bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized controlled trial to investigate impact of site‐based safer sex programmes in Kingston, Jamaica: trial design, methods and baseline findings
Authors: Weir S. S. , Figueroa J. P. , Byfield L. , Hall A. , Cummings S. , Suchindran C. 
Published: August 2010

SummaryObjective  To describe the design, methods and baseline findings of a multi‐level prevention intervention to increase consistent condom use among persons at public social sites in Kingston, Jamaica, who have new or concurrent sexual partnerships.Methods  A two‐arm randomized controlled trial (RCT) of 147 sites where persons meet new sex partners. Sites were identified by community informants as places where people meet new sexual partners, which include bars, street locations, bus stops, malls and others. Sites were sorted into 50 clusters based on geographic proximity and type of site and randomized to receive a multi‐level site‐based intervention or not. Intervention components include on‐site HIV testing, condom promotion and peer education. Effectiveness of the intervention will be measured by comparing the proportion of persons with new or multiple partners in the past year who report recent inconsistent condom use at intervention vs. control sites.Results  Baseline surveys were conducted at 66 intervention (711 men, 845 women) and 65 control sites (654 men, 738 women). Characteristics of intervention and control sites as well as the characteristics of patrons at these sites were similar. The outcome variable was balanced with approximately 30% of men and 25% of women at intervention and control sites reporting a new partner or more than one partner in the past year and recent inconsistent condom use.Conclusions  The baseline findings confirm that the population is an appropriate target group for HIV prevention and that randomization will provide the means to estimate programme effectiveness.
Noble goals, unforeseen consequences: control of tropical diseases in colonial Central Africa and the iatrogenic transmission of blood‐borne viruses
Authors: Pépin Jacques , Labbé Annie‐Claude 
Published: August 2010

SummaryBackground  In southern Cameroon, 40–50% of individuals born before 1945 have antibodies against hepatitis C virus (HCV), suggesting massive iatrogenic transmission of at least one blood‐borne virus in the region of the world where SIVcpz emerged into HIV‐1.Objective  To estimate the potential role of disease control programs that used intravenous (IV) drugs in the transmission of blood‐borne viruses, especially HCV.Methods  We reviewed, for 1921–1959, records of health services in Cameroun, Oubangui‐Chari, Gabon and Moyen‐Congo. We calculated the incidence of diseases whose treatment required the administration of IV drugs, and compared these with previously published data on HCV prevalence.Results  Several IV drugs were used against African trypanosomiasis, leprosy, yaws and syphilis. However, yaws was the only disease whose incidence was high enough so that up to half of some birth cohorts could have acquired HCV. Yaws incidence varied dramatically between regions, and was often >200 per 1000 per year in southern Cameroon, where extremely high HCV prevalence was found. Yaws incidence peaked between 1935 and 1955, a period which coincided with the emergence of HCV and HIV.Conclusion  Age, geographical and temporal distributions of yaws suggest that the HCV epidemic in Cameroon was driven by campaigns against yaws (and, secondarily, syphilis) using arsenicals and other metallic drugs. The same interventions may have exponentially amplified other blood‐borne viruses, including SIVcpz/HIV‐1.
Helicobacter pylori isolates recovered from gastric biopsies of patients with gastro‐duodenal pathologies in Cameroon: current status of antibiogram
Authors: Ndip Roland N. , Malange Takang Alertia E. , Ojongokpoko Juliet E. A. , Luma Henry N. , Malongue Agnes , Akoachere Jane‐Francis T. K. , Ndip Lucy M. , MacMillan Martin , Weaver Lawrence T. 
Published: August 2010

