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PubMed2003

Diseases of free-ranging chickens in the Qwa-Qwa District of the northeastern Free State province of South Africa.

A total of 177 free-ranging chickens from 19 Qwa-Qwa villages were bled from wing veins over a period of 6 months (June-November 2000). Serological tests indicated that 5% of chickens tested had been exposed to Newcastle disease, 43% to infectious bronchitis and 63% to Mycoplasma gallisepticum infection. McMaster and Visser sieve techniques were used to determine helminth and coccidia from pooled fresh faecal samples. Helminths isolated in 37% of the villages investigated were Heterakis, Ascaridia and Capillaria species. Eimeria species were also isolated in 32% of the villages investigated. The red fowl mite (Dermanyssus gallinae) was isolated from some of the birds and their nests. Data from a questionnaire survey indicated that all farmers interviewed had never received any technical support and that their chickens had never been vaccinated against any avian diseases. Only 10.5% of the owners interviewed had scientific knowledge on poultry diseases. There is an urgent need for the government to support free-ranging poultry farmers by providing subsidised vaccinations and technical support in order to develop and stimulate economic development in impoverished rural areas of South Africa.

Animals↗
PubMed2000

Scurvy in an unrepentant carnivore.

For centuries, scurvy, or vitamin C deficiency, decimated crews of sailing ships on long sea voyages and populations deprived of fresh fruits and vegetables during times of war or famine. Today, scurvy is extremely rare in the United States, and its classic findings of perifollicular petechiae, edema and purpura of the lower extremities, corkscrew hairs, and hemorrhagic gingivitis may go unrecognized. We report the case of a man from rural Appalachia who developed typical signs and symptoms of scurvy on two separate occasions, approximately 2 years apart. Both times, the patient underwent an extensive work-up and was diagnosed with numerous other conditions before his vitamin C deficiency was recognized. We discuss the clinical presentation, pathophysiology, diagnosis, and treatment of scurvy, with attention to specific findings that should alert the clinician to this diagnosis.

Biopsy↗
PubMedDate not supplied

The effect of introduction of minimal standards of neonatal care on in-hospital mortality.

A retrospective study was done to assess the effect on in-hospital neonatal mortality of a series of interventions in neonatal care in the highlands of Papua New Guinea. Between 1995 and 1997, prior to the interventions, the mortality among neonates admitted to the Goroka Hospital Special Care Nursery was 18% and two-thirds of very low birthweight (1-1.5 kg) neonates died. The interventions began in December 1997 and were aimed at reducing mortality among all neonates and particularly among those with very low birthweight. Compared to the 30-month period prior to the interventions, the in-hospital neonatal mortality in the 30-month period after the interventions began was 44% lower (relative risk (RR) 0.56, 95% confidence interval (CI) 0.45-0.69). After adjustment for a higher number of neonates <1500 g in the pre-intervention period, the relative risk was 0.59 (0.48-0.74). The mortality in the intervention phase for very low birthweight babies was 56% lower (RR 0.44, 95% CI 0.30-0.65) and for moderate low birthweight (1.5-2 kg) 50% lower (RR 0.50, 95% CI 0.28-0.90). Mortality was also significantly lower in the intervention phase in neonates with a diagnosis of septicaemia or pneumonia (RR 0.36, 95% CI 0.19-0.67), but there were no differences in mortality from birth asphyxia, meconium aspiration or extremely low birthweight (<1 kg). We estimate that in the 30 months after beginning the interventions 82 neonatal deaths that would previously have occurred were avoided. The costs of the improvements in technology described are estimated at US$445 (K1000) per life saved, but substantial training and improved supervision of staff and other human factors may have been more important than equipment. Apnoea monitors were the single most important technology introduced. A similar evaluation of the effect of minimal standards should be done without the use of incubators and overhead heaters, as these are costly and may be dangerous when used by less experienced operators. The 33 neonatal deaths that we estimate were avoided each year because of the interventions represent less than 10% of all neonatal deaths in the province. Although this study provides justification for increasing the technology for supportive neonatal care and training in medium-sized hospitals in rural areas in developing countries, estimates of cost-effectiveness must be compared with other interventions that will effectively lower neonatal mortality, both in and out of hospitals.

