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 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study of the health care delivery facilities in the Kainji Lake area of Nigeria (an artificial lake created in 1968) showed that hospitals, a health centre, maternal and child health centres, public health units, dispensaries and leper institutions, controlled by various organizations, are available. Dispensaries and leper settlements/clinics form the most numerous health providers in the rural areas. Analysis of 1973 data from eight dispensaries around Lake Kainji showed that malaria, gastroenteritis, chest and skin infections, venereal diseases and shistosomiasis constitute the major health problems. Observations of the environmental sanitation in the study area by the author support the idea that the diseases emanate particularly from the low standard of environmental health. A suggestion is made for the establishment of a central organization charged with the responsibilities for health planning and development. The evaluation of the impact of hte dispensaries as health providers is needed for future health planning. A health care delivery system supported by operational research should be initiated at the village level.
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PMID:A communication on health and development in the Kainji Lake area of Nigeria. 3 38

Dispensaries have been the most common providers of health services in the Kainji Lake rural area of Nigeria and the only form of health facility in this area. A survey of the working conditions of the dispensary assistants showed that 70% of the respondents are already frustrated because of lack of support, supervision, and prospects for further training. A proposal is made for further training of the dispensary assistants and for improving their conditions of service. The seasonal distribution of the common diseases (malaria, gastroenteritis, chest infections, skin diseases, gonorrhoea, and schistosomiasis) shows that infection follows the pattern of rainfall, and that there are some differences between the pattern of these common diseases and the common ailments reported by the villagers located away from the dispensaries. A suggestion is made for the introduction of primary health workers to meet the health needs of the villagers, 60% of whom have not received dispensary services.
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PMID:The role of dispensaries in community health care in the Kainji Lake area of Nigeria. 49 95

1. Growth in weight and height in 152 children between the ages of 0-6 and 3 years was investigated in Keneba, a rural Gambian village. By 1 year of age the average weight-for-age of the children was only 75% of the Jelliffe (1966) standard. 2. The relationship between the prevalence of nine different categories of diseases and growth was investigated to determine the quantitative contribution of the diseases to the growth faltering observed. There was a highly significant negative relationship between gastroenteritis and both weight gain and height gain. The only other disease category having a similar relationship was malaria, but in this instance only with weight gain. 3. Although over-all growth in weight and height was considerably below the standard values, multiple regression analysis indicated that after the age of 1 year, except in July and August, normal and sometimes slow 'catch-up' growth would be possible in the absence of gastroenteritis. 4. Attention is drawn to the limitations of the use of anthropometry in a settled village community as the only criterion by which dietary adequacy can be judged.
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PMID:A quantitative study into the role of infection in determining nutritional status in Gambian village children. 86 Nov 94

A hypothesis which explains disease prevalence among different socio-economic groups following early infantile modulation of cell-mediated immunity by infection and nutrition related stress is presented. Wealthy populations living under highly hygienic circumstances can develop their cell-mediated immunity to genetic expectation while their humoral systems remains unstimulated. Primitive populations protect the infant's immune development by breast feeding and suffer from temporary cell-mediated immune deficiencies due to intercurrent infectious disease and famine later on. Intermediary populations harbour a small percentage of people, whose cell-mediated immune system has been permanently damaged by infection in early childhood, leading to a high incidence of diseases linked to cell-mediated immune deficiency. The possible cocarcinogenesis of the cell-mediated immune deficiency following repeated gastroenteritis and persistent stimulation of B cells, leading to alpha heavy chain disease and primary intestinal lymphoma, or due to falciparum malaria in newborns and its impact on the EB virus genome in development of Burkitt's lymphoma, are discussed.
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PMID:Immune modulation and disease patterns in population groups. 122 70

The verbal autopsy (VA) is an epidemiological tool that is widely used to ascribe causes of death by interviewing bereaved relatives of children who were not under medical supervision at the time of death. This technique was assessed by comparison with a prospective survey of 303 childhood deaths at a district hospital in Kenya where medically confirmed diagnoses were available. Common causes of death were detected by VA with specificities greater than 80%. Sensitivity of the VA technique was greater than 75% for measles, neonatal tetanus, malnutrition, and trauma-related deaths; however, malaria, anaemia, acute respiratory-tract infection, gastroenteritis, and meningitis were detected with sensitivities of less than 50%. There may have been unwarranted optimism in the ability of VAs to detect some of the major causes of death, such as malaria, in African children. VA used in malaria-specific intervention trials should be interpreted with caution and only in the light of known sensitivities and specificities.
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PMID:Childhood deaths in Africa: uses and limitations of verbal autopsies. 135 14