SummaryObjective  To determine the prevalence of Helicobacter pylori in patients with gastro‐duodenal pathologies and the susceptibility patterns of isolates to the currently recommended antibiotic treatment regimen used in Cameroon.Methods  Consecutive dyspeptic patients referred to Douala General Hospital, Cameroon for endoscopy were recruited in the study. Gastric biopsies were collected from the patients and H. pylori isolated and identified following standard microbiology and biochemical techniques. Antibiotic susceptibility was determined by disk diffusion and agar dilution methods against clarithromycin, tetracycline, amoxicillin and metronidazole. Data were analysed using chi‐square test and significance considered at P < 0.05.Results  Seventy‐one (92.2%) of the 77 patients (mean age 44.5 ± 15.7, range 15–77 years) were positive for H. pylori. The antibiotic susceptibility rates were 56% for tetracycline, 55.3% for clarithromycin, 14.4% for amoxicillin and 6.8% for metronidazole. The prevalence of clarithromycin resistance in males vs. females was 42.1%vs. 46.7%, while for metronidazole it was 89.5%vs. 94.7% (P > 0.05). Antimicrobial susceptibility results also revealed 12 antibiotypes based on resistance to the antimicrobial agents investigated. The resistance pattern, amoxicillin and metronidazole (AMRR METR) was the most common (23.7%) amongst the isolates. More than 60% of the isolates exhibited multi‐drug resistance to three or four antibiotics.Conclusion  Multi‐drug resistance is common against the current treatment regimen in Cameroon and, therefore, calls for urgent studies involving newer and broad spectrum antibiotics to address the problem.
Who develops severe malaria? Impact of access to healthcare, socio‐economic and environmental factors on children in Yemen: a case‐control study
Authors: Al‐Taiar Abdullah , Jaffar Shabbar , Assabri Ali , Al‐Habori Molham , Azazy Ahmed , Al‐Gabri Arwa , Al‐Ganadi Mohammed , Attal Bothaina , Whitty Christopher J. M. 
Published: August 2010

SummaryObjective  To investigate the impact of socio‐economic and environmental factors on developing severe malaria in comparison with mild malaria in Yemen.Method  Case‐control study comparing 343 children aged 6 months to 10 years diagnosed with WHO‐defined severe malaria (cases) at the main children’s hospital in Taiz and 445 children with mild malaria (controls) diagnosed in the health centres, which serve the areas where the cases came from.Results  In univariate analysis, age <1 year, distance from health centre, delay to treatment and driving time to health centre were associated with progression from mild to severe malaria. In multivariate analysis, distance to nearest health centre >2 km was significantly associated with progression to severe disease. Environmental and vector control factors associated with protection from acquiring malaria (such as sleeping under bednets) were not associated with protection from moving from mild to severe disease.Conclusions  Innovative ways to improve access to antimalarial treatment for those living more then 2 km away from health centres such as home management of malaria, especially for infants and young children, should be explored in malaria‐endemic areas of Yemen.
Integrating research into routine service delivery in an antiretroviral treatment programme: lessons learnt from a cluster randomized trial comparing strategies of HIV care in Jinja, Uganda
Authors: Jaffar Shabbar , Amuron Barbara , Birungi Josephine , Namara Geoffrey , Nabiryo Christine , Coutinho Alex , Grosskurth Heiner 
Published: August 2010

SummaryTrials integrated into normal health service delivery are designed to evaluate the effectiveness of interventions under real‐life conditions. However, integrating research into service delivery creates many operational challenges and raises ethical dilemmas. Here we discuss the operational and ethical issues arising from such trials using the example of a cluster randomized trial evaluating two strategies of ART delivery in Jinja, south‐east Uganda.
Associations among handwashing indicators, wealth, and symptoms of childhood respiratory illness in urban Bangladesh
Authors: Luby Stephen P. , Halder Amal K. 
Published: August 2010

SummaryObjectives  To explore the relationship of easy to collect handwashing indicators with socioeconomic status and reported respiratory disease among children <5 years of age.Methods  We added several handwashing indicators to a population‐based, cross‐sectional study of respiratory illness in Dhaka, Bangladesh. We constructed a wealth index using 12 household characteristics analysed with principal component analysis to assess socioeconomic status.Results  Of 6970 households, 92% had a bar of body soap, 41% had a place with water to wash hands inside the house, and 40% had soap present at the most convenient place to wash hands. Handwashing indicators were more common among households with higher socioeconomic status. Within each wealth quintile a place to wash hands within the household was strongly associated with the presence of soap at the handwashing location (odds ratios 13–70). In general estimated equation models that controlled for socioeconomic status, the presence of a place inside the house with water to wash hands was the only handwashing indicator significantly associated with a child in the household who reported cough or difficulty breathing in the preceding 7 days (adjusted odds ratio 0.95, 95% confidence interval 0.93–0.98, P < 0.001).Conclusion  Handwashing indicators were strongly influenced by socio‐economic status and so would not be an independent measure of handwashing behaviour. Handwashing promotion efforts in urban Dhaka that include specific efforts to provide handwashing facilities inside the house are more likely to improve handwashing behaviour than interventions that ignore this component.
Direct data capture using hand‐held computers in rural Burkina Faso: experiences, benefits and lessons learnt
Authors: Byass Peter , Hounton Sennen , Ouédraogo Moctar , Somé Henri , Diallo Ibrahima , Fottrell Edward , Emmelin Axel , Meda Nicolas 
Published: August 2010

