bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation and application of verbal autopsies in a rural area of South Africa
Authors: Kahn Kathleen , Tollman Stephen M. , Garenne Michel , Gear John S. S. 
Published: March 2003

Summary objective  To validate the causes of death determined with a single verbal autopsy instrument covering all age groups in the Agincourt subdistrict of rural South Africa. methods  Verbal autopsies (VAs) were conducted on all deaths recorded during annual demographic and health surveillance over a 3‐year period (1992–95) in a population of about 63 000 people. Trained fieldworkers elicited signs and symptoms of the terminal illness from a close caregiver, using a comprehensive questionnaire written in the local language. Questionnaires were assessed blind by three clinicians who assigned a probable cause of death using a stepwise consensus process. Validation involved comparison of VA diagnoses with hospital reference diagnoses obtained for those who died in a district hospital; and calculation of sensitivity, specificity and positive predictive value (PPV) for children under 5 years, and adults 15 years and older. results  A total of 127 hospital diagnoses satisfied the criteria for inclusion as reference diagnoses. For communicable diseases, sensitivity of VA diagnoses among children was 69%, specificity 96%, and PPV 90%; among adults the values were 89, 93 and 76%. Lower values were found for non‐communicable diseases: 75, 91 and 86% among children; and 64, 50 and 80% among adults. Most misclassification occurred within the category itself. For deaths due to accidents or violence, sensitivity was 100%, specificity 97%, and PPV 80% among children; and 75, 98 and 60% among adults. Since causes of death were largely age‐specific, few differences in sensitivity, specificity and PPV were found for adults and children. The frequency distribution of causes of death based on VAs closely approximated that of the hospital records used for validation. conclusion  VA findings need to be validated before they can be applied to district health planning. In Agincourt, a single verbal autopsy instrument provided a reasonable estimate of the frequency of causes of death among adults and children. Findings can be reliably used to inform local health planning and evaluation.
Eosinophil granule proteins in serum and urine of patients with helminth infections and atopic dermatitis
Authors: Tischendorf F. W. , Brattig N. W. , Lintzel M. , Büttner D. W. , Burchard G. D. , Bork K. , Müller M. 
Published: March 2003

Summary Eosinophil cationic protein (ECP) and eosinophil‐derived neurotoxin (EPX) are cytotoxic molecules involved in helminth infections and allergic reactions. Hitherto most clinical chemical studies have been concerned with the analysis of serum ECP in allergic diseases. The aim of this study was to examine whether serum as well as urine levels of these proteins are useful clinical chemical parameters in helminthiases and allergic diseases such as atopic dermatitis. Comparing these diseases under the same methodological conditions, levels of ECP and EPX were generally higher in helminthiases than in atopic dermatitis and non‐helminth, non‐allergic diseases. The highest levels of both proteins occurred in tropical worm diseases, in particular hookworm disease and onchocerciasis. When comparing helminthiases with allergic disorder, only hookworm disease (ECP and EPX) and onchocerciasis (EPX) exhibited significantly higher eosinophil cationic protein serum levels than atopic dermatitis. In patients with schistosomiasis mansoni and egg loads of > 1000–10 000 eggs/g stool (epg) EPX serum levels were significantly higher than in patients exhibiting loads < 1000 epg. Urinary analyses revealed only EPX to be present in measurable amounts. Levels of this protein were much higher in urine of patients with hookworm disease and onchocerciasis than in those with atopic dermatitis and in healthy controls. The results suggest that besides serum EPX, urinary EPX may be a useful clinical chemical parameter in eosinophilia of helminth and allergic aetiology.
Sexually transmitted infections and associated socio‐demographic and behavioural factors in women seeking primary care suggest Madagascar’s vulnerability to rapid HIV spread
Authors: Behets Frieda , Andriamiadana Jocelyne , Rasamilalao Desire , Ratsimbazafy Norbert , Randrianasolo Daudet , Dallabetta Gina , Cohen Myron 
Published: March 2003

