to estimate the total number (including unreported cases) of tuberculosis cases in the city. By creating a log-linear model from the pattern of case replication between data sets, a model of best fit was created from which the number of cases present in the population, but not identified in any of the data sets, was estimated. False positive diagnoses were found in 67/516 (13%) of notifications and in 65/241 (27%) of in-patient codings. After excluding these, the total combined number of cases from all data sources was 473. CR methods identified only twelve extra cases (2.5%) making the estimated number of true cases total 485. Of these, in-patient codings identified 36.3%, microbiological records 56.3% and notifications 92.6%. It was concluded that notification of tuberculosis is very complete in Liverpool. Capture-recapture methods can be used to assess completeness of notification data in other settings.

Adolescent↗
PubMed2001

Protozoan enteric infection in AIDS related diarrhea in Thailand.

The aim of this study was to determine the prevalence of enteric protozoa and other pathogens in AIDS patients with diarrhea in Bangkok, Thailand. Of 288 consecutive patients screened in the 10 month period between November 1999-August 2000 inclusive, 55 (19.2%) had Cryptosporidium spp, 13 (4.5%) had Isospora oocyst, 11 (3.8%) had Giardia lamblia, 3 (0.9%) had Entamoeba histolytica, and 1 (0.3%) had Iodamoeba butschlii infection. The prevalence of microsporidia was 11% in this study. Of 251 patients for whom stool culture for bacteria was performed, enteric bacterial pathogens isolated were Campylobacter spp in 18 (7.1%), Salmonella spp in 11 (4.3%), and Shigella spp in 1 (0.5%). Other pathogens found in these patients were Clostridium difficile in 16/102 (15.6%). Mycobacterium spp in 18/287 (6.2%), and Strongyloides stercoralis in 23/288 (8.0%). Overall, parasitic and bacterial pathogens were identified in 140 (48.6%) patients. These pathogens were identified by the routine simple wet smear technique in 32, formalin-ether concentration method in 46, culture for S. stercoralis in 5, and culture for bacteria in 30. Additional test, using modified Ziehl-Neelsen staining, identified cryptosporidial oocyst, isospora oocyst, and Mycobacterium spp in 72. The microsporidia, initially identified by modified trichrome blue staining, all were then determined to be Enterocytozoon bieneusi by thin sectioning electron microscopy. Protozoan and bacterial pathogens were confirmed to be important etiologic agents in diarrhea in AIDS in Thailand. They were all associated with increased mortality. Routine stool examination by simple wet smear detected only one-fourth of these pathogens. Therefore all diagnostic techniques for these organisms should be made more widely available in Thailand.

AIDS-Related Opportunistic Infections↗
PubMed2001

Hepatitis B prevalence and risk factors for HBsAg carriage amongst Somali households in Liverpool.

The prevalence of hepatitis B core antibody (anti-HBc) and surface antigen (HBsAg) in the Somali population in Liverpool is described and groups who may benefit from vaccination are identified. A cross-sectional descriptive study was undertaken. A total of 439 subjects, aged between 10 months and 80 years, from 151 households, were screened for anti-HBc and HBsAg. One hundred ninety-four (44.2%) were children aged less than 15 years. Three hundred and nine (69%) of enrolled subjects were born in Somalia, 122 (27.2%) were born in the UK and 8 were born elsewhere. Of the study population, 5.7% were carriers of HBsAg, with the highest prevalence in adults aged 20 to 44 years (9.4%). A history of circumcision (RR 95% CI; 1.2, 1.1-1.5) was the most significant risk factor for HBsAg carriage, but was not significant on multivariate analysis. Prevalence of anti-HBc was 27.5%, and increased with age over the first four decades. Univariate analysis showed that a history of living in a refugee camp (RR 95% CI; 3.1, 1.7-5.7), receiving an injection in Somalia (2.1, 1.7-2.5), a history of circumcision or other surgical procedure in Somalia (1.4, 1.3-1.6) and being born in Somalia (1.3, 1.2-1.4) were significant risk factors for anti-HBc positivity. On multivariate analysis, only circumcision (OR 95% CI; 4.3, 1.8-10.3) and receiving an injection in Somalia (2.5, 1.5-4.4) remained significant. Seven of 80 (8.7%) children born in the UK and aged five years or less had evidence of exposure to hepatitis B, of whom only one had a close family member identified to be HBsAg seropositive. Previous infection with hepatitis B is common in this population. Horizontal transmission may be continuing at an early age within the UK, suggesting a population of at risk individuals who would benefit from surveillance and immunisation. Community circumcision is a risk factor for hepatitis B transmission and best practice should be followed when this procedure is undertaken.