SummaryObjectives  To assess our experiences of using hand‐held computers (personal digital assistants, PDAs) for direct data capture in a large community‐based geo‐referenced survey in rural Burkina Faso, highlighting benefits and lessons learnt from their use.Methods  A population‐based geo‐referenced survey of over 500 000 people was undertaken using PDAs with in‐built GPS receivers and the resulting database analysed in terms of successful completion, error rates and interview durations.Results  Surveys were successfully completed for 84 861 households (98.3%) by 127 interviewers. The data input error rate was assessed at 0.24%, with more than half of the errors being made by less than 10% of the interviewers. Faster interviewers were not less accurate. Time‐stamped and geo‐referenced data allowed reconstruction of particular interviewer‐day activities.Conclusions  Although the survey setting was challenging, the feasibility of using direct data capture on a large scale was well established. We learnt that, with more experience, we could have made better use of real‐time entry and quality control checking procedures. The work involved in designing and setting up a complex survey on PDAs prior to data collection should not be underestimated.
From evaluating a Skilled Care Initiative in rural Burkina Faso to policy implications for safe motherhood in Africa
Authors: Meda Nicolas , Hounton Sennen , De Brouwere Vincent , Sombié Issiaka , Byass Peter ,   on behalf of the IMMPACT Burkina Evaluation Study Group
Published: August 2010

SummaryEvaluation findings from a particular setting need to be generalized into policy implications if they are to find widespread use. Skilled attendance at delivery is widely regarded as one of the most important intervention strategies for safe motherhood in low‐resource settings, particularly in Africa, but implementations of such strategies are often not rigorously evaluated or interpreted into future policy. Initiative for Maternal Mortality Programme Assessment (Immpact) has applied a package of research‐based monitoring and evaluation tools to assess the Family Care International Skilled Care Initiative in Ouargaye District, Burkina Faso. This evaluation research aimed to generate reliable, evidence‐based policies for accelerating safe motherhood programmes in Burkina Faso and elsewhere in Africa. Five policy priorities were identified as representing real chances of improving the safety of motherhood: (1) enhancing national coverage of delivery by professionally skilled attendants; (2) to provide a network of 24‐h basic emergency obstetric care within 5 km; (3) to have an effective referral system, equipped and resourced to undertake a reasonable number of Caesarean sections; (4) to promote community mobilization activities as a lever to increasing delivery care utilization; and (5) to implement strategies to remove financial barriers to delivery care. To meet Millennium Development Goal five by 2015, both supply and demand side constraints on the provision of quality maternity care have to be addressed, which in turn need greater political commitment and funding.
Barriers to access to antiretroviral treatment in developing countries: a review
Authors: Posse Mariana , Meheus Filip , Van Asten Henri , Van Der Ven Andre , Baltussen Rob 
Published: August 2010

SummaryObjective  To present a review of barriers impeding people living with HIV/AIDS in developing countries from accessing treatment, and to make recommendations for further studies.Methods  Electronic databases, websites of main global agencies and international AIDS conferences were searched for relevant articles published between 1996 and 2007. Articles were reviewed using the Andersen and May framework of access to health services and barriers were categorized as either population‐level or health system‐level barriers.Results  A total of 19 studies (7 articles and 12 abstracts) in English were reviewed. The barriers most frequently cited at the population level were lack of information about antiretroviral therapy (ART), perceived high costs for ART and stigma. Barriers most frequently cited at the health system level were long distance from home to the health facility, lack of co‐ordination across services and limited involvement of the community in the programme planning process.Conclusions  Dissemination of information about HIV/AIDS and alternative related care, and alternative health financing policies seem to be the most relevant policy measures to remove barriers. In view of the paucity of evidence on barriers to access to ART, research should address the relative importance of barriers, include a mix of qualitative and quantitative research methods and evaluate barriers in different settings.
Factors associated with increased risk of progression to respiratory syncytial virus‐associated pneumonia in young Kenyan children*
Authors: Okiro Emelda A. , Ngama Mwanajuma , Bett Ann , Cane Patricia A. , Medley Graham F. , James Nokes D. 
Published: August 2010