OBJECTIVES To examine sexually transmitted infections (STIs) and associated socio‐demographic and behavioural factors in women seeking care for genital discharge syndrome in Antananarivo, Madagascar. METHODS One thousand and sixty‐six consecutive symptomatic women were interviewed and examined; bacterial vaginosis (BV), vulvovaginal candidiasis, trichomoniasis (TV), cervical infection (CI) due to chlamydial or gonococcal infections, and syphilis seroreactivity were determined by laboratory diagnosis. Associations between STIs and individual characteristics were evaluated using bivariate and logistic regression analyses. RESULTS The prevalence of BV, TV, CI, and syphilis seroreactivity was, respectively, 85%, 16%, 49%, 16% in 94 prostitutes; 70%, 18%, 30%, 13% in 96 occasional sex traders; and 53%, 24%, 17%, and 4% in 876 general women. CI was independently and positively associated with a symptomatic partner, new sex partner in last 3 months, unfaithful partner, prostitution, joblessness and being < 25 years old. Syphilis was associated with low schooling, young age at coital debut, sex trading, and > 1 sex partner in the previous 3 months. CONCLUSIONS These high STI rates and associated characteristics suggest the local vulnerability to rapid HIV spread and show the need for prevention efforts that involve youth, prostitutes, occasional sex traders, sex clients, and men who have concurrent sexual partnerships.
A systematic review of current knowledge of HIV epidemiology and of sexual behaviour in Nepal
Authors: Furber Andrew S. , Newell James N. , Lubben Marianne M. 
Published: March 2003

OBJECTIVE To systematically review information on HIV epidemiology and on sexual behaviour in Nepal with a view to identifying gaps in current knowledge. METHODS Systematic review covering electronic databases, web‐based information, personal contact with experts and hand searching of key journals. RESULTS HIV‐1 seroprevalence has been rising rapidly in association with high‐risk behaviours, with current levels of 40% amongst the nation's injecting drug users and approaching 20% amongst Kathmandu's female commercial sex workers (FCSWs). HIV seroprevalence remains low in the general population (0.29% of 15–49 year olds). There are significant methodological limitations in many of the seroprevalence studies identified, and these estimates need to be treated with caution. There are extensive migration patterns both within the country and internationally which provide the potential for considerable sexual networking. However, studies of sexual behaviour have focused on FCSWs and the extent of sexual networks within the general population is largely unknown. CONCLUSIONS Whilst some of the ingredients are present for an explosive HIV epidemic in Nepal, crucial knowledge on sexual behaviour in the general population is missing. Research on sexual networking is urgently required to guide HIV control in Nepal. There is also a need for further good‐quality epidemiological studies of HIV seroprevalence.
Levels and causes of maternal mortality in Senegal
Authors: Kodio Belco , De Bernis Luc , Ba Mariame , Ronsmans Carine , Pison Gilles , Etard Jean‐François 
Published: March 2003

OBJECTIVES  To report the findings of a direct, community‐based, assessment of maternal mortality and medical causes of death using verbal autopsy in three unique cohorts in rural Senegal. METHODS  Methods from ongoing demographic surveillance systems. We obtained records of all deaths and births in women of age 15–49 over a period of 14 years in Niakhar, 10 years in Bandafassi and 13 years in Mlomp. Relatives of all women who died were interviewed using a standard questionnaire. Causes of death were assigned by three physicians independently. Maternal deaths were defined according to the ninth and tenth revisions of the International Classification of Diseases. RESULTS  The maternal mortality ratio was similar in Mlomp [436 per 100 000 live births (95% confidence interval 209–802)] and Niakhar [516 per 100 000 (413–636)] but significantly higher in the more remote area of Bandafassi [852 (587–1196)] [relative risk compared with Niakhar 1.6 (1.0–2.4)]. Two‐thirds of the maternal deaths were from direct obstetric causes, haemorrhage being the most common. Abortion was rare. CONCLUSIONS  Demographic surveillance systems are useful tools for the measurement of maternal mortality provided special studies are carried out to arrive at the levels and causes of maternal death. The estimates of maternal mortality reported here are lower than those published by the WHO and UNICEF but remain extremely high, particularly in the very remote areas with very limited health infrastructure, where as many as one in 19 women may be expected to die as a consequence of childbirth.
Factors contributing to high mortality due to pneumonia among under‐fives in Kalabo District, Zambia
Authors: Stekelenburg J. , Kashumba E. , Wolffers I. 
Published: March 2003