Clinical Protocols↗
PubMedDate not supplied

[The structural and functional changes in therapeutic-preventive services rendered to the population of the Russian Federation in the recent decade].

The article contains the results of a comprehensive analysis of the functional transformations and of the efficiency of the system of therapeutic-and-preventive aid in the Russian Federation during the 90-ies. It is pointed out that the below parameters in the activity of health care institutions have essentially improved during the recent years: days during which the hospital beds are occupied per year, an average duration of treatment, turn-over of hospital beds, and number of visits to the doctor per one citizen. The number of surgical interventions, made in out-patients' clinics, and the scope of activity of day-time hospitals have increased. At the same time, the reduction of the network and activity of therapeutic-and-preventive institutions (TPI) has been primarily taken place in rural areas; the development of the outpatient surgery has been accompanied by an increasing number of surgeries in hospitals; the quantity of hospitalizations and the absolute number of hospitalized patients have been growing during the recent 4 years (1998-2001). The networks of medical rehabilitation institutions and of nurse care are poorly developed, and the share of beds for such networks is insufficient. The TPI staff, which is not replaced by physical persons, has been increasing; the provision of population with doctors remains high, while the number of paramedical personnel has been decreasing; and the coefficient of jobs-combining has been increasing.

Efficiency, Organizational↗
PubMed1953

Observations on brucellosis due to Brucella melitensis.

A special study was made of the problem of brucellosis due to Brucella melitensis in visits to Mexico City in 1948, to the FAO/WHO Brucellosis Centres at Montpellier (France), Florence (Italy), and Rijeka (Yugoslavia) in 1951, and to Spain in 1952. Br. melitensis infection in human beings causes more severe illness than Br. abortus infection. It develops primarily in rural communities living in close contact with goats and sheep; cattle and swine may also harbour the infection.In diagnosis, the agglutination test has proved the most satisfactory procedure; testing would be more uniformly reliable if a single antigen were used. Lack of funds and technical assistance have in many instances limited the bacteriological studies upon which a more definitive diagnosis of brucellosis depends.Antibiotics, Brucella vaccines, and colloidal preparations of gold and silver-used separately and in combination-have proved of varying therapeutic value, although response to antibiotics is less favourable than in cases of Br. abortus infection.While the drastic measures-involving the slaughter of about 10,000 sheep-taken in Slovenia, Yugoslavia, in the late 1940's, against an outbreak of brucellosis, is an inspiring example of how the disease can be eradicated, the removal of all diseased animals is rarely feasible economically. It is hoped that future research will reveal a practicable alternative in the immunization of sheep and goats against the disease.

Animals↗
PubMed1992

Which way for housing and human settlements?

In order to clarify the housing and settlements component of the European health-for-all programme and to identify perceived priorities with a view to the preparation of training materials, members of WHO's Rural and Urban Development and Housing Network were invited to complete a questionnaire. The results are reported below. The questionnaire can be used in identifying local development priorities, comparing attitudes, and studying perceived needs. Intended as a tool for policy-makers, course organizers and public health professionals, it is available from the authors of the present article.

City Planning↗
PubMed2005

Home water treatment by direct filtration with natural coagulant.

Seeds of the plant species Strychnos potatorum and Moringa oleifera contain natural polyelectrolytes which can be used as coagulants to clarify turbid waters. In laboratory tests, direct filtration of a turbid surface water (turbidity 15-25 NTU, heterotrophic bacteria 280-500 cfu ml(-1), and fecal coliforms 280-500 MPN 100 ml(-1)), with seeds of S. potatorum or M. oleifera as coagulant, produced a substantial improvement in its aesthetic and microbiological quality (turbidity 0.3-1.5 NTU, heterotrophic bacteria 5-20 cfu ml(-1) and fecal coliforms 5-10 MPN 100 ml(-1)). The method appears suitable for home water treatment in rural areas of developing countries. These natural coagulants produce a 'low risk' water; however, additional disinfection or boiling should be practised during localised outbreaks/epidemics of enteric infections.

Bacteria↗
PubMed2005

Contribution of Geographic Information Systems and location models to planning of wastewater systems.

