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PubMed1989

Can the causal model approach contribute to the study of the epidemiology and the control of sleeping sickness?

A causal model links together, in an hierarchical manner, a set of hypotheses about the causes of, and mechanisms leading to, a phenomenon under study. Initially used in nutrition studies for identifying the variables to be observed, such models have proven useful in the choice and evaluation of interventions, as well as in the selection of relevant special studies to be carried out inside a broader research programme. The authors describe a technique of model building used by nutritionists, and argue that this approach could be of benefit in the study and control of african trypanosomiasis. Their hypothesis is that although causal models do not substitute for mathematical models, the latter ones, and epidemiological models in general, would be (1) more correct logically; (2) fitting reality more closely; and (3) more useful for the analyst, the decision maker and the field worker, if they were built from an preceding causal model.

Humans↗

PubMed1986

False epidemiological results from the bulk transport of dried filter papers in urinary schistosomiasis.

In field studies in Schistosoma haematobium endemic areas, dried filters must be transported in bulk to central laboratories, either for primary screening and counting, or for quality control of field workers. We examined filters before and after bulk transport, from three populations, of high, medium and low prevalence rate. A total of 312 filters were examined before and after transport; 28.6% of all eggs on filters were lost during transport. Negative filters became positive during transport, and hence false prevalence rates resulted from after transport studies. Egg loss did not seem to be related to initial egg density. The operational results of these findings could be serious, in terms of distribution of treatment and evaluation of results and costs.

Animals↗

PubMed1988

Detection with a monoclonal antibody of an antigen, characteristic of the genus Schistosoma, excreted in the urine.

In the host, the antigen excreted by schistosomes in the circulating blood is concentrated in the urine. A mouse monoclonal antibody of the IgM class type lambda, directed against an epitope of the intestinal epithelium of the adult worm, is obtained. The antigen found in the urine of the host as well as the monoclonal antibody has been previously characterized. It is of a polysaccharidic nature, is thermostable and specific for the genus Schistosoma. The antigen is found at all stages of the life cycle and, particularly, in the egg where it is found in large amounts. Detection of the antigen is by means of inhibition of the passive haemagglutination test. There is a fundamental advantage in detecting the metabolic antigen excreted by schistosomes instead of looking for circulating antibodies. The antigen is directly released by the parasite itself, antibodies being, by contrast, produced by the host, indirectly therefore, and in a way that varies from one individual to the next. Collecting urine specimens is, for field workers, easier than obtaining blood from the inhabitants. The detection of the antigen in the urine is made a rather simple procedure since the antigen is concentrated by the kidney and free in urine, instead of remaining conjugated with antibodies like it is in the blood. When used in the Cameroon for the study of prevalence in two foci of schistosomiasis, intestinal (Nalassi Emana) and urinary (Barombi Kotto), the test detecting the antigen in urine gives good correlations with the parasitological examinations looking for eggs of S. mansoni and S. haematobium in feces and urine.

Adolescent↗

PubMedDate not supplied

Satisfied IUD acceptors as family planning motivators in Sri Lanka.

In this study, government midwives were teamed with currently satisfied IUD acceptors to strengthen field motivational and recruitment efforts. The objective was to increase the number of new IUD acceptors. In the experimental study areas, a total of 3,019 new IUD acceptors were recruited. Time series regression analysis revealed a significant difference between the experimental and comparison areas that was over and above what might be expected on the basis of the past history of differences between these two areas. These and other findings suggest that teaming currently satisfied acceptors with government field-workers can have a substantial impact on the recruitment of new family planning users.

Consumer Behavior↗

PubMedDate not supplied

Uses of a psychiatric case register. Evaluation studies.

The Groningen case register, modelled after the Camberwell register, was initiated with a point prevalence count on the 31st of December 1973, and accumulates since data on contacts with psychiatric services of all people in a small town in the north of the Netherlands, with a population of 43,783 inhabitants. It has been running smoothly for the past twelve years with increasing interest and involvement on the part of the field workers and policy makers. Examples are given of the use of the register in evaluating new services, patterns of care, continuity of care and deinstitutionalization, in which it has proved its value as a tool for evaluation.

Continuity of Patient Care↗

PubMed1985

Solvent exposure from liquid sampling media.