Summaryobjective  To determine factors contributing to high mortality caused by pneumonia among children under 5 years of age in Kalabo District.methods  In a cross‐sectional descriptive study 78 mothers and 16 health workers were interviewed using structured questionnaires. Focus group discussions were held with groups of women who did not take part in the survey. Registers, patient records, drug stock control cards, drug stores and equipment were reviewed or checked.results  Pneumonia is an important public health problem in Kalabo District. Knowledge about the disease and its treatment is inadequate, both in health workers and in mothers. Low birth weight and distance contribute to high mortality. Mother and Child Health (MCH) clinic visits protect against mortality.conclusion  The community should be educated to recognize the signs and symptoms of pneumonia and to understand the importance of early and adequate treatment. As MCH clinics can play an important role, health workers, especially at rural health centre level, should be re‐trained in case definition, case management and the use of available protocols. Strategies to fight the impact of pneumonia in the district should be part of an integrated package of care focusing on all prevalent childhood diseases, as they overlap in many cases.
Knowledge and use of prevention measures related to dengue in northern Thailand
Authors: Van Benthem B. H. B. , Khantikul N. , Panart K. , Kessels P. J. , Somboon P. , Oskam L. 
Published: March 2003

Summaryobjective  To determine the frequency and determinants of knowledge of dengue infection in three sites in northern Thailand, and to compare prevention measures of people with and without knowledge of dengue.methods  In May 2001 we conducted an epidemiological survey among 1650 persons living in three areas in northern Thailand. Knowledge of dengue and the use of prevention measures were measured by means of a structured questionnaire. Differences in knowledge of dengue and the use of prevention measures between risk groups were calculated by chi‐square test. Logistic regression was used to identify determinants of knowledge.results  Of the 1650 persons, 67% had knowledge of dengue. Fever (81%) and rash (77%) were the most frequently mentioned symptoms. Persons with knowledge of dengue reported a significantly higher use of prevention measures than persons without knowledge of dengue. In multivariate analyses, knowledge of dengue significantly differed by age, sex, occupation and site (P < 0.05). Younger people knew more about dengue than older persons: adjusted odds ratio (aOR) of 6.75 [95% confidence interval (CI): 4.32–10.6] for the 15–29 age group compared with people aged 60 and older. In comparison with farmers (reference group), knowledge of dengue was significantly higher among students (aOR: 10.6, 95% CI: 4.27–26.4), but lower among housewives or unemployed persons (aOR: 0.44, 95% CI: 0.31–0.64).conclusion  The overall knowledge of dengue was high, but housewives, unemployed and old persons had relatively little knowledge of dengue. Therefore, these groups may need special attention in future dengue education programmes. Persons with knowledge of the disease more frequently reported the use of preventive measures, indicating the value of education programmes as a tool in dengue prevention.
Characterization and management of a Jack Russell terrier with congenital ichthyosis
Authors: Lewis  , Ford  , Kwochka  
Published: March 2003

A prospective clinical trial was carried out in a 6‐week‐old male Jack Russell terrier with congenital ichthyosis to evaluate stratum corneum lipids; transmission electron microscopy of skin specimens; and clinical and dermatopathological response to vitamin A alcohol therapy. Also evaluated were the clinical, dermatopathological, and epidermal cell proliferation kinetics response to a synthetic retinoid in a dog with congenital ichthyosis. Epidermal cell renewal time was markedly decreased compared with normal and seborrhoeic dogs. Skin specimens were characterized by severe and diffuse compact orthokeratosis that extended into the infundi‐bulum of the hair follicles. The stratum granulosum was normal. On transmission electron microscopy, the stratum corneum was thickened and intercorneocyte spaces were extremely narrow. The first three corneocyte layers contained tonofilaments that were irregular, coarse and wavy. Tonofilament packing appeared more normal and regular in the fourth and fifth corneocyte layers. Outer layers of stratum corneum were extraordinarily electron‐dense compared with normal. There was a decrease in stratum corneum free fatty acid and acyl‐ceramide and an increase in ceramide III levels compared with three normal dogs. Three months of oral vitamin A alcohol did not result in clinical improvement, although histologically the orthokeratosis was less compact. After 6 months of oral etretinate therapy, comedones and scales were markedly less evident grossly. Although compact orthokeratosis was still present on histological examination of skin, it was less than that present at 6 weeks of age. Epidermal cell kinetics were not altered after etretinate therapy.
Investigation on the use of 0.3% tacrolimus lotion for canine atopic dermatitis: a pilot study
Authors: Marsella Rosanna , Nicklin Constance F. 
Published: March 2003

