bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of maternal height as a risk factor of dystocia: a meta‐analysis
Authors: Dujardin Bruno , Cutsem Roger Van , Lambrechts Thierry 
Published: November 2003

SummaryTen publications and studies on the relation between maternal height and the risk of dystocia due to cephalopelvic disproportion (CPD) are analysed. The rate of Caesarean sections was chosen as the CPD indicator. When maternal height is presented in percentiles, curves can be superimposed, and sensitivities and specificities of the various studies may be analysed together. One biased study was excluded; the remaining 9 were pooled and regression lines calculated for sensitivity (Se) and specificity (Sp) of the entire set of points. The resulting model, i.e. Se = 10.9+1.99 Y and Sp = 99.9 − 0.99 Y, permits easy calculation of the expected sensitivity and specificity for each percentile Y. When the frequency of Caesarean section due to CPD is known, positive and negative predictive values can also be calculated. The proposed formulas can also be used to determine confidence intervals.The findings in terms of the sensitivity and specificity of low maternal height as a risk factor for dystocia indicate that 1 out of 5 pregnant women would have to be referred for further investigation to identify half of the cases of mechanical dystocia necessitating Caesarean section. The predictive value for a Caesarean rate of 2% (a value often seen in developing countries) for this 20th percentile would be only 5%. Practical ways of choosing a reference criterion are suggested. A two‐track strategy (antenatal check‐ups and community monitoring) is proposed.
Knowledge and beliefs about transmission, prevention and control of lymphatic filariasis in rural areas of South India
Authors: Ramaiah K. D. , Kumar K. N. Vijay , Ramu K. 
Published: November 2003

SummaryTo identify the gaps in people's knowledge of lymphatic filariasis, we collected descriptive and quantitative information in rural areas of Tamil Nadu, South India. People are well aware of filariasis in their communities and recognize its different clinical manifestations. Only 9% of those with and 20% of those without the disease knew that filariasis is caused through mosquito bites; the rest attributed it to many other causes. People's knowledge about transmission and prevention of filariasis is also very poor. The study identifies the rationale for people's misconceptions about the disease. Misconceptions and ignorance could adversely affect personal protection measures against mosquito bites and the use of appropriate treatment. Health education campaigns aimed at highlighting the role of mosquitoes in transmission and the importance of early diagnosis should help people in taking personal protection measures and seeking appropriate treatment.
Mefloquine tolerability during chemoprophylaxis: focus on adverse event assessments, stereochemistry and compliance
Authors: Schlagenhauf P. , Steffen R. , Lobel H. , Johnson R. , Letz R. , Tschopp A. , Vranjes N. , Bergqvist Y. , Ericsson O. , Hellgren U. , Rombo L. , Mannino S. , Handschin J. , Stürchler D. 
Published: November 2003

SummaryThis longitudinal study of travellers to Africa taking mefloquine (MQ) chemoprophylaxis aimed to quantify and assess non‐serious adverse events (AE) occurring during short‐term prophylaxis and relate these to concentrations of racemic MQ, its enantiomers and metabolite. A total of 420 volunteers (52% F) participated. AEs with some impact on activities were reported by 11.2% of participants including 7.9% of neurological/psychiatric symptoms. Women were more likely to report AEs (P=0.02). The standardized questionnaires used showed more pathological indicators in travellers who reported subjective AE with significantly more dizziness, distress, sleep disturbances and a high total mood disturbance (TMD) in the AE group. There was, however, no significant performance deficit in computerized psychomotor tests in those experiencing AE. Furthermore, no significant differences were observed in enantiomer ratios, metabolite concentrations, or racemic MQ levels in participants with or without AEs suggesting that these factors are not the main predictors of mefloquine intolerability.
Isometamidium concentrations in the sera of cattle maintained under a chemoprophylactic regime in a tsetse‐infested area of Zimbabwe
Authors: Eisler M. C. , Maruta J. , Nqindi J. , Connor R. J. , Ushewokunze‐Obatolu U. , Holmes P. H. , Peregrine A. S. 
Published: November 2003

