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Biomedical subjects

P R Fischer

Publications and source records attributed to P R Fischer.

At least 37 records · Page 2Linked to original sources
PubMed1993

Malaria during pregnancy: neonatal morbidity and mortality and the efficacy of chloroquine chemoprophylaxis.

In malaria-endemic regions, the impact of malaria upon pregnancy and the value of chemoprophylaxis for malaria for pregnant women remain controversial. We prospectively studied 302 pregnant women who presented in labor to Centre Médical Evangélique, Nyankunde, Zaire. We evaluated the incidence of malarial infection in mothers, placentas, and neonates and examined the effect of infection on birth weight and perinatal mortality. We analyzed the outcome of pregnancy in relation to prophylaxis with chloroquine, controlling for parity and prenatal clinic attendance. Peripartum smears of maternal blood (21%), placentas (33%), cord blood (9%), and neonatal blood (7%) were positive for Plasmodium falciparum. Maternal malaria increased the risk of perinatal death (relative risk [RR] = 12.4) and low birth weight (RR = 3.7). Neonatal malaria increased the risk of perinatal death (RR = 7.2). Chloroquine prophylaxis protected against maternal (RR = 0.4) and fetal malaria (RR = 0.2), low birth weight (RR = 0.39), and perinatal death (RR = 0.38). Peripartum malaria increases the risk of perinatal death and low birth weight. Chemoprophylaxis with chloroquine during pregnancy may have a protective effect, even in certain areas where chloroquine-resistant P. falciparum is endemic.

Birth Weight↗
PubMed1993

Tropical pediatrics.

Tropical pediatrics often is more a study of the consequences of poverty than of exotic infections. Pediatricians involved with the care of children in or from the tropics must deal with poverty, place an appropriate emphasis on preventive medicine, and seek to bridge their own cultural and linguistic barriers. Malaria, diarrheal disease, and malnutrition account for a large part of pediatric morbidity and mortality in tropical countries. P falciparum can cause severe malarial disease. Treatment must be initiated promptly; resistance to antimalarial drugs is possible. Hygienic and nutritional prevention of diarrhea must be coupled with widespread use of oral rehydration therapy for acute cases of diarrhea. Identification and early treatment of mildly malnourished children can prevent some of the mortality of overt marasmus and kwashiorkor.

Child↗
PubMed1992

How many bloods will a 'HIVCHEK' check? Multiple tests for HIV antibody for a single screening kit.

Detection of HIV infection in blood donors or populations is usually by testing sera for antibodies to HIV-1 and HIV-2. Screening tests are now highly sensitive and specific, but still expensive and scarce in Africa. We tested the commercially available kits 'HIVCHEK 1 + 2' in two field laboratories, on specimens from blood donors and antenatal women in rural Zaire. We describe a method of using one test kit for up to five serum samples, saving money and time. In 491 antenatal mothers in Eastern Zaire, among whom the HIV seroprevalence was 3.3%, we compared 'HIVCHEK' results with results obtained by ELISA and Western blot. The 'HIVCHEK' multiple-sample method had a sensitivity of 82% and a specificity of 99.6%. In an area with an HIV seroprevalence of < 4%, using 'HIVCHEK' by the multiple sample method would lead to a saving of about 2,400 pounds for every 1000 individuals tested.

AIDS Serodiagnosis↗
PubMed1991

Co-sleeping and neonatal weight loss.

The degree of neonatal weight loss and the time required for a newborn to regain birth-weight vary between different populations. It has been suggested that co-sleeping, the sharing of a single bed by mother and baby, might be an important factor in determining the neonatal weight change. In a rural setting in central Africa, 203 mother-baby pairs were studied. For 101 babies cared for in cribs and for 102 babies who shared their mothers' beds, sleeping location was associated with no significant difference either in the weight loss (6.3% for each group) or the time taken to regain birthweight (5.3 days for crib-cared babies and 5.4 days for co-sleepers). It is concluded that co-sleeping does not play a major role in determining the neonatal weight change.

Birth Weight↗
PubMed1990

Neonatal weight loss in rural Zaire.

It has been reported that some African babies lose less weight during the neonatal period than their Caucasian counterparts. A prospective study of 330 newborns in rural Zaire was done to evaluate the degree of newborn weight loss and to determine what factors might be causally associated with the weight loss. Overall, the mean weight loss was 7%. Factors correlated with weight loss were asphyxia, birthweight and age at the initiation of breast feeding. The weight loss in the population studied was similar to that reported in Caucasian babies. Early initiation of breast feeding might decrease the degree of weight loss. Further studies are needed to assess the significance of weight changes in the neonatal period.

Asphyxia Neonatorum↗
PubMed1990

Malignant tumors in children of northeastern Zaire. A comparison of distribution patterns.