Abstract The efficacy of 0.3% tacrolimus lotion (maximum dosage: 0.3 mg kg−1 per day) for treatment of atopic dermatitis (AD) was evaluated. Systemic absorption and effects on complete blood cell counts (CBC) and chemistry panels were also investigated. Eight dogs were assigned randomly to either a tacrolimus or a vehicle lotion treatment group. Both owners and investigator were blinded to the treatment. After 4 weeks, there was a 2‐week wash‐out period and treatments were reversed. Owners scored pruritus weekly while the investigator scored pruritus and erythema at the beginning and end of each treatment period. Investigator scores for pruritus in the tacrolimus group significantly decreased by the end of the study (P = 0.03). Investigator scores for erythema in the tacrolimus group were significantly lower than those in the placebo group at the end of the study (P = 0.005). There was no difference between groups with respect to owner scores for pruritus. No changes in the CBC and chemistry panels were noted. Mean blood concentrations of tacrolimus were below toxic levels.
Dermal arteritis of the nasal philtrum in a Giant Schnauzer and three Saint Bernard dogs
Authors: Torres Sheila M. F. , Brien Timothy O. , Scott Danny W. 
Published: March 2003

Abstract Arteritis of the nasal philtrum is described in four dogs. Two of the Saint Bernards were related. The lesions were solitary, well‐circumscribed, linear ulcers that were neither pruritic nor painful. The age of the dogs at the time the owners first noticed the lesion ranged from 3 to 6 years. The ulcers had been present for 0.5–5 years before diagnosis was pursued. Three of the dogs experienced repeated, mild episodes of arterial bleeding from the ulcers. Two dogs also experienced a severe episode of bleeding that required surgical intervention. Histopathological findings included a V‐shaped ulcer, neutrophilic dermal inflammation subjacent to the ulcer and lymphoplasmacytic dermatitis bordering the ulcer. The most remarkable pathological findings were present in the deep dermal arteries and arterioles subjacent to the ulcer. The changes were characterized by subendothelial spindle cell proliferation with marked extracellular matrix deposition that stained blue with Alcian Blue (mucin) and Masson's trichrome (collagen) and resulted in intimal thickening, and stenosis of dermal arteries and arterioles. Immunohistochemical studies suggested that the proliferating spindle cells were of either myofibroblast or smooth muscle origin (actin and vimentin positive). Anti‐inflammatory therapy (glucocorticoids; tetracycline and niacinamide; fish oil) may be beneficial for long‐term control of this condition, however, long‐term maintenance treatment appears to be necessary.
Determination of ‘irritant’ threshold concentrations for intradermal testing with allergenic insect extracts in normal horses
Authors: O. Morris Daniel , Lindborg Susan 
Published: March 2003

Abstract Sixteen healthy horses with no history of skin or respiratory disease were used for an intradermal testing (IDT) threshold study, in order to determine the concentrations of 13 commercial allergenic insect extracts most appropriate for IDT. Five dilutions of each extract were used, which included the manufacturer's recommended concentrations for equine IDT, plus one dilution higher and three lower than these standard concentrations. Allergens tested included caddisfly (Trichoptera spp.), mayfly (Ephemeroptera spp.), horsefly (Tabanus spp.), deerfly (Chrysops spp.), fire ant (Solenopsis invicta), black ant (Camponotus pennsylvanicus), cockroach mix (Periplaneta americana and Blattella germanica), mosquito (Aedes aegypti), house fly (Musca domestica), moth (Heterocera spp.), flea (Ctenocephalides canis/C. felis), Culicoides variipennis and Culicoides nubeculosis. Two separate methods were used to calculate the allergen concentration for each insect extract where the normal horses, as a group, ceased to show false‐positive (‘irritant’) reactions. ‘Irritant’ threshold concentrations were determined for 9/13 of these allergens, whereas the other 4 were undetermined due to either insufficient reactivity (flea, C. variipennis) or excessive reactivity (black ant, moth) to the concentrations tested. Recommended concentrations for future use in equine patients with suspected insect hypersensitivity include: 125 pnu mL−1 (mayfly); 250 pnu mL−1 (caddisfly, horsefly, deerfly, fire ant, house fly); 500 pnu mL−1 (cockroach); 1000 pnu mL−1 (mosquito); and 1:10 000 w/v (C. nubeculosis).
Effect of the rust fungus Puccinia chondrillina TU 788 on plant size and plant size variability in Chondrilla juncea
Authors: Hanley M E , Groves R H 
Published: March 2003