SummaryAn experiment was carried out to determine the concentrations of the trypanocidal drug isometamidium chloride in the sera of cattle maintained under a chemoprophylactic regimen at Rekomitjie, Zimbabwe, an area of high tsetse challenge in the Zambezi valley. In February 1993, 24 cattle at this site were treated intramuscularly with isometamidium chloride at a dose of 1.0 mg/kg body weight. Thereafter all animals were monitored regularly for 6 months for the presence of trypanosomes and sera were collected to determine the concentrations of isometamidium using an ELISA. Isometamidium treated cattle appeared to be protected against trypanosome infections for at least 18 weeks following treatment. Thereafter, three trypanosome infections were detected, between 20 and 22 weeks following treatment. In contrast, in 18 untreated control cattle at the same site, 9 trypanosome infections were detected over the first 18 weeks of the experiment. Quantification of the isometamidium concentration in sera from the drug treated cattle indicated that the apparent half‐life of isometamidium in these animals was 23 days. This was similar to the half‐life observed previously in cattle treated under laboratory conditions. The isometamidium ELISA was shown to be capable of quantifying drug levels in 20 out of 23 cattle for at least 70 days after treatment. There was no evidence of drug resistant trypanosomes at this site.
On estimating the basic reproduction number forSchistosoma haematobium
Authors: Woolhouse M. E. J. , Hasibeder G. , Chandiwana S. K. 
Published: November 2003

SummaryExisting estimates of the basic reproduction number,Ro, for human schistosomes are mostly in the range 1–4, implying that schistosomes should be relatively easy to eliminate from endemic areas, which is contrary to practical experience. An estimate ofRofor a site in Zimbabwe is obtained here using a mathematical model explicitly incorporating two features believed to be epidemiologically significant; age‐dependent exposure and acquired immunity. Parameter estimates are, as far as possible, obtained independently, but the coefficients representing man‐snail and snail‐man transmission, as well as parameters representing effects of acquired immunity, must be estimated indirectly by fitting the model to field data. Heterogeneity in human exposure and contamination is crudely incorporated by considering ‘wormy and non‐wormy’ fractions of the population. The results suggestRoto be in the range 4–5 or more, higher than previous estimates and despite only moderate levels of infection at this site. It is shown that this estimate is sensitive to the form of the underlying model. The application of less realistic models may lead to less reliable estimates ofRo.
The public and domestic domains in the transmission of disease
Authors: Cairncross Sandy , Blumenthal Ursula , Kolsky Peter , Moraes Luiz , Tayeh Ahmed 
Published: November 2003

SummaryThis paper discusses the distinction between the transmission of infectious diseases within the domestic domain (the area normally occupied by and under the control of a household) and that in the public domain, which includes public places of work, schooling, commerce and recreation as well as the streets and fields. Whereas transmission in the public domain can allow a single case to cause a large epidemic, transmission in the domestic domain is less dramatic and often ignored, although it may account for a substantial number of cases. Statistical methods are available to estimate the relative importance of the two. To control transmission in the public domain, intervention by public authorities is likely to be required. Two examples show how environmental interventions for disease control tend to address transmission in one or the other domain; interventions are needed in both domains in order to interrupt transmission.
Membrane characterization of amastigote‐like forms of Leishmania donovani
Authors: Gupta Nidhi , Goyal Neena , Kumar Raj , Agrawal Ashok K. , Seth Prahlad K. , Rastogi Anil K. 
Published: November 2003

SummaryDuring in vitro transformation, Leishmania donovani promastigotes converted into amastigote‐like forms and underwent several changes in membrane parameters. They exhibited significantly increased microviscosity comparable to true amastigotes. Activities of several functionally important membrane bound enzymes were also altered, thereby indicating a change in their orientation. Peanut agglutinin was found to be specific for agglutination of stationary phase promastigotes whereas wheat‐germ agglutinin was specific for the amastigote‐like forms as well as for pure amastigotes, implying the presence of specific glycoconjugates on the parasite surface.
Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo‐controlled, double‐blind study*
Authors: Syed Tanweer A. , Ahmad S. Ashfaq , Holt Albert H. , Ahmad Seyed Ali , Ahmad Seyed Hamzeh , Afzal Mohammad 
Published: November 2003