In an effort to better understand the epidemiology of cancer in Zaire, a retrospective review of biopsy-proven malignant tumors was undertaken. Of 188 biopsies taken from children aged 0-15 years over a 4.5 year period, 73 (39%) revealed malignancy. Fifty-six percent of patients with malignant tumors were boys. Lymphoma was the most common tumor (28 patients, 15 with Burkitt's Lymphoma). Sarcoma (15 patients), carcinoma (8 patients), Wilms' Tumor (6 patients), and retinoblastoma (5 patients) were also seen. Lymphomas were most heavily represented in the first 5 years of life, while sarcoma and carcinoma accounted for most of the malignancies in children after 10 years of age. Lymphomas and sarcomas are relatively more common in Zaire than in North America and Europe, while leukemia and central nervous system tumors are notably less common in Zaire. In view of current limitations on health care in rural Zaire, cancer care should be directed toward early diagnosis, quick referral for appropriate surgical care, and use of the limited arsenal of chemotherapy.

Adolescent↗
PubMed1988

Prevention of neonatal conjunctivitis in Zaire.

With the emergence of chlamydia as a major cause of neonatal conjunctivitis, silver nitrate is no longer the prophylactic agent of choice in many parts of the world. We studied 450 consecutive newborns in north-eastern Zaire in an effort to determine which of two agents provided the most effective prophylaxis. None of 236 newborns treated at birth with 1% silver nitrate and none of 123 treated with 1% tetracycline was found to develop conjunctivitis. Three of 91 "forgotten" babies developed gonococcal conjunctivitis. Nurses, thinking tetracycline was "messy", tended to "forget" to treat babies for whom tetracycline was prescribed. The use of silver nitrate still provides adequate prophylaxis in Zaire. Potential changes in the prophylactic regimen would need to take the perceptions of health care workers into account.

Conjunctivitis, Bacterial↗
PubMed1988

Measles in Zaire: 1987.

Despite widespread efforts to prevent measles, a measles epidemic raged in Zaire during 1986 and early 1987. Hospitalized patients were studied with the goals of better understanding the weakness of the current efforts and of suggesting improvements in the local practice of primary health care. One hundred seventy five patients were hospitalized with measles or measles complications between October 1986 and February 1987 at the Evangelical Medical Center in northeastern Zaire. Ten percent died. Most patients were young (but older than 15 months) and poorly nourished. All patients were incompletely vaccinated. A changed vaccine schedule is proposed, and more thorough application of primary health care measures is encouraged.

Adolescent↗
PubMed1984

Bactericidal activities of five antibiotics during short-term exposure to coagulase-negative staphylococci.

After a 1-h exposure to concentrations used for topical prophylaxis in neurosurgical procedures, bacitracin, vancomycin, and oxacillin were bactericidal against more than 90% of 48 body fluid isolates of coagulase-negative staphylococci. More than 10% of isolates survived despite exposure for 4 h to concentrations of gentamicin and streptomycin greater than those employed for topical prophylaxis.

Anti-Bacterial Agents↗
PubMedDate not supplied

HIV seroprevalence among healthy blood donors in northeastern Zaire.

Human immunodeficiency virus (HIV)-antibody screening of blood donors in northeastern Zaire was reviewed to determine overall seroprevalence in the population and to identify particular subgroups of the population who are at relatively high risk. Six hundred and seventy-five healthy blood donors were tested from March 1989 to May 1990 using either the HIV-CHEK or Karpas cell tests. A total of 25 donors (3.7%) were seropositive, and seropositivity was more common in female donors (5.4%) than in male donors (2.5%, P less than 0.05). Donors who came from major population centres had a higher rate of seropositivity than did individuals coming from rural villages (10.5% vs 2.0%, P less than 0.001). There was a tendency toward increasing seroprevalence during the 13 months of the study with 2.8% of donors positive in 1989 and 5.8% positive in 1990 (P less than 0.1). It is concluded that in healthy blood donors in northeastern Zaire: (1) HIV seropositivity is more frequent in women and in individuals coming from major population centres, and, (2) HIV seropositivity seems to be increasing rapidly.

Blood Donors↗
PubMedDate not supplied

HIV seroprevalence in healthy blood donors in northeastern Zaire.

Despite high seroprevalence rates in some parts of Africa, there is notable variation in prevalence between population subgroups. To document changes and trends in HIV seroprevalence in northeastern Zaire, 1989 to 1992 blood donor data were reviewed. Overall, 2453 donors were tested with seropositivity varying from 2.8% in 1989 to 6.9% in 1992. The increase in seropositivity was significant for men (2.5 to 5.8%, P = 0.017) and for people residing in rural areas (2.0 to 6.1%, P = 0.0008) but not for women (5.4 to 8.6%, P = 0.15) nor for urban individuals (10.5 to 8.6%, P = 0.55). These findings suggest that: 1) HIV infection is spreading in previously less-affected population subgroups rather than increasing widely in the entire population, 2) the HIV epidemic could be reaching a plateau or endemic phase in northeastern Zaire, and, 3) continued blood donor screening and wise transfusion practices are needed.

Blood Donors↗