acase@tulane.edu

acase@tulane.edu

acase@tulane.edu

acase@tulane.edu

acase@tulane.edu

The severe shortage and maldistribution of Western-trained health personnel in Nigeria, and the realization that traditional healers and midwives are the only available providers of health care to most Nigerians living in rural areas led to the recommendation that traditional practitioners be integrated into the present hospital-oriented medical system in the country. Though the two systems of care are utilized jointly by a number of consumers, the recommendation faces several problems; and the inadequacy of existing modern health care facilities further represent a major public health planning problem Most of the studies undertaken in Nigeria to identify some of the socio-demographic and cultural factors which influence the pattern of utilization of health care facilities were conducted in Ibadan/Ibarapa division of Western Nigeria. Their findings, though in general agreement, could not be widely applied to the diverse ethnic/cultural groups in the country The purposes of this study were: First, to identify the pattern of utilization of maternity care services and the socio-demographic and cultural characteristics of 'users' and 'non-users' of modern maternity care services among reproductive-aged Egba-Egbado Yoruba women residing in a rural area of Ogun State (Nigeria). Second, to assess the influence of selected socio-demographic and cultural variables, illness behavior, and knowledge and attitudes of the women regarding modern (hospital-oriented) maternity care on their utilization of existing maternity care services and personnel A sample of 250 households was systematically selected for this study, and 304 Egba-Egbado Yoruba women (age 15-44) who had a child between January, 1979 and December, 1981 were interviewed concerning pregnancy, delivery and child care. An interview schedule prepared especially for the purposes of this study was administered to the eligible women by trained interviewers The factors found to differentiate 'users' from 'non-users' were socio-economic factors (level of education, literacy, and occupation), the use of native medicines during pregnancy, knowledge of location of a 'hospital', number of times attended antenatal clinic, and their utilization experience within the system On the basis of this study, a number of considerations are derived for the planning of maternity health education programs needed, and recommendations are given for future studies that will improve the information base for health planning in general / acase@tulane.edu

acase@tulane.edu

Background: Fungal infections such as Candida in pediatric patients are associated with worse clinical outcomes and increased costs, yet it is not definitively known if particular Candida species are associated with worse clinical outcomes than others. Differential risk factor exposures among the species group may also exist. This retrospective study of hospitalized pediatric patients at a large U.S. urban pediatric hospital aims to determine whether certain Candida species are more strongly associated with worse outcomes than others, as well as whether certain risk factors more strongly predispose patients to infection with certain Candida species. Methods: Microbiology lab records from patients seen from 2003-2010 at Children's Hospital of New Orleans, Louisiana, were reviewed to assemble a cohort of patients with invasive or disseminated Candida infections. Data on numerous measures of disease severity/outcome and risk factors were abstracted and analyzed to determine differences associated with various Candida species. Hospital patients’ length of stay and survival were also compared to those of a national patient sample from the corresponding years’ editions of the National Hospital Discharge Survey. Results: 106 cases of infection were analyzed. In general, differences among Candida species in terms of disease severity/outcome were insignificant. Nonalbicans species were associated with a significantly longer length of stay post diagnosis, as well as longer courses of treatment. C. albicans was associated with a higher number of antihypotensive medications required and length of mechanical ventilation postdiagnosis. C. tropicalis was associated with the highest mortality rate. In a multivariate model, borderline significantly higher risk for non-albicans infection was observed for patients receiving antifungal prophylaxis and longer than 96 hours mechanical ventilation. Higher risk for C. albicans infection was associated with antineoplastic chemotherapy. Longer lengths of stay and higher mortality rates were observed at the hospital studied compared to patients in the NHDS sample. Conclusion: Interspecies differences may exist for Candida in terms of disease severity and risk factors. Efforts to prevent infection should be tailored to the Candida species most likely to affect the pediatric subpopulation of interest, such as through targeted prophylaxis. Sound infection control practices are of critical importance in minimizing the impact of these infections. / acase@tulane.edu

acase@tulane.edu

From July, 1977 through March, 1979 a study of Schistosoma haematobium was conducted in the Sahelian portion of the Senegal River Basin (SRB). A prevalence survey for schistosomiasis was conducted in 19 villages in the SRB, chosen to represent various ethnic groups and types of surface water / acase@tulane.edu