SummaryThe purpose of this double‐blind, placebo‐controlled study was to evaluate the clinical efficacy and tolerability of topical Aloe vera extract 0.5% in a hydrophilic cream to cure patients with psoriasis vulgaris. Sixty patients (36M/24F) aged 18–50 years (mean 25.6) with slight to moderate chronic plaque‐type psoriasis and PASI (Psoriasis Area and Severity Index) scores between 4.8 and 16.7 (mean 9.3) were enrolled and randomized to two parallel groups. The mean duration of the disease prior to enrolment was 8.5 years (range 1–21). Patients were provided with a precoded 100 g tube, placebo or active (with 0.5%Aloe vera extract), and they self‐administered trial medication topically (without occlusion) at home 3 times daily for 5 consecutive days per week (maximum 4 weeks active treatment). Patients were examined on a weekly basis and those showing a progressive reduction of lesions, desquamation followed by decreased erythema, infiltration and lowered PASI score were considered healed. The study was scheduled for 16 weeks with 12 months of follow‐up on a monthly basis. The treatment was well tolerated by all the patients, with no adverse drug‐related symptoms and no dropouts. By the end of the study, the Aloe vera extract cream had cured 25/30 patients (83.3%) compared to the placebo cure rate of 2/30 (6.6%) (P<0.001) resulting in significant clearing of the psoriatic plaques (328/396 (82.8%) vs placebo 28/366 (7.7%), P<0.001) and a decreased PASI score to a mean of 2.2. The findings of this study suggest that topically applied Aloe vera extract 0.5% in a hydrophilic cream is more effective than placebo, and has not shown toxic or any other objective side‐effects. Therefore, the regimen can be considered a safe and alternative treatment to cure patients suffering from psoriasis.
Non‐typhoidal Salmonella bacteraemia: clinical features and risk factors
Authors: Thamlikitkul Visanu , Dhiraputra Chertsak , Paisarnsinsup Thongchai , Chareandee Chokchai 
Published: November 2003

SummaryA case control study was conducted to determine the risk factors of non‐typhoidal Salmonella bacteraemia. Eighty adult patients with non‐typhoidal Salmonella bacteraemia admitted to Siriraj Hospital from January to December 1993 served as the cases. The controls comprised 3 groups: group 1, 80 adult in‐patients with Escherichia coli bacteraemia; group 2, 80 adult in‐patients who did not have bacteraemia and had been admitted to the hospital during the same period as the cases; group 3, 80 in‐patients who did not have Salmonella bacteraemia and matched the cases in terms of gender, age, hospital services and admission date. AIDS and corticosteroid use were the major risk factors for acquiring non‐typhoidal Salmonella bacteraemia with an odds ratio of 7.27 to 12.31 (95% confidence interval of 3.39 to 29.40). Almost all patients with non‐typhoidal Salmonella bacteraemia presented with a fever for a median duration of 7 days. AIDS patients usually had concomitant opportunistic infections. Salmonella group D was the most common serogroup. Most patients were treated with co‐trimoxazole, quinolones, ceftriaxone and ampicillin. Localized suppurative complications were observed in 14% of the patients; the overall mortality rate was 36.3%, 12% of whom died prior to receiving appropriate antibiotics for Salmonella.
Helminth infections, morbidity indicators and schistosomiasis treatment history in three villages, Dongting Lake region, PR China
Authors: Booth Mark , Li Yuesheng , Tanner Marcel 
Published: November 2003

SummaryIn order to estimate the public health impact of helminth infections, and to provide baseline data for interventions, parasitological and morbidity surveys were conducted among inhabitants of three villages in Dongting Lake region, Hunan Province, China. Ascaris lumbricoides was found to be the most common helminth infection, followed by Trichuris trichiura and Schistosoma japonicum. Left liver enlargement was the most common indicator of morbidity. Observed numbers of multiple species infections closely correlated with expected figures generated from a simple probabilistic model. Heterogeneity was observed in age and sex‐standardized infection and morbidity prevalences among the villages and occupations. Males had higher levels of infection, were more likely to suffer morbidity, and were more likely to have been treated for schistosomiasis than women. The prevalence of each morbidity indicator was positively correlated with the number of times of treatment for schistosomiasis, and negatively correlated with number of years since last treatment. The results imply that treatment history for S. japonicum infection may be a good indicator of current morbidity risk.
Polymerase chain reaction for detecting Onchocerca volvulus in pools of blackflies
Authors: Oskam L. , Schoone G. J. , Kroon C. C. M. , Lujan R. , Davies J. B. 
Published: November 2003

