Search PubMed⌕ Search

Biomedical subjects

P Shears

Publications and source records attributed to P Shears.

48 records · Page 3Linked to original sources
PubMed1988

Occurrence of multiple antibiotic resistance and R plasmids in Enterobacteriaceae isolated from children in the Sudan.

The prevalence of resistance to six commonly-used antimicrobial agents in faecal coliforms from children in Khartoum, Sudan was studied. A relatively high prevalence of resistance was found, ranging from 96% of children with isolates resistant to ampicillin to 70% of children with isolates resistant to chloramphenicol. Seventy-seven percent of children had isolates with high-level resistance to trimethoprim (MIC greater than 1000 micrograms/ml). Twenty-nine different resistance patterns were found. Thirty-nine percent of the children had isolates resistant to all six antibiotics studied, and 80% of children had isolates resistant to at least four. Transfer of resistance to each of the antimicrobials, in varying combinations, was demonstrated, but did not occur for all resistance patterns. Plasmid analysis showed plasmids ranging from 160 MDa to 2.8 MDa and isolates contained from one to five plasmids of different sizes. There were no consistent relationships between resistance pattern and plasmid profile, but multiple resistance transfer was mediated commonly by plasmids with a molecular weight of 62 MDa. The high prevalence of potentially transferable antibiotic resistance in gut commensals of children in the Sudan may be of importance in the management of enteric and other infections requiring antimicrobial treatment.

Ampicillin Resistance↗
PubMed1988

A preliminary investigation of antibiotic resistance in Enterobacteriaceae isolated from children with diarrhoea from four developing countries.

The prevalence of resistance to commonly used antibiotics was investigated in groups of children from four developing countries, Peru, Belize, Zaire and Sudan. Enterobacteriaceae spp. isolated from faeces of children with diarrhoea were tested for sensitivity to ampicillin, tetracycline, sulphonamide, trimethoprim, streptomycin and chloramphenicol. Overall, the highest prevalence of resistance was to sulphonamide (56% of children) and the lowest was to chloramphenicol (19% of children). For individual locations, isolates from Sudan had the highest prevalence of antibiotic resistance, 65% of the isolates being resistant to ampicillin, tetracycline, trimethoprim and streptomycin. Transfer of resistance was studied for some isolates using Escherichia coli Hb101 as recipient.

Belize↗
PubMed1987

Epidemiological assessment of the health and nutrition of Ethiopian refugees in emergency camps in Sudan, 1985.

The findings from epidemiological data that were collected from emergency camps for Ethiopian refugees during a mass influx of refugees into Eastern Sudan in 1985 are presented. An overall mortality of 8.9 per 10,000 a day was recorded during February 1985, and in children under 5 years of age the rate was 22 per 10,000 a day. The estimated prevalence of malnutrition (calculated as less than 80% of the reference weight for height) ranged from 32% to 52% among children of preschool age. The principal causes of morbidity and mortality were measles, diarrhoea and dysentery, respiratory infections, and malaria. The findings suggest that malnutrition and disease increased in these refugees after they arrived in the camps. Epidemiological assessment is essential to help to maintain the health and nutrition of refugees in emergency camps.

Adolescent↗
PubMed1987

Measures of nutritional status. Survey of young children in north-east Brazil.

In 738 children aged under 5 from three communities in north-east Brazil, nutritional status was assessed by four means-weight for age, height for age, weight for height, and middle upper arm circumference (MUAC). As judged by weight for age, 43% of children were adequately nourished and only 2% were severely malnourished. Stunting (less than 85% height for age) was seen in 8% and wasting (less than 70% weight for height) in 1%. There was poor agreement between MUAC (a measure of wasting) and weight for height when the conventional cut-off points for MUAC were applied. Although agreement improved with new MUAC cut-off points the probability of correct diagnosis of wasting (sensitivity) remained low. Although height for age and weight for height were the most useful measures of nutritional status, MUAC may be the best available in famine victims and refugees.

Age Factors↗
PubMed1987

A note on antibiotic resistance in Escherichia coli isolated from children with diarrhoea in the Sudan.

This study investigates antibiotic resistance in gut commensals obtained from children presenting with diarrhoea in Khartoum and Juba, Sudan. Fifty-one isolates of Escherichia coli were obtained from the faeces of 34 children. Sensitivity to six antibiotics generally available in Sudan were determined for all isolates using a disc diffusion method. Twenty-five (74%) of the children had isolates resistant to at least four of the antibiotics, and seven (20%) had isolates resistant to all six antibiotics. A greater number of resistant isolates was obtained from inpatients than outpatients but were significantly different for only two antibiotics. There was no significant difference in the prevalence of resistant isolates obtained from children below 1 year of age. The results suggest that multiply resistant Escherichia coli may be acquired from the environment, and may play a role in the epidemiology of multiply resistant enteric pathogens.