This paper presents the contributions of Geographic Information Systems (GIS) and location models towards planning regional wastewater systems (sewers and wastewater treatment plants) serving small agglomerations, i.e. agglomerations with less than 2,000 inhabitants. The main goal was to develop a decision support tool for tracing and locating regional wastewater systems. The main results of the model are expressed in terms of number, capacity and location of Wastewater Treatment Plants (WWTP) and the length of main sewers. The decision process concerning the location and capacity of wastewater systems has a number of parameters that can be optimized. These parameters include the total sewer length and number, capacity and location of WWTP. The optimization of parameters should lead to the minimization of construction and operation costs of the integrated system. Location models have been considered as tools for decision support, mainly when a geo-referenced database can be used. In these cases, the GIS may represent an important role for the analysis of data and results especially in the preliminary stage of planning and design. After selecting the spatial location model and the heuristics, two greedy algorithms were implemented in Visual Basic for Applications on the ArcGIS software environment. To illustrate the application of these algorithms a case study was developed, in a rural area located in the central part of Portugal.

Algorithms↗
PubMed2005

Computing TaqMan probes for multiplex PCR detection of E. coli O157 serotypes in water.

Diarrheagenic E. coli strains contribute to water related diseases in urban and rural environment in developing and developed world. E. coli pathotype and pathogenicity varies due to complex multifactorial mechanism involving a large number of virulence factors. Rapid assessment of the virulence pattern of E. coli isolates is possible by Real-Time PCR probes like TaqMan. For designing TaqMan probes and primers for multiplex PCR selected E. coli gene sequences: stx1, stx2, hlyA, chuA, eae, lacZ, lamB and fimA were retrieved from NCBI's GenBank database. The alignment of the multiple sequences and analysis of conserved sequences was carried out using ClustalW and BLAST programs. The primers and Taqmen probes were designed using Beacon Designer software version 2.1 for two multiplexed PCR assays. In silico PCR simulation of these assays showed PCR products for stx2 (248bp) stx1 (102 bp), lacZ (228bp) and lamB (86 bp) in multiplex #1 and eae (200bp), chuA (147 bp), hlyA (141bp) and fimA (79 bp) in multiplex #2, respectively. These multiplexed PCR amplification products and probes can be used to identify and confirm presence of O157:H7/ H7-, O157:H43/45 and O26:H-/H11 serotypes. In conclusion, multiplex Real-Time Polymerase Chain Reaction oligomers and TaqMan probes designed and validated in silico will be helpful in management of water quality and outbreaks, by improving specificity and minimizing time needed for in vitro verification work.

Base Sequence↗
PubMedDate not supplied

A global research agenda for leptospirosis.

Leptospirosis is a zoonotic spirochetal disease of global importance. This disease continues to have a major impact on people living in urban and rural areas of developing countries with inestimable morbidity and mortality. Funding for research and control efforts is currently haphazard, not organized and not effective for public health efforts, primarily because there are no concerted, ongoing international efforts to assess the impact of leptospirosis on human health. Major issues in the field need to be addressed to develop strategies of control, amelioration and treatment. These include the following: mechanisms of naturally acquired and vaccine-induced protective immunity against clinical leptospirosis; mechanisms of severe leptospirosis pathogenesis; standardized, precise and simplified taxonomy of Leptospira relevant to disease manifestations, transmission and control; effective adjunct treatments in addition to antimicrobials; and environmental assessment for risk of leptospirosis transmission and relevant mammalian reservoirs. Once effective ongoing, collaborative international efforts to assess the impact of leptospirosis on human and veterinary health are underway, appropriate mobilization of clinical and public health research funding will follow.

Humans↗
PubMed2006

Prevalence of asthma and allergic diseases in Sanliurfa, Turkey, and the relation to environmental and socioeconomic factors: is the hygiene hypothesis enough?