SummaryThe detection of Onchocerca volvulus infected simuliids or blackflies is routinely done by dissection and microscopic examination of individual flies, but this method is tedious and time consuming. Here we describe a method of detecting single O. volvulus infected blackflies in pools of uninfected blackflies. Using a PCR with Onchocerca specific primers it is possible to reproducibly detect one heavily infected blackfly in a pool of 80 flies, or to detect one blackfly inoculated with one microfilaria in a pool of 20 flies. With the method described large numbers of blackflies can be rapidly screened for the presence of O. volvulus infected flies.
Typhoid fever in Ujung Pandang, Indonesia – high‐risk groups and high‐risk behaviours
Authors: Velema Johan P. , Van Wijnen Germaine , Bult Peter , Van Naerssen Ton , Jota Santa 
Published: November 2003

We performed a hospital‐based case‐control study to identify high‐risk groups and routes of transmission of typhoid fever in the city of Ujung Pandang on the island of Sulawesi, Indonesia. The annual incidence of this disease in southern Sulawesi is estimated at 3.1/1000 and the case fatality at 5.1% Cases were 50 patients over 13 years of age admitted to Stella Maris Hospital with a diagnosis of typhoid fever between June and September 1991. Diagnosis was made on clinical grounds and in 90% of cases confirmed by a Widal test. Controls were 42 patients admitted for non‐infectious disorders during the same period and individually matched by age and sex. Controls did not have a history of typhoid fever. Interviews took place in hospital. Analysis was by unconditional logistic regression. High‐risk groups consisted of those who were single, unemployed and those who had a university education. Median age of cases was 22 years. Consumption of food from warungs (food stalls in the street) was strongly associated with risk (OR = 45). Both cases and controls washed hands after use of the toilet and before meals, but cases used soap significantly less often (OR = 30). The results of this study can be used to take preventive measures against this severe disease of educated and single young adults by targetting them for IEC‐activities emphasizing the importance of thorough hand‐washing and the need to take care in the selection of street‐foods.
The reliability of self‐reported blood in urine and schistosomiasis as indicators of Schistosoma haematobium infection in school children: a study in Muheza District, Tanzania
Authors: Ansell Juliet , Guyatt Helen , Hall Andrew , Kihamia Charles , Kivugo Joyce , Ntimbwa Perpetua , Bundy Donald 
Published: November 2003

SummaryThe use of self‐reported blood in urine and schistosomiasis by school children was investigated as a tool to estimate the prevalence of infection with Schistosoma haematobium and to identify infected individuals. A general questionnaire about common health problems, including questions about blood in urine and schistosomiasis, was administered by teachers to 25443 children in 137 primary schools in Muheza District, Tanzania. The prevalence of reported schistosomiasis was calculated for each school and used to select 15 schools across a range in prevalence. All children in the 15 schools (n = 2370) were interviewed again by a nurse and gave a urine sample which was subjected to a quantitative microscopical examination for the eggs of S. haematobium by filtration. The prevalence of reported schistosomiasis by the interview in the 15 schools correlated strongly with the prevalence reported during the questionnaire survey. The prevalence of reported schistosomiasis in the interview was strongly correlated with the prevalence of infection determined by microscopy and consistently under‐estimated the latter by around 20% across a range in prevalence from 22% to 93%. The sensitivity of diagnosis by an interview increased almost linearly with the prevalence of infection, so that when the prevalence was high, more infected children reported schistosomiasis. The percentage of children who were correct in their self‐diagnosis was independent of the prevalence of infection and of the mean concentration of eggs in urine, and averaged 75%. These findings suggest that self‐reported schistosomiasis is a useful method to estimate the prevalence of infection in schools and might be used to identify infected individuals.
Predicting high‐risk years for malaria in Colombia using parameters of El Niño Southern Oscillation
Authors: Bouma M.J. , Poveda G. , Rojas W. , Chavasse D. , Quiñones M. , Cox J. , Patz J. 
Published: November 2003

