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At least 55 records · Page 3Linked to original sources
PubMed1998

Lead poisoning of children in Africa, IV: Exposure to dust lead in primary schools in south-central Durban, South Africa.

Twenty primary schools in three areas (Merebank, Austerville and Bluff) of south-central Durban, South Africa were studied to determine if dust lead loading (microgram/m2) is high enough to constitute a risk to children. Atmospheric lead fallout rates in the schools varied from 9 to 264 micrograms/m2 per day and were higher than the values now being reported in the developed countries. Mean outside dust lead loadings were 425 micrograms/m2 in Merebank, 771 micrograms/m2 in Austerville and 1174 micrograms/m2 in Bluff areas, and 25% of the primary schools were found to have mean outside dust lead loading above 1000 micrograms/m2. Mean dust lead loadings inside classrooms were 2-4 times lower than the outside rates, and showed no significant difference among schools in the three areas. Dust lead loadings were correlated with lead concentrations in dust but not with distance from the highway or with atmospheric lead deposition rates. Exposure to dust lead in classrooms and in the school yard is considered to be an important contributor to blood lead levels in, and hence a potential health hazard to, children in many urban areas of the city.

Africa↗
PubMed2006

Dental caries trends in 5- to 6-year-old and 11- to 13-year-old children in three UNICEF designated regions--Sub Saharan Africa, Middle East and North Africa, Latin America and Caribbean: 1970-2004.

AIM: The aim of the study was to investigate trends in dental caries prevalence and severity in three developing regions of the world over 35 years. DESIGN: A systematic review of published information. METHODS: Online databases were used to find 130 caries epidemiological studies that used WHO caries diagnostic criteria, published between 1970 and 2004 among 5- to 6-year-old and 11- to 13-year-old children. Mean caries rates were calculated in seven 5-year periods followed by plotting, and analysis of co-variance (region, period). RESULTS: Trends in mean prevalence and mean dmft among 5- to 6-year-olds were confusing but among 11- to 13-year-olds were clearer. Both mean prevalence and mean DMFT were lowest in Sub-Saharan Africa and highest in Latin America and the Caribbean. Rates decreased with time in Latin America and the Caribbean and remained more or less static in the other two regions. Analysis of covariance showed a significant effect of region (P<0.01) for mean prevalence at 5- to 6-years. For mean prevalence at 11-to 13-years, as well as mean dmft and DMFT in both age groupings there were significant effects of region (P=0.01 to <0.0001) and period (P<0.05 to <0.0001). CONCLUSIONS: The common perception that dental caries rates are increasing in developing countries was not supported in this systematic review.

Adolescent↗
PubMed2001

1998 survey of cardiac pacing in South Africa--report of the working group on registries of the cardiac arrhythmia society of South Africa (CASSA).

BACKGROUND: Permanent pacemakers provide effective relief of symptoms and are life-saving in patients with symptomatic heart block. Since pacemakers are only implanted by cardiologists or cardiothoracic surgeons in tertiary hospitals, the rates of pacemaker implantation provide a readily auditable measure of tertiary health care. METHODS: A survey was conducted of pacemaker implantation in South Africa in 1998, using questionnaires completed by implanters and information on the total number of pacemakers sold during the period, supplied by pacemaker distributors. RESULTS: A total of 1,643 new pacemakers were implanted in 1998 by 112 doctors working in 31 institutions (9 public and 22 private). The annual implant rate per million population was 39, compared with 31/million in 1995, an increase of 25.8%. Public hospitals accounted for 31.7% of primary pacemaker implants in 1998 as opposed to 37% in 1995. Practice in the public sector differed from that in the private sector in that atrioventricular (AV) block was the major indication for pacing in 75.3% versus 45.3%, whereas sinus node dysfunction accounted for 34.9% of private patients, as opposed to 16.2% of public hospital patients. Simple VVI single-chamber pacemakers accounted for 49.5% of public hospital implants versus only 9.6% in private patients. The reverse was true for dual-chamber implants (12.1% v. 42.3%). Severe cost constraints in the public sector have resulted in increasing use of cheaper single-chamber pacemakers for more stringent indications (predominantly AV block). The overall implant rate remains low compared with a median of 283/million in Europe. Large discrepancies persist between race groups (232/million whites, as opposed to 8.8/million blacks) and regions (89.3/million in the Western Cape versus 10.8/million in the four provinces without pacemaker implanters). CONCLUSION: It is likely that socio-economic factors play a major role in the unequal distribution of this highly effective treatment for potentially lethal bradyarrhythmias. The changing trends in pacemaker implantations indicate a shift of tertiary health care resources from the public to the private sectors.

