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African governments are generally plagued with inadequate public health care systems, rapid population growth, low or negative economic growth rates, and shrinking government budgets. How to finance the expansion of health care and improve the quality of services in such a context is one of the most important issues they face. In Guinea-Bissau, the village health post is the most peripheral unit in the health care provider system, offering simple treatments and basic drugs. The system of care at that level is based upon community participation. Villagers provide the necessary materials and labor to build a standard two-room health post, and the government donates materials for windows, door, and hinges, plus simple equipment and an initial stock of drugs estimated to last for six months. The community collects funds to ensure that the initial drug supply is continuously replenished. One or more community members are selected and trained as volunteer village health workers (VHWs) or traditional birth attendants (TBA) in basic training which lasts 15 days, followed by annual 5-day refresher courses. VHWs are educated to treat malaria, diarrhea, conjunctivitis, cough, pain, and wounds, while TBAs are taught how to provide control and prophylaxis during pregnancy, and help in normal child deliveries. By early 1989, 449 units had been established, covering 20-25% of the population, but with large regional variation. This paper reports findings from a three-week field survey conducted in 1989 to gather information on this approach and its potential to mobilize additional resources for the health sector.
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PMID:Prepaid financing of primary health care in Guinea-Bissau: an assessment of 18 village health posts. 749 23

Acid anhydrides are low-molecular-weight chemicals known to cause respiratory irritancy and allergy. Skin allergy has on rare occasions been reported. 2 workers contracted hives and itching on uncovered skin after 2 months exposure to methyltetrahydrophthalic anhydride (MTHPA) and methylhexahydrophthalic anhydride (MHHPA), to which they had airborne exposure. Later, the patients also developed conjunctivitis, rhinitis, sore throat, cough or asthma. In addition to MTHPA, 1 worker was also exposed to unsaturated polyester resin (UP). Both patients' immediate allergy to MTHPA and MHHPA was verified by positive prick tests to MTHPA and MHHPA, conjugated with human serum albumin (HSA), and positive radioallergosorbent tests (RASTs) to these anhydrides. On prick testing, both patients also reacted to a phthalic anhydride (PA)-HSA-conjugate and 1 of the patients to UP-HSA-conjugate. Specific immediate allergy to UP was shown by RAST. RAST inhibition with MTHPA, MHHPA and UP-resin conjugates confirmed IgE-mediated allergy and cross-reactivity between anhydrides. Our patients had developed airborne contact urticaria caused by phthalic anhydrides, in addition to respiratory allergy. Phthalic anhydride contained in the UP resin was possibly responsible for the immediate reaction of the skin.
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PMID:Immunologic contact urticaria due to airborne methylhexahydrophthalic and methyltetrahydrophthalic anhydrides. 760 Jul 75

A study was undertaken to determine the extent of measles underreporting among preschool-age children. In two community surveys conducted in inner-city Los Angeles during 1990 and 1991, respondents were asked whether preschool-age children in their households had ever been ill with measles. Information about measles episodes was obtained and medical records were reviewed, when available. A probable measles case was defined as having 3 or more days of rash with fever of 38.3 degrees centigrade or greater, and either cough, coryza, or conjunctivitis. To determine the proportion of cases reported, probable measles cases identified were matched with measles cases reported to the Los Angeles County Department of Health Services. Of the 947 children ages 6 weeks through 59 months included in the surveys, 35 children had experienced an illness episode which met the probable measles case definition. Ten (29 percent) of the 35 probable measles cases were reported to the health department. Hospitals reported 9 (69 percent) of 13 probable measles cases evaluated while private physicians' offices reported 0 (0 percent) of 12 evaluated (Fisher's exact test, P < 0.001), although 5 children were seen by private physicians before rash onset. Reporting was more complete for cases occurring during 1990 and 1991 (33 percent) than from 1987 through 1989 (18 percent). The hospitalization rate for preschool-age children with probable measles cases in the catchment area was estimated to be 8 percent (95 percent confidence interval = 0 to 18 percent). Although measles is a serious communicable disease which is almost completely preventable, cases of it among preschool-age children in this high incidence area were substantially underreported,especially by private physicians. Due to reporting bias, reported measles cases were representative of more severe cases than all the cases that occurred.
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PMID:Measles reporting completeness during a community-wide epidemic in inner-city Los Angeles. 763 Sep 92

Many reports describe an increase in the incidence of allergies in recent years. Thus the epidemiological studies are necessary for efficacious prophylaxis. The aim of our study was to estimate the prevalence of allergic diseases in schoolchildren. Allergic rhinitis and/or conjunctivitis was observed in 16.7%. Atopic dermatitis occurred in 12.9% cases. We showed the discrepancy between the number of children with symptoms suggestive for asthma (wheezing--11.1%, breathlessness--19.4%, nocturnal cough--4.9%, exercise-induced cough--9.8%) and number of cases diagnosed as asthma (3.2%). Family history of allergy increased the risk of allergic diseases in studied population.
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PMID:[Asthma, allergic rhinitis and atopic dermatitis in schoolchildren]. 764 27

The major manifestations of giant cell arteritis have been well described. Pulmonary manifestations, however, are rare. We report the case of a 75 year old woman with temporal arteritis, presenting with atypical manifestations, i.e. nodular pulmonary lesions, dry cough, rhinitis, conjunctivitis, and otitis with hearing loss. We conclude that overlapping features of giant cell arteritis and Wegener's granulomatosis occur in some patients.
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PMID:Unusual manifestations of giant cell arteritis: pulmonary nodules, cough, conjunctivitis and otitis with deafness. 771 13