SummaryThe interannual variation in malaria cases in Colombia between 1960 and 1992 shows a close association with a periodic climatic phenomenon known as El Niño Southern Oscillation (ENSO). Compared with other years, malaria cases increased by 17.3% during a Niño year and by 35.1% in the post‐Niño year. The annual total number of malaria cases is also strongly correlated (r= 0.62, P < 0.001) with sea surface temperature (SST) anomalies in the eastern equatorial Pacific, a principal parameter of ENSO. The strong relation between malaria and ENSO in Colombia can be used to predict high and low‐risk years for malaria with sufficient time to mobilize resources to reduce the impact of epidemics. In view of the current El Niño conditions, we anticipate an increase in malaria cases in Colombia in 1998. Further studies to elucidate the mechanisms which underlie the association are required. As Colombia has a wide range of climatic conditions, regional studies relating climate and vector ecology to malaria incidence may further improve an ENSO‐based early warning system. Predicting malaria risk associated with ENSO and related climate variables may also serve as a short‐term analogue for predicting longer‐term effects posed by global climate change.
Trachoma in Jimma Zone, South Western Ethiopia.
Authors: Zerihun Negussie 
Published: November 2003

SummaryA population‐based survey on trachoma was carried out in Jimma zone. The survey showed that trachoma is hyperendemic: of 7,423 people examined, 33.02% had signs of trachoma, 28.9% of males and 37.01% of females; 26.13% of the urban and 34.09% of the rural population had clinical signs of trachoma. Active trachoma (TF*TI) was seen in 24.5% of the study population (an estimated half million people). The prevalence of signs of active trachoma among children 0–10 years of age was 35.7%. Blinding trachoma (CO*TT) was seen in 3.81% of the population: 6.86% of the female population aged 15 years had trichiasis and/or entropion.Both active and critical trachoma were significantly associated with the female gender (P < 0.0000001 for each), living in rural areas (P < 0.0001 for each type), parental illiteracy (P < 0.0000001 for each) and absence of a latrine (P < 0.01 for each). Shorter distance of the household water supply was associated with a higher prevalence of both active and cicatricial trachoma. This was significant only for cases of active trachoma living in households within 16 to 30 minutes walking distance from the water source (P < 0.03).An estimated 17000 people in the zone are blind; 3500 of these from trachoma. About 52,000 people are in danger of blindness from trichiasis. Primary eye care activities such as promoting health education (face washing) among community members, especially women and children, mass chemotherapy for trachoma, training of health workers and establishment of community‐based surgical services are recommended. These are to be executed by the Zonal Health Department in close collaboration with the community, governmental and non‐governmental organisations.
Light and electron microscopic findings in rhinosporidiosis after dapsone therapy
Authors: Venkateswaran Sarada , Date Anand , Job Anand , Mathan Minnie 
Published: November 2003

SummaryMorphological findings in serial nasal mucosal biopsies from three cases of rhinosporidiosis on dapsone therapy were compared with biopsies from 33 patients taken before dapsone or surgical treatment was initiated. All biopsies were examined by light microscopy and five by electron microscopy. Counts of histologically intact and degenerated organisms showed a decreasing proportion of intact forms with treatment.
Availability of antibiotics as over‐the‐counter drugs in pharmacies: a threat to public health in Vietnam
Authors: Duong Dat Van , Binns Colin William , Le Truyen Van 
Published: November 2003

SummaryA survey on the use of antibiotics purchased through retail pharmacies was conducted in the Badinh district of Hanoi, Vietnam. The survey found that purchasers visit a pharmacy when they or those who felt they needed antibiotics had minor symptoms such as cough (34.1%), sore throat (32.5%), stomach upsets (10.0%) and diarrhoea (8.8%). The most often purchased antibiotics were ampicillin (31.1%), amoxyllin (16.7%), cotrimoxazol (11.6%), tetracycline (5.2%) and cephalexin (4.8%). The median of the purchased quantity was to tablets, the mean 11.34 tablets (95% CI 9.65–12.97). About 30% of the purchasers intended to take antibiotics for three days or less. The mean cost of a antibiotic purchase was US$1.27 (95%CI 1.06–1.39). The main reason for not taking a full course of antibiotics was not economic constraint, but the purchasers poor knowledge about antibiotics. Logistic regression analysis indicates that age of purchasers, length of symptoms and kinds of treatment used before visiting a pharmacy could be used as predictive variables for the decision to buy antibiotics in preference to alternative drugs. Antibiotics are used when illness lasts longer than one week and antibiotics have not yet been taken. Antibiotics are‐also purchased by young rather than old people. The study documents the need for better health education about the rational use of antibiotics in the general public.