Use of a personal sampling method using a toluene-based solution in a midget impinger led to the suspicion that it would result in toluene exposure to the worker. Field data from three workplaces indicate that in open environments, 8-hour TWA toluene exposures range from 3.6 - 20.1 mg/m3 with a mean of 8.9 mg/m3. However, sampling in semi-confined spaces resulted in 8-hour TWA concentrations up to 189 mg/m3, or 50% of the NIOSH-recommended exposure limit (375 mg/m3). Use of this and similar wet sampling methods in confined spaces requires investigators to be aware of the degree of ventilation in the space; and suggests the need to predict potential exposures before sampling. The vapor pressure method is a rapid, safe and simple way to predict this potential exposure.

Air Pollutants, Occupational↗

PubMed1985

Potential false positive egg-counts through the reuse of polyamide filters in the diagnosis of urinary schistosomiasis.

Nytrel monofilament polyamide filters have recently been strongly advocated as a cheap reusable method for filtering urine in field studies of Schistosoma haematobium endemic areas. We examined 1230 persons in a highly endemic area, filtering 10 ml urine through Nytrel filters and counting the eggs retained. It was found that staining Nytrel filters speeded up the counting process and made the detection of light infections much easier. After very careful washing and rinsing 12.0% of unstained filters and 4.8% of stained filters retained eggs. In view of the implication of these findings for epidemiological studies and control programmes, it is suggested that field workers consider the use of disposable paper filters.

Animals↗

PubMed1972

The effect of a control programme against Schistosoma mansoni on the prevalence and intensity of infection on an irrigated sugar estate in northern Tanzania.

On an irrigated sugar estate in northern Tanzania a control programme against Schistosoma mansoni was carried out during 1968-70. Through the routine use of molluscicides, the population of Biomphalaria pfeifferi snails was kept at a greatly reduced level. Concurrently a mass campaign was carried out to detect residents who were infected with S. mansoni so that they might be treated. The effect of these measures on the overall prevalence of the disease was measured by random studies before and after the mass diagnosis and treatment. The techniques used for mass diagnosis, for treatment, and for the prevalence studies are described, and the results of the control programme are presented and discussed. In the mass diagnosis campaign over 90% of the population were examined and 2 286 courses of treatment were administered to 1 922 persons. The combination of chemotherapy and snail control led to a significant reduction in the number of S. mansoni. infections. In field workers the prevalence was reduced from 59% in early 1969 to 31% in late 1970. In nonfield workers the reduction was from 36% to 15% and in the wives of employees from 28% to 14%. The main reasons why the prevalence was not reduced further were considered to be the failure of the drugs used to effect a complete parasitological cure and the inability of the mass diagnosis campaign to detect light infections. It was estimated that the overall reduction in the number of eggs released into the community as a result of the control programme was about 85%.

Adult↗

PubMed1984

Problems of urban leprosy control with special reference to case holding.

The prevalence of leprosy and the proportion of bacteriologically positive cases in different parts of endemic and highly dense Bombay, India, are presented. The attendance of 8574 cases is retrospectively analyzed with respect to age, sex, occupation, type of leprosy, and presence or absence of deformity. Defaulters (6090) were traced, and the reasons for nonattendance were ascertained in 22% of the cases. In those cases who could be contacted and in those who had high bacterial and morphological indexes, multidrug therapy was being given at either a clinic or, if not possible, at their homes by experienced field workers under supervision. Recommendations are made for improving urban leprosy control work in general and for case holding in particular.

Adolescent↗

PubMed1984

Minimal requirements for planning control projects.

The different life cycles of trematodes causing the snail-transmitted infections, the complex interactions of the numerous groups of variables representing the five major areas of the epidemiology - human prevalence, incidence and intensity rates, parasite strains, intermediate hosts, ecological backgrounds and human behavioural factors - all combine to render control projects both area and parasite specific. Control must never be equated with eradication which is the complete and permanent cessation of transmission - and rarely, if ever, achievable. In medical and epidemiological terms, control means reduction of morbidity and mortality. Minimum requirements common to efficient planning for any control projects are: a community awareness of the problem; a community expression for the need of control; pathological, statistical and socio-economic evidence of morbidity/mortality produced and the associated economic loss to area, region or country, medical interest and governmental commitment to action as a priority in health policies; appropriate, simple, yet adequate diagnostic technology; appropriate control tools, which, for this group of infections, will rely heavily on population-based chemotherapy; a cadre of trained technicians, field workers and health educators; a programme for training trainers; a delivery system which can be used as an entry point to other health improvements, e.g. sanitation, nutrition, family planning; baseline demographic and epidemiologic information, a pre-tested system of data recording, collection, reduction and analysis; and, finally, funding support. These factors will be discussed.