The purpose of this study was to identify and describe the Hispanic mothers' initial sources of advice and help with children's illnesses; beliefs about the etiology and seriousness of certain children's illnesses, namely, fever, cough, diarrhea, vomiting, conjunctivitis, skin rash, minor wounds, and burns; practices for the management of these children's health problems, including the use of home remedies, if any. Interviews were conducted with 100 women of Hispanic origin who had at least one child age 5 years or less and who were attending a community clinic in a rural area of central California. Mothers' beliefs about problem etiologies varied widely and revealed several misconceptions, folk beliefs, and lack of knowledge. The findings also revealed that only 32% of the mothers used or would use health professionals as the initial source of advice or help with children's problems. The majority of the subjects (81%) admitted to using home remedies to manage children's problems; 17% sought the help of a folk healer (mainly for the treatment of empacho). The various types of home remedies used by mothers were described and included the ingestion or application of certain foods, fluids, herbal teas, or other materials as well as methods to eliminate the perceived causes of the problems. It is important to note that 11% of the mothers had used azarcon or greta (substances containing lead) for treating empacho and other stomach problems in children. The need for culturally responsive and sensitive health care is discussed.
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PMID:Hispanic mothers' beliefs and practices regarding selected children's health problems. 783 80

Infectious laryngotracheitis (ILT) was diagnosed as the cause of an outbreak of respiratory disease in broiler chickens in California. The classical form of ILT is characterized by dyspnea, gasping, coughing, and expectoration of bloody exudate. Most of the broilers submitted to the diagnostic laboratory showed a non-classical presentation of ILT, in which mucoid tracheitis and conjunctivitis were the most consistent lesions. Historically, most of the ILT cases diagnosed in our laboratory have consisted of layers with classical signs and lesions. It is not known whether this non classical presentation of ILT in broilers is due to differences in the way broilers respond to ILT infection or to the nature of the ILT virus isolate.
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PMID:An outbreak of infectious laryngotracheitis in California broilers. 800 92

The authors show a scientific literary review on Ch. trachomatis pneumonia. A distinctive syndrome pneumonia has been reported in infants infected by Chlamydia (at 2-3 months of age) in genital-urinary infected mothers. The infection may be preceded by conjunctivitis, in apyrexia followed by attacks of coughing pertussis-like. Blood eosinophilia is present. Although favorable prognosis in infancy, erythromycin is the drug of choice shortening the clinical course erythromycin is also recommended in woman infected prevention.
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PMID:[Pulmonary infections in children. III. Pneumonia due to Chlamydia trachomatis]. 809 Jan 37

The nature and extent of changes associated with equine arteritis virus (EAV) infection of the reproductive tract was documented in 21 prepubertal and 15 peripubertal colts. This study was part of an investigation into the relationship between stage of reproductive tract maturity and susceptibility to the experimental establishment of persistent infection with EAV. After intranasal challenge with a field isolate of EAV, all colts developed clinical signs of equine viral arteritis (EVA) from which they recovered rapidly. Clinical signs during the acute phase consisted of fever, serous to mucopurulent ocular and nasal discharge, oedema of the limbs, scrotum or prepuce, scleral injection, conjunctivitis, icterus, cough, diarrhoea, stiff gait, lethargy, inappetence and depression. At necropsy, the most significant macroscopic lesions included excessive accumulation of fluid within the thoracic and abdominal cavities, lymph node enlargement and oedema of the reproductive tract. Colts killed 7 to 14 days after challenge had acute necrotizing vasculitis involving the testes, epididymides, vasa deferentia, ampullae, prostatic lobes, vesicular glands and bulbourethral glands. Vasculitis was characterized by striking fibrinoid necrosis of small muscular arteries with extravasation of erythrocytes and proteinaceous material into the media, adventitia and perivascular tissues. Colts examined on days 28-180 had lymphocytic and plasmacytic inflammatory cell infiltrates in the lamina propria and muscularis of the epididymides and accessory sex glands. The vascular lesions found during the acute phase of EAV infection contrasted with the multifocal lympho-plasmacytic infiltrates found within the parenchyma of the reproductive tract during the chronic phase. One peripubertal colt was found to be persistently infected with EAV 15 months after challenge. This colt had marked lympho-plasmacytic infiltrates in the ampullae at necropsy.
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PMID:Pathological changes associated with equine arteritis virus infection of the reproductive tract in prepubertal and peripubertal colts. 830 Sep 16

The health impact of exposure to sawdusts on 59 sawmill workers from southwest Nigeria was studied. Workers were chosen by a two-stage random sampling method from 15 privately owned sawmills. Peak flow and spirometric measurements were obtained from all workers. They also underwent a structured questionnaire which elicited occupationally related symptoms. Age and sex matched controls consisting of 199 workers from similar socio-economic backgrounds as the subjects underwent similar questionnaire and lung function tests. Results showed a high prevalence of respiratory symptoms, principally cough, chest pain and sputum production, among the workers. Most of the workers also had high prevalence of conjunctivitis, skin irritation and hearing difficulties when compared with controls. Pulmonary function parameters were also significantly lower (p < 0.05 in sawmill workers than controls). Although a large number (94.9%) of the workers were aware of the potential hazards of exposure to sawdusts, less than 20% wore protective masks. Our study highlights the need for health and safety regulation in the workplace. There is also a need for improved methods of dust control in factories with high levels of dust particulates, particularly in the developing world.
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PMID:Occupational health status of sawmill workers in Nigeria. 878 53


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