Anti-Bacterial Agents↗
PubMed1987

Acute lymphoblastic leukaemia: trimethoprim resistant organisms during treatment.

A cross sectional study was carried out in children receiving treatment for acute lymphoblastic leukaemia to determine the prevalence of trimethoprim resistant organisms in their gut flora and to compare this with a control population. There was a significantly higher prevalence of trimethoprim resistant bacteria in the study group (61%) compared with controls (14%). A longitudinal study showed that emergence of these organisms was intermittent during treatment.

Child↗
PubMed1987

Communicable disease epidemiology following migration: studies from the African famine.

Few epidemiological studies have been undertaken of morbidity and mortality due to communicable disease in mass migration. This article reviews data from refugee displacement areas in north-east Africa. Risk factors to increase morbidity and mortality include 1) breakdown of health services, 2) movement to new ecological zones, 3) malnutrition, and 4) crowding and poor sanitation in relief camps. Highest mortalities are recorded in children under 5 years old, principal causes being measles, gastro-enteritis, chest infections, and malaria. The greatest morbidity and mortality occurs after arrival in relief camps, and could be reduced by epidemiologically based, selective health programs. This article stresses the importance of regional level coordination between relief agencies and the need for an effective disease surveillance system.

Africa↗
PubMed1985

Evaluating the impact of mother and child health (MCH) services at village level: a survey in Tanzania, and lessons for elsewhere.

An evaluation has been carried out of the impact at village level of seven Mother and Child Health (MCH) programmes on problems of health and nutrition in Tanzania. The evaluation highlighted the problem of shortage of base-line data in attempting to measure the impact of programmes quantitatively. The results obtained indicate that apart from immunization coverage, ranging from 70% for BCG problems to 30% for measles, the programmes were having limited impact on the principal problems health and nutrition problems of mothers and children. The evaluation emphasises the need to move from the package approach to MCH to programmes based on a more objective assessment of the priority problems in a specific area, and on a realistic assessment of community awareness of their health problems.

Anemia↗
PubMed1985

Nutrition studies of Ugandan refugees in Sudan and Rwanda. A report on surveys using the mid-upper arm circumference method.

Nutritional surveys were undertaken in refugee camps in southern Sudan and Rwanda. Nutrition status was assessed using the mid-upper arm circumference method. A high level of malnutrition was found in the main transit camp for refugees from Uganda into southern Sudan. Nutrition status in refugee settlements was adequate in the Rwanda camps, where refugees had only been displaced for a short period of time; there was only a limited degree of malnutrition. The findings correlate with the time period of displacement of the refugees.

Arm↗
PubMed1984

Tuberculosis control in Somali refugee camps.

By mid-1981 an estimated 500 000 refugees were living in camps in Somalia. As the temporary camps have become permanent, crowded settlements, tuberculosis has become an increasing health problem. Initial treatment programmes were started in most of the camps, which had no microscopy facilities or active case finding. This paper describes the subsequent evaluation of the tuberculosis programme in one of the camps in the N.W. of Somalia, with a population of 25 000, and the recommendations proposed to improve its effectiveness. Fifty per cent of patients started on treatment were lost to the programme in the first year: many had left the camp, others defaulted while remaining there. As microscopy facilities became available it was possible to concentrate the limited resources on sputum positive patients and to attempt active case finding. Evaluation of the programme has indicated particular problems in the managements of tuberculosis in refugee camps.

Humans↗
PubMedDate not supplied

Antibiotic resistance in the tropics. Epidemiology and surveillance of antimicrobial resistance in the tropics.

Antimicrobial resistance is threatening to undermine many of the health care improvements achieved in the tropics in the past 2 decades. While only limited data are available, there is evidence from most tropical areas of the spread of resistant bacterial strains in diseases from typhoid and bacillary dysentery to tuberculosis and, as in industrialized countries, multiply resistant hospital pathogens including methicillin-resistant Staphylococcus aureus (MRSA). Attempts to control the spread of resistant bacteria are limited by the lack of surveillance data at both the local and international level. For effective surveillance programmes to be implemented, the strengthening of laboratory services at district and national level, with a long-term commitment to resources, training and quality control, is essential.

Bacterial Infections↗