Adolescent↗
PubMed2000

Pyogenic lung infections: factors for predicting clinical outcome of lung abscess and thoracic empyema.

Lung abscess and thoracic empyema continue to cause significant morbidity and mortality despite appropriate antibiotic therapy and various options for drainage of empyema. Multiple factors, including the patient's general state of health, the presence of underlying disease, the virulence of the pathogen responsible, and the promptness of drainage of empyema, appear to dictate the clinical outcome. However, the available data are derived from uncontrolled, retrospective studies and the high morbidity and mortality rates underscore the need for large prospective studies to better evaluate factors that may predict the clinical outcome of these conditions.

Drainage↗
PubMed2000

Tropical and exotic infections. Proceedings of the 5th Liverpool Tropical School Bayer Symposium on Microbial Diseases. 14 February 1998.

In summary, MDR strains of S. typhi are both epidemic and endemic in many countries in Asia and MDR S. paratyphi A has recently emerged in Pakistan. Multiple clones may be present in a given area at any time. Fluoroquinolones and third generation cephalosporins have been used widely over the past decade to treat MDR strains. The clinical superiority of fluoroquinolones is now threatened by the rapid emergence of chromosomally mediated resistance and cephalosporin resistance is also being reported. Whether these problems can be overcome by the use of newer fluoroquinolones or cephalosporins remains to be seen. Meanwhile, furazolidone and azithromycin deserve further trials, and clinical and molecular surveillance of resistance patterns remains essential.

Cholera↗
PubMed2000

Infections in AIDS.

Explore the source record for details and available documents.

AIDS-Related Opportunistic Infections↗
PubMed2000

Analysis of plasmid and chromosomal DNA of multidrug-resistant Salmonella enterica serovar typhi from Asia.

Molecular analysis of chromosomal DNA from 193 multidrug-resistant (MDR) Salmonella enterica serovar Typhi isolates from 1990 to 1995 from Pakistan, Kuwait, Malaysia, Bangladesh, and India produced a total of five major different pulsed-field gel electrophoresis (PFGE) patterns. Even within a particular country MDR S. enterica serovar Typhi DNA was found to be in different PFGE groups. Similar self-transferable 98-MDa plasmids belonging to either incompatibility group incHI1 or incHI1/FIIA were implicated in the MDR phenotype in S. enterica serovar Typhi isolates from all the locations except Quetta, Pakistan, where the majority were of incFIA. A total of five different PFGE genotypes with six different plasmids, based on incompatibility and restriction endonuclease analysis groups, were found among these MDR S. enterica serovar Typhi isolates.

Anti-Bacterial Agents↗
PubMed2000

How many data sources are needed to determine diabetes prevalence by capture-recapture?

BACKGROUND: Capture-recapture (CR) methods are increasingly used to estimate the size of human populations, including those with diabetes. Few studies have examined the demographic details needed to match patients on the lists used in these techniques, or to determine the optimum number of lists. METHODS: Six lists of known diabetic patients attending different medical settings during the study year were obtained. The effects on total enumeration after aggregation of these lists were examined using increasing numbers of demographic data items as patient identifiers. The CR estimates of prevalence were obtained using 15 different combinations of two lists. Estimates were obtained after log-linear modelling for interdependence between different combinations of three and four lists, and after combining the six available lists into three logical lists. RESULTS: For matching patients, adding date of birth to first name and family name as matching criteria increased the total of identified patients from 2500 to 2585 (3% increase), corresponding to a period prevalence of 1.5% (95% CI : 1.41-1.52). Addition of further identifiers, such as partial postcode, only increased the estimate by a further 15 patients (0.5%), and more detailed matching with full postcode introduced uncertainty. The use of two-list CR yielded widely varying estimates of the total diabetic population from 1379 (95% CI : 435-2273) to 9554 (95% CI : 7291-10 983). Log-linear modelling using different combinations of three and four lists produced estimates of 5074 (95% CI : 4417-5947) and 5578 (95% CI : 4918-7081), respectively, after compensating for statistical interdependence between the lists used. The appropriate condensation of six available lists into three lists for modelling yielded estimates of 5492 (95% CI : 4870-6285), corresponding to a CR-adjusted period prevalence of 3.1% (95% CI : 3.03-3.19%). CONCLUSIONS: In a Western population, the only demographic data required for matching patients on lists used for CR methods are first name, family name and date of birth, if unique identifiers such as social security numbers are not available. Two lists alone do not produce reliable data, and at least three lists are needed to allow for modelling for 'dependence' between datasets. The use of more than three lists does not substantially alter the absolute value or confidence of enumeration, and multiple lists (if available) should be condensed into three lists for use in CR calculations.

Databases, Factual↗