[Ambulatory chemotherapy of tuberculosis patients under rural dispensary conditions].
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
To help determine the educational needs of both students and practitioners, an inventory of musculoskeletal and neurologic disorders was made of eight rural family practices for one year. Data on 54,043 patients representing 152,482 visits was put into an automated information system at the time care was received and coded by diagnosis. Computer listings provided the frequency of 372 diagnoses, the age distribution for diagnoses and the percent of total patients for each diagnosis. Physical medicine and rehabilitation (PM&R) conditions accounted for a minimum of 6.9% of the total visits and 11.7% of conditions that occurred individually in small numbers. PM&R conditions were fairly evenly distributed throughout all age ranges, indicating a need for education in both pediatric and adult areas. The breakdown of PM&R conditions by category provides valuable insight for future curriculum development.
OBJECTIVES: To assess the rapid plasma reagin (RPR) test performance in the field and to evaluate a new rapid syphilis test (RST) as a primary screen for syphilis. METHODS: 1325 women of reproductive age from rural communities in the Gambia were tested for syphilis seropositivity using a RPR 18 mm circle card and a RST strip. Within 1 week a repeat RPR and a TPHA test were carried out using standard techniques in the laboratory. RESULTS: Comparing field tests to a diagnosis of "active" syphilis defined as laboratory RPR and TPHA positive, the RPR test was 77.5% sensitive and 94.1% specific; the RST was 75.0% sensitive and 95.2% specific. The RST was easier to use and interpret than the RPR test especially where field conditions were difficult. In this setting with a low prevalence of syphilis in the community (3%), the chance of someone with a positive test being confirmed as having serologically active syphilis was less than 50% for both tests. CONCLUSIONS: The appropriateness of syphilis screening using RPR testing in antenatal clinics and health centres should be questioned if there is a low prevalence in the population, conditions for testing are poor, and resources limited. There is still an urgent need for an appropriate rapid syphilis test for field use.
BACKGROUND: Many skin diseases in developing countries are associated with socioeconomic factors. It is generally agreed that a public health approach to dermatology in this setting is particularly appropriate; but, there has been little epidemiologic research done to examine which particular socioeconomic factors are important determinants of the prevalence of skin disease. This is especially true in sub-Saharan Africa. METHODS: A survey of two villages in Ngara district, North West Tanzania, involved 254 randomly selected households using a questionnaire, measurements of houses and water quality, and examination of the skin of 1114 household members. RESULTS: Significant skin disease was encountered in 300 individuals (26.9%). Transmissible diseases comprised the bulk of skin disease (73.9%) with younger age groups being affected most. Socioeconomic conditions were poor, with low quality, crowded housing, low levels of literacy, unsatisfactory water sources, and few households with a regular cash income. Household density was significantly associated with transmissible skin disease. Other indicators of poverty (e.g., no regular cash income and illiteracy) did not correlate with the prevalence of skin disease. CONCLUSIONS: Skin disease as highly prevalent in the villages surveyed, especially transmissible diseases in the younger age groups. Household density was the only socioeconomic factor significantly associated with skin disease. Reduction of household density is an attainable intervention that could reduce the prevalence of skin disease in rural African populations. Simple studies like this one should be the first step in community dermatology, assessing the burden of skin disease in communities and looking for particular factors with which public health interventions could effectively reduce the prevalence of skin disease.
Non-compliance to correct dosing is thought to be one of the main causes of treatment failure of chloroquine in the home management of childhood malaria. There are few studies of compliance to drugs used for tropical diseases. In order to study compliance in the rural setting, chloroquine syrup was packaged with a novel pictorial insert for compliance to correct dosing. Compliance was assessed in a field trial in September 1996-December 1997, involving 632 children with uncomplicated malaria in Udi local government area in Nigeria. Written informed consent was obtained from mothers/guardians before children were enrolled in the study. There were 3 arms to the trial: control villages (group I) received chloroquine syrup without further intervention, group II received a pictorial insert with chloroquine syrup, and group III received chloroquine syrup, the pictorial insert and verbal instructions. Each group was made up of 3 health centres. Compliance was assessed by volumetric measurement of the chloroquine syrup left in 30-mL bottles and by questionnaires administered to mothers/helpers of the children. Control villages recorded full compliance for 36.5 +/- 4.4% of the children, group II for 51.9 +/- 7.9% and group III for 73.3 +/- 4.2%. There was a significant correlation (P < 0.0001) between full compliance, improvement and time for improvement of the condition. This study is deemed important because it focuses on children, who bear the greatest burden of malaria. It is unique for introducing a pictorial insert that illiterate villagers, who may not understand the use of age or weight in drug dispensing, may utilize as a substitute.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The purpose of this analysis is to increase understanding of how and why rural hospitals change, with an eye toward the relevance of these questions to overall access and quality in the rural community. This study reports the threats that precipitated three major classes of organizational change (specialization, conversion, and closure) in 16 rural hospital cases. The authors identify the types and levels of threat faced by the case hospitals and examine how different threat situations may lead toward different classes of change. Conversions and closures typically seem to result from moderate- or high-threat situations. Specializations seem to result from low- or moderate-threat situations.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.