BACKGROUND: The prevalence of asthma and allergic diseases has been reported to be higher in urban than in rural areas between developed and underdeveloped countries and within any given country. Studies in Turkey have yielded different results for different regions. This study aimed to investigate the prevalence of asthma and atopy in Sanliurfa, Turkey, and the influence of environmental factors. MATERIALS AND METHODS: We recruited 1108 children from different areas of Sanliurfa and administered the questionnaire of the International Study of Asthma and Allergies in Childhood. Items asking for socioeconomic data were also included. Skin prick and purified protein derivative tests were performed on the children. Measles antibodies were determined and feces were analyzed for parasites. RESULTS: The total prevalence of atopic diseases was 8.6% (n = 95/1108), asthma 1.9% (n=21/1108), allergic rhinitis 2.9% (n=32/1108), and allergic conjunctivitis 3.8% (n=42/1108). The rate of atopic diseases was 5.6% (n=32/573) in children attending schools in peripheral, less urban, slum areas while it was 11.8% (n=63/535) in those attending city-center schools (OR, 2.2; 95% confidence interval [CI]; 1.4-3.5; P<.001). Skin prick test positivity was observed in 3.9% (n=43/1108) overall; at schools in slum areas it was 1.9% (n=11/573), whereas at central schools the rate was 6% (n=32/535) (OR, 4.08; 95% CI, 2.03-8.20; P<.001). The prevalence of asthma and atopic diseases was significantly higher in children who have a family history of atopy, attend a central school, live in an apartment, have more rooms in their homes, and enjoy better economic conditions. CONCLUSION: We found associations between various factors suggested by the hygiene hypothesis and asthma, and very low rates of prevalence of asthma and atopic diseases both in Sanliurfa in comparison with the more developed western regions and in the peripheral slum areas. The hygiene hypothesis is helpful in explaining these observations.

Adolescent↗
PubMed1989

[Application of solar disinfection to drinking water in tropical regions].

Since unsafe water elicits a broad spectrum of bacteriological, parasitological and virological diseases, purification of polluted drinking water has to be developed in tropical rural regions. Around 70% of rural wells and 7% of bore-holes contain water unsafe for human consumption. Water is also contaminated during transport and storage. Several techniques of purification have been recommended to protect drinking water. Recently, sterilisation in the U. V. or simply in the sun rays has been systematically tested. In tropical rural areas, solar disinfection has given questionable results. It affords no guarantee for the health of the consumer in contrast with other techniques as chlorination.

Communicable Disease Control↗
PubMed1987

[Strife between the dispensing physician and the pharmacist--a historical overview. II. 1840-1928].

The professional interaction between physicians and the pharmaceutical profession in South Africa in the years 1840-1928 is reviewed. The years 1840-1880 were characterised by relatively peaceful coexistence in metropolitan areas, but rather unorthodox developments in outlying rural areas. Here physicians found it difficult to make a living due to fierce competition from medicine-selling traders, self-medicating farming communities and apothecaries allowed to practise as clinicians (even appointed as district surgeons). The establishment of professional and statutory organisations and the promulgation of appropriate health legislation brought stability to the health scene but failed to remove friction between dispensing doctors and pharmacists. After the unification of South Africa in 1910, the two professions co-operated in fits and starts towards the ultimate formulation of the Medical Dental and Pharmacy Act of 1928. The rise of the pharmaceutical manufacturing industry brought a new perspective to the retail pharmacist's professional role.

History, 19th Century↗
PubMed1987

Recording of birth weight in a primary health care setting in India.

The feasibility of recording birth weights in two community development blocks in rural areas was tested for general application of the procedure in a Primary Health Care setting. During the four year study period, the birth weights were recorded in 1,919 babies in one block and 1,596 in the other with a success rate of 98%. Although the incidence was 22% in block A and 34% in block B, the mean birth weights were statistically similar (p = greater than 0.05). The mean birth weights and the weight ranges recorded by research staff and PHC workers were comparable. The adoption of a simple, technically feasible, inexpensive, culturally acceptable technique which is suitable for local conditions is recommended. This should be accomplished in a step-wise manner.

Attitude to Health↗
PubMed1984

Socio-economic and cultural aspects of human trematode infections in Korea.