SummaryObjectives  To identify factors associated with developing severe respiratory syncytial virus (RSV) pneumonia and their commonality with all‐cause lower respiratory tract infection (LRTI), in order to isolate those risk factors specifically associated with RSV‐LRTI and identify targets for control.Methods  A birth cohort of rural Kenyan children was intensively monitored for acute respiratory infection (ARI) over three RSV epidemics. RSV was diagnosed by immunofluorescence of nasal washings collected at each ARI episode. Cox regression was used to determine the relative risk of disease for a range of co‐factors.Results  A total of 469 children provided 937 years of follow‐up, and experienced 857 all‐cause LRTI, 362 RSV‐ARI and 92 RSV‐LRTI episodes. Factors associated with RSV‐LRTI, but not RSV‐ARI, were severe stunting (z‐score ≤−2, RR 1.7 95%CI 1.1–2.8), crowding (increased number of children, RR 2.6, 1.0–6.5) and number of siblings under 6 years (RR 2.0, 1.2–3.4). Moderate and severe stunting (z‐score ≤−1), crowding and a sibling aged over 5 years sleeping in the same room as the index child were associated with increased risk of all‐cause LRTI, whereas higher educational level of the primary caretaker was associated with protection.Conclusion  We identify factors related to host nutritional status (stunting) and contact intensity (crowding, siblings) which are distinguishable in their association with RSV severe disease in infant and young child. These factors are broadly in common with those associated with all‐cause LRTI. The results support targeted strategies for prevention.
Long‐lasting insecticidal nets fail at household level to reduce abundance of sandfly vector Phlebotomus argentipes in treated houses in Bihar (India)
Authors: Dinesh Diwakar S. , Das Pradeep , Picado Albert , Davies Clive , Speybroeck Niko , Ostyn Bart , Boelaert Marleen , Coosemans Marc 
Published: August 2010

SummaryObjective  To determine whether the use of long‐lasting insecticidal nets (LLINS) at household level are effective in reducing the abundance of Phlebotomus argentipes, vector of anthroponotic visceral leishmaniasis in India, Nepal and Bangladesh.Methods  The impact of two long‐lasting nets (Olyset and PermaNet) on indoor sandfly abundance was evaluated in selected houses of three endemic hamlets in Bihar (India). It was assumed that most sandflies breed inside the houses and that LLINs would progressively reduce the indoor density during the reproduction season. A campaign of indoor spraying with dichloro‐diphenyl‐trichloroethane (DDT) interfered with the trial but did not affect the sandfly population.Results  Only the density of males of P. argentipes was significantly reduced by both the LLINs but not the females.Conclusions  These findings suggest that most female sandflies are coming from outside and that LLINs do not reduce their entry rate.
Signs and symptoms associated with Heterobasidion annosum and Armillaria ostoyae infection in dead and dying mountain pine (Pinus mugo ssp. uncinata)
Authors: Bendel M. , Rigling D. 
Published: August 2010

SummarySymptoms and signs associated with root rot caused by Heterobasidion annosum or Armillaria ostoyae in mountain pines (Pinus mugo ssp. uncinata) were investigated in the Swiss Alps. A sample of dying or recently dead mountain pine trees (≥12 cm d.b.h.) and saplings (<1.3 m height) was assessed for root pathogen infection by taking root samples followed by isolations in the laboratory. From a subsample, an additional core was taken from the butt of each tree and evaluated in the same fashion. A total of 157 dying or recently dead mountain pine trees and 184 saplings with roots infected by either of the two pathogens or which lacked infection were analyzed using logistic regression models. The main objectives were to determine the most prominent symptoms induced by the fungi (resinosis), signs of the fungi (mycelia, fruiting bodies and rhizomorphs), and tree characteristics (d.b.h./height and evidence of wounds) that would allow an easy and reliable determination of H. annosum and/or A. ostoyae infection of mountain pines in the field. Heterobasidion annosum caused both root and butt rot on mountain pine, whereas A. ostoyae was mostly restricted to the root systems of the trees sampled. The most discriminating sign for the presence of A. ostoyae infection was the presence of characteristic mycelial fans, and for H. annosum root rot the presence of H. annosum mycelia (sheets of paper‐thin mycelium and mycelial pustules). In addition, resinosis was a powerful predictor for A. ostoyae in trees. Symptoms and signs indicating A. ostoyae or H. annosum infections were more reliable for saplings than for mature trees. Armillaria rhizomorphs were not useful in detecting A. ostoyae infection and, if present, were often formed by saprophytic Armillaria species. Heterobasidion annosum fruiting bodies were rarely observed and poorly reflected the widespread occurrence of this pathogen in the mountain pine forests.
Urea Transfer in Ruminants
Authors: E.Borhami B. , Farid M. , Ahmed M. H. , El‐Shazly K. , Naga M. A. 
Published: August 2010