Anthelmintics↗

PubMed1983

Plants with potential to enhance significant tumor growth.

Of 20,000 plant extracts submitted to the National Cancer Institute antitumor screens from 1960 to 1980, over 95% exhibited inadequate tumor-inhibiting activity or promoted tumor growth. Of these, 50 extracts representing 42 species showed significant levels of tumor growth enhancement compared to controls on the basis of tumor weights when the extracts were administered to test and control animals dosed equally on the basis of implanted tumor weights. Because of the continuing threat of environmentally induced or promoted cancer in the human population, the species identified in this report are deemed worthy of studies designed to quantitate the risks of contact by botanists, hikers, plant hobbyists, and field workers. Even more fundamental, studies of these plants could provide knowledge of new compounds under the influence of which tumor growth is enhanced. Further studies might also reveal the mechanisms of this tumor enhancement.

Animals↗

PubMed1983

A solvent extraction technique for the measurement of 222Rn at ambient air concentrations.

The high solubility of radon in cold organic solvents is exploited to extract radon directly from a sample air stream into a hexane-based liquid scintillation solution. Up to 10 l. of air is passed through 20 ml of solvent held at -78 degrees C in a bath of dry ice and acetone. The solvent is then transferred to an ordinary glass liquid scintillation vial that has been preloaded with 2 ml of concentrated fluors. A large number of samples can be prepared in a short time with minimal equipment, making it possible for field workers to conveniently collect numerous samples prior to returning to the laboratory. After allowing an interval of at least 3 hr after processing for radon daughter ingrowth, the vials are counted on an unmodified liquid scintillation system with a narrow window set around the radon and polonium alpha peaks. The large sample volume more than compensates for the relatively high alpha background of liquid scintillators. Relevant theoretical considerations and alternate sampling strategies are discussed.

Air↗

PubMed1981

Rheumatic fever and rheumatic heart disease in rural South Indian children.

A preliminary pilot study of streptococcal infection and sequelae was initiated in 23 villages in 1973 using trained field workers for case detection. Part of the pilot programme, in 1974-75, involved 374 rural and 664 urban schoolchildren, and revealed that 14.9% of them had streptococcal pyoderma while pharyngitis was seen in 4.2%. The pilot study also revealed a high prevalence of rheumatic fever (RF) and rheumatic heart disease (RHD) in both rural (5.4/1000) and urban (6.0/1000) pupils. A long-term surveillance study was then undertaken in 3890 pupils attending 15 rural schools, from July 1975 to December 1978, when the prevalence of RF was found to be 0.5/1000 and of RHD, 4.4/1000, giving an overall rate of 4.9/1000. The incidence rate was found to be 1.7/1000 per year in 1976, 1.6/1000 per year in 1977, and 0 in 1978. The rate of compliance with primary prophylaxis was 90-100%, and with secondary prophylaxis was 92-93% of the 27 cases.

Adolescent↗

PubMed1982

The logistics of dietary surveys.

This paper discusses where time goes in the practical conduct of dietary surveys. Examples of recent surveys provide guidance on the number of dietary records that can be collected. These range from 1.3 to 16.8 dietary records per full-time field worker per week averaged over the total duration of the study. Factors particularly influencing these numbers include: the number of interviews needed to collect each record, whether the subjects are visited at home or seen in a central place, whether the survey is cross sectional or longitudinal, the number of days on each record, the complexity of the eating patterns, whether food tables require expanding with additional items and the amount of work needed to collect the information on composition and weights of foods necessary for the interpretation and coding of the diet records.

Child↗

PubMed1982

An observational study of DDT house spraying in a rural area of Thailand.