Liver, lung and intestinal trematode infections in Korea are a public health problem, as 3 to 4 million individuals appear to be infected. Corresponding with recently developed and established strategies to control the major endemic trematode infections, also a country specific national control project in Korea is being considered. It concerns the three human trematode infections prevalent in this country, namely clonorchiasis, paragonimiasis and metagonimiasis. In addition to chemotherapy, approaches based on local conditions may be included in such strategies in order to achieve the best possible results. The present paper tries to identify the human socio-economic and cultural factors traditionally involved in the transmission of these trematode infections in Korea. It also describes the changes of patterns of agricultural practices and general environmental modifications that have been achieved by the socio-economic development even in rural communities as concerns the transmission of these parasitic infections. Based on these behavioural and environmental factors, the prevalence of these infections decreased even without any application of mass chemotherapy. Consequently, it can be expected that further health educational and mass chemotherapy programmes will drastically reduce transmission. Cooperation of communities involved will certainly contribute to making control measures a success.

Agriculture↗
PubMed1983

Major nutritional problems of children in Nigeria and possible solutions--Anambra State experience.

Seventeen towns in Anambra State, Nigeria were investigated with a view of identifying some of the existing nutritional problems of children in Nigeria. Information on nutritional status and demographic data were obtained by visiting the primary schools, maternity homes and the child welfare centres. House to house visits were also made. A total of 3406 children (0-17 years) were seen. Analysis of data revealed among other things, a high incidence of malnutrition as judged by weight for age measurements according to the Harvard Standard Values. Thirty per cent of the 3-year olds and 20% of the older girls and boys were severely malnourished. Poor earning power, poor management of money, food and poor methods of food preparation and high cost of foods were major causes of malnutrition in urban and rural areas. Economic development had in general led to an improvement in nutrition, but reliance on the economic growth in Anambra State however, would not significantly cut the very great differences in the standard of living. Many malnourished children came from the poorest sectors of the society which are likely to benefit only slowly from an increase in the average standard of living. A more realistic approach may be gradual introduction (from a few schools) of free school milk with snack or hot school lunch programmes in Anambra State.

Adolescent↗
PubMedDate not supplied

[Bases for control of arthropod vectors: II--Present means (author's transl)].

A review of the present means of control of arthropod vectors in which the authors consider:--individual means aimed at the prevention of bites by utilizing clothes, repellents, mosquito nets and insecticide sprays,--collective means which are either physical, biological or chemical. Physical means are specially used for water control either in "peridomestic actions" or in large scale campaign's related to rural or industrial development scheme. Actually biological means are represented only by larvivorous fishes. The chemical control is the most important, its various requisites, and techniques are given.

Animals↗
PubMed1993

Response of hemophilia A with bleeding to fresh dry plasma.

Fresh dry plasma (FDP) is a lyophilized form of fresh frozen plasma (FFP) which can be stored at 4 degrees C for one year. One bottle of FDP is prepared from 220 ml of FFP and contains FVIII: C 0.75 +/- 0.3 U/ml (mean +/- 1 SD). This study describes the clinical and laboratory response in 7 severe and 4 moderate hemophilia A patients. The age ranged from 7-17 years (mean +/- SD = 11.7 +/- 2.9 years). Either 12.4 ml/kg. FDP or 12.2 ml/kg FFP was transfused to the patients when they had bleeding episodes such as hemarthrosis, hematoma. 16 episodes of FDP and 12 episodes of FFP transfusion were studied. The bleeding could be effectively controlled by FDP or FFP except one patient who had physical therapy at 8 hours post FDP transfusion. The increment of FVIII:C was 14.1 +/- 5.3% at 30 minutes after FDP transfusion and 12.1 +/- 3.7% at 30 minutes after FFP transfusion. The recovery rate was 83.2 +/- 32.6% in FDP and 65.3 +/- 22.7% in FFP transfusion. The FVIII:C was decreased to 78.9 +/- 12.3%, 55.6 +/- 13% and 16.3% of the initial level at 2, 8, 24 hours after FDP transfusion respectively which were not statistically significantly different from FFP transfusion. No serious complication was found. FDP will replace FFP for the treatment of coagulation disorders such as hemophilia A. It is an useful alternative therapy which can be provided to the hemophiliac patients in the rural area in developing countries.

Adolescent↗