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PubMed2006

Increase in hospital mortality from non-communicable disease and HIV-related conditions in Bulawayo, Zimbabwe, between 1992 and 2000.

The HIV/AIDS pandemic is creating a strain on health care services in the developing world, with knock-on consequences for HIV negative patients. We looked for possible changes over time in the patterns of illness and outcomes of admission to an adult medical unit in Zimbabwe. We performed a prospective descriptive study of discharge diagnoses and causes of in-hospital ;mortality for all medical patients under the care of one consultant at Mpilo Central Hospital, Bulawayo, Zimbabwe. Two similar 7-month periods were compared in 1992 and 2000. Data recorded included: initials, sex, alive or dead status, diagnosis and HIV/AIDS status. Similar numbers of patients were admitted in 1992 and 2000 (1305 and 1369), but in-hospital mortality increased from 13.3% to 28.6% (P < 0.001), especially in male patients (13.1% to 33.9% P < 0.001). Mortality rates increased for both infectious and non-communicable diseases such as cardiac failure, stroke and diabetes. The 10 most common diagnoses were similar, apart from Pneumocystis carinii pneumonia (PCP) cases, which increased from 18 to 90. The proportion of patients clinically or serologically positive for HIV/AIDS rose from 13.9% to 51.1% (P < 0.001), but the number of cases of the HIV wasting syndrome (SLIM)/chronic gastroenteritis did not change significantly. In 1992 there happened to be a large number of cases of malaria transmission. Mortality related to both communicable and non-communicable diseases increased, confirming that HIV negative patients are also being affected by the strain on health services. Although based on clinical and radiological diagnosis, PCP pneumonia appears to be increasingly common in this area.

AIDS-Related Opportunistic Infections↗
PubMed1976

Surveillance of communicable diseases in tropical Africa.

In tropical Africa, parasitic and infective diseases remain the predominant causes of mortality and morbidity, and health and epidemiological services are poorly developed. Experience elsewhere has shown the value of surveillance in the control of communicable diseases and this paper contains a brief review of the use of surveillance in tropical African countries and considers the priorities, techniques and constraints of the major programmes.

Africa↗
PubMed1992

The French communicable diseases computer network: a technical view.

This paper describes an information system (IS) established in France in 1984 for the national surveillance of communicable diseases. This IS is based on a videotex server and a relational database management system. The videotex server is the IS front-end. It performs the following functions: interpersonal communications, synthetic information retrieval into an epidemiologic info-base and data entry owing to its specialized applications. The relational database management system allows the user to manage and consult an epidemiologic database updated in quasi-real time. Several specific tools have also been developed in order to enhance data representation and analysis and the decision support capabilities of the IS.

Algorithms↗
PubMedDate not supplied

The threat of communicable diseases following natural disasters: a public health response.

Natural disasters, such as the recent Indian Ocean tsunami, can have a rapid onset, broad impact, and produce many factors that work synergistically to increase the risk of morbidity and mortality caused by communicable diseases. The primary goal of emergency health interventions is to prevent epidemics and improve deteriorating health conditions among the population affected. Morbidity and mortality due to infectious diseases can be minimized providing these intervention efforts are implemented in a timely and coordinated fashion. This article presents a review of some of the major issues relevant to preparedness and response for natural disasters.

Communicable Disease Control↗