In recent years, introduction of new and more effective agents has improved the overall therapy for parasitic infections. This field, however, is still plagued by numerous problems, including the development of resistance to antimicrobial agents (especially with malaria), unavailability of agents in the United States or lack of approval by the Food and Drug Administration, and major toxicities or lack of experience in pregnant women and children, which limits use in these groups of patients. Widespread resistance of Plasmodium falciparum to chloroquine and other agents has complicated the treatment and prophylaxis of this type of malaria. A combination of quinine and Fansidar is usually effective oral therapy for falciparum malaria; quinidine may be administered if intravenous therapy is needed. Mefloquine, which is currently recommended for prophylaxis against chloroquine-resistant P. falciparum, is also effective for single-dose oral treatment, although this regimen has not yet been approved by the Food and Drug Administration. Metronidazole has been widely used for treatment of gastroenteritis due to Entamoeba histolytica and Giardia lamblia (not approved by the Food and Drug Administration for the latter) and is considered safe and effective. A new macrolide, azithromycin, has been reported to be effective for cryptosporidiosis in experimental animals; currently, no effective therapy is available for human infections. Combinations of sulfonamides with other antifolates, trimethoprim or pyrimethamine, are recommended therapy for Pneumocystis carinii pneumonia or toxoplasmosis, respectively. Therapies for the various types of leishmaniasis and trypanosomiasis are complex, often toxic, and often of limited efficacy. The benzimidazoles are effective for roundworm infections, although thiabendazole has severe toxic effects. The recent introduction of ivermectin has revolutionized the treatment and control of onchocerciasis. Another relatively new agent, praziquantel, is a true broad-spectrum anthelmintic agent that is effective against most trematodes, many adult cestodes, and larval cestodes as well (especially cysticerci of Taenia solium).
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PMID:Antiparasitic agents. 154 96

Using computerized in-patients' discharge records, a descriptive analysis was carried out of all medical admission in 1987 in a general hospital. The survey found that there were a total of 4053 admissions in 1987. A wide range of medical disorders were seen reflecting the lack of subspecialization. Cardiovascular disorders topped accounting for 25.6% of all admissions, followed by gastrointestinal and hepatobiliary disorders 12.8% and respiratory disorders 10.7%. The commonest specific medical disorders seen were hypertension 13.8%, diabetes mellitus 10.2%, ischaemic heart disease 7% and asthma 4.5%. The age, sex, ethnic and geographical distributions of the common medical disorders seen appear to conform to two broad pattern; hypertension, diabetes, ischaemic heart disease and cerebrovascular disease affected the older patients, had even ethic distribution and predominantly urban. Malaria, non-specific fever, viral hepatitis and acute gastroenteritis affected the younger patients, predominantly rural and Malay. Information from such surveys may be useful for planning and organization of medical services.
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PMID:Descriptive analysis of total medical admissions and common medical disorders in 1987 Kuantan General Hospital, using computerized in-patients' discharge record. 183 19

International mass travel poses a challenge to our knowledge about health problems outside the Western World. Although infections dominate among imported diseases, the risk of contracting such illness is often exaggerated. Hence, medical examination of subjectively healthy persons after travelling abroad is rarely warranted, but should be offered adopted children and refugees from developing countries. Among the imported diseases, malaria, typhoid and tuberculosis should always be considered in cases of fever. Other commonly imported diseases include gastroenteritis, hepatitis, infections of skin and soft tissues, and sexually transmitted infections. Reference is made to some courses offering further education in the field of imported health problems.
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PMID:[Imported health problems]. 204 37

Five hundred and ninety-four patients were consecutively admitted to an infectious disease unit over a 2-year period with a referral diagnosis of acute gastroenteritis or food poisoning. In 175 (29%) patients, gastrointestinal symptoms were associated with a condition other than gastrointestinal infection. Non-infective gastrointestinal disease was present in 90 patients, systemic infection in 50 and systemic disease in 35. Four illustrative case histories are presented to emphasize the need for a high index of suspicion if diseases such as malaria, septicaemia or appendicitis are not to be missed.
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PMID:Acute gastroenteritis: the need to remember alternative diagnoses. 208 49

Thirty-two episodes of malaria (10 confirmed by laboratory tests) were reported by 162 people living in 18 developing countries under the auspices of one British missionary society. Malaria was endemic in all countries involved, and a total of 367 person-years were observed. The overall incidence rate for malaria was 87.3 per 1000 person-years at risk. Important factors identified were residence in West Africa compared with elsewhere (relative risk (RR) = 13.0, P less than 0.001), being in the 20-39 year age group (RR = 3.2, P less than 0.002), history of gastroenteritis (RR = 3.1, P less than 0.002) and living in a rural area (RR = 1.7, n.s.). Chemoprophylaxis was taken by 119 people (73.5%).
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PMID:Risk factors for malaria among British missionaries living in tropical countries. 227 4


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