ZusammenfassungHarnstoffumsatz bei Wiederkäuern 2. Harnstoffumsatz bei Schafen unter semi‐ariden HaltungsbedingungenErwachsene Barki‐Schafe mit Pansenfisteln erhielten eine Diät mit niedrigem Proteinge‐halt. Die Reation bestand aus Gerstenkleie, Alexandrinerklee‐Heu und Weizenstroh.Die Schafe wurden 2 verschiedenen Behandlungen unterworfen. Bei der ersten wurde den Tieren vor der Fütterung Wasser gegeben, bei der zweiten erhielten die Tiere nur an jedem 3. Tag Wasser. 7 — 9 mg bzw. 15—18 mg Harnstoff‐N wurden dann direkt in den Pansen infundiert oder es wurden 15—18 mg Harnstoff‐N intravenös injeziert. Die Infusion wurde 12 Stunden nach der Fütterung begonnen und dauerte 10 Stunden. Die Ver‐suchsdauer betrug bei getränkten Tieren 12 Tage und bei Wasserentzug 15 Tage.Aus den Ergebnissen geht hervor, daß eine intraruminale Harnstoffinfusion den NH3‐N‐Gehalt im Pansen wesentlich erhöht.Die intravenöse Harnstoffinfusion hatte keine Einwirkung auf den NH3‐N‐Gehalt im Pansen. Wasserentzug erhöht den NH3‐Gehalt im Pansen signifikant.Wasserentzug führte zu einem deutlich höheren Plasmaharnstoffgehalt als Wasserzu‐gabe. Bei getränkten Schafen betrug der berechnete Harnstoffrückfluß in den Pansen 2,86 g Harnstoff‐N pro Tag gegenüber 0,95 g bei Wasserentzug.Die Stickstoffbilanz war bei den getränkten Schafen negativ, bei Wasserentzug positiv, nach Harnstoffinfusion positiv.Die Ausscheidung von Harnstoff über den Harn stieg sowohl bei intraruminaler als auch bei intravenöser Harnstoffinfusion und zwar bei Wasserentzug stärker als bei getränkten Tieren.
Serum sickness following streptokinase
Authors: BANHAM NEIL D G 
Published: August 2010

ABSTRACTA case of serum sickness following the administration of streptokinase is presented. This has not previously been reported in Australia.It typically presents, as in this case, seven to 10 days after administration of streptokinase, with a vasculitic rash and arthritis and resolves spontaneously over about a week with conservative management.Corticosteroids have been advocated for more severe cases.Mild cases may occur and go unrecognised because of the delayed onset and infrequency of this condition.
Strangulated gastrothorax mimicking tension pneumothorax
Authors: SMART N G , WORLEY P J 
Published: August 2010

ABSTRACTA case of strangulated tension gastrothorax in a 34 year old man with a past history of Nissen fundoplication and asthma is described. Presenting with acute respiratory distress, decreased breath sounds and cardiovascular collapse, the chest radiograph was initially read as a tension pneumothorax. Tube thoracostomy resulted in clinical improvement by perforating and decompressing the stomach. The initial treatment of choice when a tension gastrothorax is identified is placement of a nasogastric tube which is both diagnostic and therapeutic. Thoracostomy by needle or chest drain may result in clinical improvement despite soiling of the pleural space and is indicated for patients in extremis when a nasogastric tube cannot be passed.