The study investigated factors affecting public co-operation in DDT house spraying which is the most important malaria control measure in Thailand. A spraying round in a rural village in an eastern province was observed by two field workers disguised as members of the DDT spraying team. Emphasis was placed on the operational practices of spraying teams and their interactions with the villagers whose houses were to sprayed with insecticides. Villagers' unco-operative attitude to their perception of insecticides as a danger to the health of children, pregnant women and domestic animals, and unsightliness caused by whitish DDT deposits on the house walls. To some extent, lack of knowledge or disbelief in the benefit of DDT house spraying also precipitated non-co-operation. The effects of these inhibiting factors varied with villagers' socioeconomic status. More importantly, the study revealed defects in the management and supervision of the spraying operation as possible causes of low coverage of DDT house spray. Lack of health education efforts in the conduct of the spraying operation and the failures of spraymen to develop good relations with the community contributed further to the villagers' limited co-operation. The success of insecticide house spraying as a malaria control measure depends on the community as well as the malaria workers.

Attitude↗

PubMed1980

[Bird mortality and monitoring the environment (author's transl)].

Birds are useful parameters in studying toxicological contamination of the environment. Birds can be heard and seen, breeding results and feeding patterns being recorded on a rather extensive scale in the Netherlands. Since 1974, a working party was constituted to study normal and abnormal death of birds. This group consists of members of ornithological and veterinary institutes as well as local field workers, bird revalidation centres and bird preservation and protection groups. In 1979, approximately 2,000 birds were available for post-mortem and bacteriological, virological and toxicological studies. The cases of poisoning were classified into acute and chronic, accidental and crop-protecting effects. In the Laboratory of the Central Veterinary Institute, Poultry Department, the birds suspected of poisoning are screened by a biological-toxicological standard method using Lebistes and Daphnia. Pseudo-poisoning is caused in nature by Pasteurellosis, accidents, etc. Investigations are restricted by predation, the likelihood of finding of dead birds and retention of dead birds of prey for taxidermy. Acute poisoning in the Netherlands is mostly associated with protection of crops, nuisance caused by pigeons and other birds in gardens. Some cases of poisoning are due to quarrels between neighbours and people who poison game-birds out of revenge. Chronic poisoning is caused by metals such as lead pellets from cartridges. Chronic and acute poisoning continue to occur as a result of illegal use of prohibited insecticides.

Animals↗

PubMedDate not supplied

Factors inhibiting the use of reversible contraceptive methods in rural south India.

In two rural districts in South India, the contraceptive prevalence rate for all modern family planning methods was 41 percent, and that for all reversible methods was only about 2 percent in 1990. Interviews with 35 health program professionals, 815 currently married women of reproductive age, 136 of their husbands, and 60 community leaders revealed that neither the demand for reversible methods nor the supply of services was strong in the study areas. Program managers and field-workers were not popularizing reversible methods, and therefore couples were unable to learn about their benefits. According to the authors, a strong commitment from program managers at all levels is needed to increase reversible-method use, and adequate services should be made available at clinics and in villages.

Adolescent↗

PubMed1994

Quality evaluation in the management of child sponsorship programmes.

Programme evaluation tactics for child sponsorship programmes have historically concentrated on quantitative analysis of service units, amount of money invested, number of countries served, the number of projects, and number of children in each project. While these are valuable measures of programme variables, they do not assess the impact of programmes on the lives of the children sponsored. Outcome measures designed to assess programme impact add greatly to the information available to child welfare professionals. This study collected data about the impact of the programme on the lives of the children. The Child Welfare League's Child Well-Being Scales (CWBS) were used to assess programme impact. Twelve scales were chosen as directly related in type to the programmes administered by Children International, a traditional and well established child sponsorship organization located in Kansas City, Missouri. A thirteenth scale was suggested by field workers in India as particularly relevant to Third World populations. The scales were translated into languages appropriate to each population in the programme countries. Social workers in each country were trained to administer and score them. This analysis used the emerging data technology becoming available to programmes in Third World countries. The system enables administrators in the Third World to evaluate, enhance and summarize their programmes in a way understandable across borders. Epi Info (Dean et al., 1990) was customized to provide the framework for the analysis. The population for this study was selected by a 5% random sampling of children currently enrolled as sponsored children (180,000+ worldwide). These were compared with a waiting-list control group selected randomly from lists of children who have applied for sponsorship but have not yet been receiving services (n = 50 from each project).(ABSTRACT TRUNCATED AT 250 WORDS)

Charities↗