Summary Chondrilla juncea is one of the most serious introduced weed species in Australia. Successful biological control has been achieved by the release of the rust fungus Puccinia chondrillina. Although P. chondrillina is thought to reduce the competitive ability of C. juncea by reducing plant size, the precise mechanism by which the pathogen controls its host is poorly understood. In this experiment, we examined the effect of P. chondrillina TU 788 infection on individual plant size, and size variability, in two genotypes (one resistant, one susceptible) of C. juncea. Exposure to P. chondrillina significantly reduced the average size of susceptible C. juncea plants, a reduction apparent in both roots and shoots. Plant size variability of the susceptible C. juncea genotype was also reduced by P. chondrillina. Plant size, and plant size variability of the resistant genotype were unaffected by exposure to rust, or association with rust‐affected plants. The effect of P. chondrillina on plant size in rust‐susceptible C. juncea plants shows how effective bio‐control of this weed may occur in field populations.
Influence of the physical and chemical properties of soil on the retention process of isoxaflutole and its two main derivatives
Authors: Beltran E , Fenet H , Cooper J F , Coste C M 
Published: March 2003

SummaryIsoxaflutole is a new pre‐emergence herbicide for use in maize and sugarcane. Its two main derivatives are a diketonitrile derivative, the 2‐cyano‐3‐cyclopropyl‐1‐(2‐methanesulfonyl‐4‐trifluoromethylphenyl)propan‐1,3‐dione, named DKN, and a benzoic acid derivative, the 2‐methanesulfonyl‐4‐trifluoromethylbenzoic acid, named BA. The adsorption/desorption processes have never been studied for isoxaflutole (IFT) at high concentrations nor for BA, and the present work aimed at completing the knowledge of the behaviour of these three molecules in conditions close to those encountered in the context of agricultural use. The adsorption/desorption study was conducted on seven soils of different physical and chemical properties, using the batch equilibrium technique. During the experiments, IFT was chemically converted into DKN in a continuous manner. This reaction appeared to be dependent on the pH of the soil and was taken into account in the calculations of the adsorbed and desorbed amounts. The adsorption isotherms obtained were predominantly C‐shaped for IFT and DKN and S‐shaped for BA, but some differences appeared on a few soils. They fitted well the Freundlich equation, and the values of the Freundlich coefficient Kfa showed that, whatever the soil, IFT was more adsorbed than its two derivatives. The main parameter influencing the adsorption of IFT appeared to be the organic matter content, whereas this effect was not evident for DKN and BA. No correlation was found between the extent of adsorption and either clay content or pH of the soil, for the three molecules.
Pharmacoeconomic analysis of topical treatments for tinea infections
Authors: Shear Neil H. , Einarson Thomas R. , Arikian Steven R. , Doyle John J. , Van Assche Daniel 
Published: March 2003

Background A payor‐perspective economic analysis of the topical creams ciclopirox, clotrimazole, ketoconazole, miconazole, and terbinafine (TER) used to treat dermatophytosis has been made. This pharmacoeconomic evaluation was conducted in Austria, Germany, and Switzerland. Methods A four‐phase approach was used. Phase 1: experts were assembled to identify the standard approach for management of fungal infections and a decision tree was constructed to model the process. Phase 2: meta‐analysis was used to determine success, failure, and relapse rates. Phase 3: economic analyses performed included cost of regimen, total expected cost, and cost‐effectiveness. Phase 4: sensitivity analyses (robustness analysis) were also executed to determine the validity of the assumptions. Results In the total expected cost analysis, TER demonstrated the lowest overall cost of treating patients. Terbinafine also provided the highest number of disease‐free days during the analytic time horizon and, consequently, the lowest cost per disease‐free day. Sensitivity analyses suggest that TER is the most cost‐effective topical product for treating dermatophytosis in Austria, Germany, and Switzerland. Conclusions All analytic scenarios suggest that TER therapy demonstrates lower expected costs and generates more DFDs when compared with the fungistatic topical therapies included in this pharmacoeconomic analysis. Terbinafine is expected to be the most cost‐effective choice in Austria, Germany, and Switzerland for treatment of dermatophytosis minor.