Data Collection↗
PubMedDate not supplied

Aspects of tuberculosis in Africa. 1. Tuberculosis in Africa in the AIDS era--the role of chemoprophylaxis.

An estimated 2.8 million people in Africa have dual infections with tuberculosis and human immunodeficiency virus (HIV). Because of the increasing numbers of cases of tuberculosis as a consequence of the HIV epidemic, chemoprophylaxis may become a cost effective tuberculosis control measure in high prevalence countries. Although isoniazid (INH) is the only drug evaluated in controlled trials of preventive tuberculosis therapy, studies are now under way to determine the efficacy of INH and other drugs, including rifampicin and pyrazinamide, in preventing tuberculosis reactivation in persons with HIV infection. If chemoprophylaxis is effective in persons with dual infection, further studies will be required to determine whether chemoprophylaxis is cost effective for tuberculosis prevention and control and whether it is feasible to introduce it as a community control measure.

Africa↗
PubMed1997

Lead poisoning of children in Africa, II. Kwazulu/Natal, South Africa.

The prevalence of elevated blood lead (PbB) levels in rural and semi-urban areas of Kwazulu/Natal (KZN) as well as the risk factors for elevation of PbB among children in informal settlements are examined. The study involved over 1200 children in two age groups: 3-5 and 8-10 years old. Average PbB level in Besters, an informal settlement in the Durban metropolitan region, was 10 micrograms/dl with 5% of the children showing PbB level of greater than 25 micrograms/dl. By comparison, average PbB value in Vulamehlo, a rural area located 90-120 km from Durban, was 3.8 micrograms/dl and 2% of the PbB was greater than 10 micrograms/dl. The results show that many children in KZN are at risk of being lead poisoned. Household factors that were significantly associated with PbB levels in children included distance from tarred roads, overcrowding, hygienic habits in the household and the burning of solid wastes for heating or cooking. Lack of significant association with child risk behaviors is attributed to the over-riding influence of high levels of contaminated dusts both indoor and outdoor. With recent introduction of unleaded gasoline in South Africa, a number of unique socio-ecological factors are expected to slow the change in PbB levels of children in some townships.

Child↗
PubMed2002

Physical inactivity is the major determinant of obesity in black women in the North West Province, South Africa: the THUSA study. Transition and Health During Urbanisation of South Africa.

OBJECTIVE: We investigated the association between measures and determinants of obesity in African women. METHODS: For a cross-sectional study of adult black women in the North West Province, South Africa, we used a stratified sample of 1040 volunteers from 37 randomly selected sites in the province according to the level of urbanization. We analyzed the association between measures of obesity, namely body mass index (BMI), waist circumference, waist-to-hip ratio, triceps and subscapular skinfolds, and socioeconomic factors, dietary intakes, and physical activity. RESULTS: The rate of obesity (BMI > 30) in the sample was 28.6%. We found a significant positive association between household income and measures of obesity. After exclusion of underreporters and adjustments for age, smoking, and household income, we found significant positive correlations between total energy intake, fat intake, and BMI. Physical activity index (derived from a subset of 530 subjects) correlated negatively with BMI and waist circumference. Subjects in the highest third of physical activity were less likely to be obese (odds ratio-0.38, 95% confidence interval-0.22-0.66). CONCLUSIONS: Women with higher incomes and lower physical activity were at the greatest risk of increased BMI. Physical inactivity showed the strongest association with measures of obesity in this study.

Adolescent↗
PubMed1998

Is anterior chamber lens implantation after intracapsular cataract extraction safe in rural black patients in Africa? A pilot study in KwaZulu-Natal, South Africa.

PURPOSE: There are an estimated 16 million people blind from cataract world-wide. In many areas the routine operation is intracapsular cataract extraction (ICCE). The role of modern anterior chamber (AC) intraocular lenses (IOLs) is being explored, and they have been shown to be safe and successful in Asia. Are they equally safe in rural black African populations? METHODS: One hundred black patients aged 50 years and over who attended Edendale Hospital were enrolled in a pilot study of insertion of AC IOLs after ICCE. They were followed up for 6 months. RESULTS: With financial remuneration, the follow-up rate at 8 weeks increased from the usual 30% to 72%. At 6 months, 67% of eyes achieved a correlated visual acuity of 6/18 or better. Thirty per cent had persistent uveitis, 16% had peripheral anterior synechiae beyond the points of haptic contact, and 5% had an intraocular pressure greater than 21 mmHg. CONCLUSIONS: A randomised trial comparing ICCE with AC IOL and extracapsular cataract extraction with posterior chamber IOL is probably not justified at this time in this population. However, there may be wide variations in the reaction of the eyes of different African ethnic groups to IOLs. In view of the successful use of AC IOLs in Asian eyes, further pilot studies of AC IOLs may be warranted in other parts of Africa where ICCE is the routine procedure.

Black or African American↗
PubMedDate not supplied

The AcP polymorphism frequencies in the Mbugu and Sango of Central Africa. (Correlations between the Pr allele frequencies and some climatic factors in Africa).

This paper reports AcP frequencies in the Mbugu and Sango of Central Africa. Among 39 sub-Saharan populations, correlations between Pr allele frequencies and latitude, humidity and altitude indicate that AcP frequencies are significantly correlated with humidity, temperature and altitude. The first-order correlations (constant humidity) diminish by approximately 70% relative to the zero-order correlation.

Africa, Central↗
PubMed2003

Diabetes in Africa. Pathogenesis of type 1 and type 2 diabetes mellitus in sub-Saharan Africa: implications for transitional populations.

The increasing prevalence and incidence of diabetes and its long-term complications in sub-Saharan Africa (SSA) could have devastating human and economic toll if the trends remain unabated in the future. Approximately 90% or majority of patients with diabetes belongs to the adult onset, type 2 diabetes category while 10% have type 1 diabetes in SSA. However, because of the paucity of metabolic and clinical data, a clear understanding of the natural history of both diseases and the classification of diabetes subtypes has been hampered. Nevertheless, we have attempted to provide a concise review of the pathophysiology of both type 1 and type 2 diabetes as well as phenotypic and clinical variations in patients residing in SSA. The limited metabolic data, (albeit increasing), from high-risk and diabetic individuals in the SSA, have contributed significantly to the understanding of the pathogenetic mechanisms of diabetes and the variations in the presentation of the disease. Sub-Saharan African patients with type 1 diabetes have essentially absolute insulin deficiency. In addition, patients with type 2 diabetes in SSA region also manifest severe insulin deficiency with varying degrees of insulin resistance. Although the exact genetic markers of both diseases are unknown, we believe studies in patients of SSA origin who reside in diverse geographic environments (African diaspora) could potentially contribute to our understanding of the genetic and environmental mediators of both diseases. However, many intrinsic, individual and societal obstacles such as poor education and illiteracy, low socio-economic status and lack of access to health care make uncertain the translation of diabetes research in SSA. In this regard, effective management and/or prevention of diabetes in SSA individuals should adopt multidisciplinary approaches. Finally, innovative health care delivery and educational models will be needed to manage diabetes and its long-term complications in SSA.

Africa South of the Sahara↗
PubMed2003

Diabetes in Africa. Challenges to health care for diabetes in Africa.

The aim of this review is to summarize the contextual, clinical and health system challenges to the delivery of health care for diabetes in Africa. Planners need to allocate sufficient resources in a context where resources for health in general are insufficient. Choices need to be made between different options for health care within this context and mechanisms are required to facilitate the implementation of the selected options and ensure that quality of care is maintained.

Africa↗
PubMed1990

A methodology for resource allocation in health care for South Africa. Part II. The British experience and its relevance to South Africa.

This second article in the series on resource allocation in health care, argues for a formula-based method of resource allocation in South Africa. The model employed in England since 1976 and its application in a number of developed and developing countries is reviewed. The international experience is related to South African conditions and the principal elements necessary for a formula to achieve greater spatial equity in South African health-resource distribution are discussed.

Delivery of Health Care↗
PubMedDate not supplied

Leprosy treatment in Africa with the Flying Doctor Service of East Africa.

The Flying Doctor Service of East Africa and the African Medical and Research Foundation (AMREF) have been especially helpful in disseminating education along with associated primary and secondary health care to leprosy-affected regions of the Third World for over thirty years. Reconstructive surgery has helped leprosy victims both functionally and psychologically, reestablishing their courage and belief in the fact that this dreaded social stigma need not affect their ability to hold a job, maintain personal relationships and lead an otherwise normal life within the community.

Africa, Eastern↗
PubMed1978

A survey of obstetric anaesthesia in the Republic of South Africa and South West Africa.

In this report we analyse the results of a questionaire sent to 341 hospitals throughout the Republic and South West Africa, asking for details of their caesarean section rate and obstetric anesthetic techniques used. Non-specialist practitioners provided 90% of anaesthetic services in the 131 (38,4%) hospitals from which replies were received. General anaesthesia was used in preference to regional anaesthesia in 90% of these hospitals. Of the institutions surveyed, 24% used neither stomach emptying nor antacid therapy pre-operatively. These and other results pertaining to their choice of anaesthetic agents and techniques are presented and discussed.

Anesthesia, Conduction↗