Thesis (Ph. D.) -- Georgia State University, 2007. / Includes abstract. Includes bibliographical references (leaves 319-350). Original electric version created as PDF file.

published_or_final_version / Microbiology / Master / Master of Philosophy

Thesis (M.S.P.H.)--University of Michigan, 1938.

Thesis (M.S.P.H.)--University of Michigan, 1938.

No description available.

Before the consolidation of the germ theory of human diseases at the end of the nineteenth century, medical explanations about disease causation were dominated by the environmental notions of medical geography. This dissertation explores how nineteenth-century Colombian physicians transformed the medical geographical approach using the early concepts and technologies of the emerging Pasteurian germ theory. I follow this transformation in the cases of periodic fevers (yellow fever and malaria), continuous fevers (typhoid fever and typhus) and leprosy. The analysis reveals that by mid century physicians had incorporated neo-Hippocratic versions of disease causation and French medical geographical ideas in order to make sense of disease of the warm, temperate and cold lands. Their conceptual network revolved around the specific, predisposing and occasional causes in which climate and geography played a determinant role. Evidence indicates that this was the case of periodic fevers of the warm lands (yellow fever and malaria). I argue that the “parasitic” hypothesis of yellow fever was accepted during the controversy around the prophylactic inoculations inspired by Pasteurism that were applied in Colombia in 1887. However, doctors struggled to reconcile the medical geographical and the bacteriological perspective of both yellow fever and malaria. Continuous fevers, on the other hand, were also framed within the medical geography scheme of disease causation. I show how during the debates about typhoid fever and typhus happening in the Colombian highlands during the 70s, 80s and 90s, doctors used medical geographical notions and developed anti-pasteurian arguments, while the international scientific community had identified the specific bacilli for typhoid fever. Finally, I argue that the strong interest of Colombian doctors on leprosy –also understood in neo-Hippocratic terms- that foster the search for local treatments based on Pasteurism (antiseptics in the 1880s and serotherapy in the 1890s) also prompted the extension of the bacteriological model and techniques to other diseases in those decades.

Typhoid fever remains an important public health problem globally. Cluster randomized effectiveness trials with typhoid Vi polysaccharide vaccine were conducted in Kolkata, India and Karachi, Pakistan, to provide evidence for vaccine introduction. While efficacy trials are limited to estimate vaccine's performance on the vaccine recipients, effectiveness trials consider the public health impact, notably the herd protection, or indirect effect, which can only be seen when vaccines are administered to groups rather than to individuals. The observed total protection by the Vi polysaccharide vaccine in school-aged children was consistent in Kolkata and Karachi (61% and 56%, respectively), and was associated with minimal side-effects. The total protection in young children, however, was different (80% in Kolkata and no protection in Karachi). The Kolkata trial demonstrated significant herd protective effects, as demonstrated by indirect protection of non-vaccinees (45%), which was not shown in the Karachi trial. The difference in the effectiveness estimates between the trials may be due to the difference in study design and the population characteristics. Immunogenicity studies were undertaken for randomly selected persons from both sites at pre-vaccination, 6 weeks, and 2 years post-vaccination. Serum Vi antibody titres (IgG) were measured through ELISA. At baseline, the GMTs were below the protective level for both sites. At six weeks after vaccination, though there is a significant increase in the GMTs in children from both site, the level of GMTs were significantly lower from those in Karachi (2,307.0 ELU vs. 1,189.1 ELU). GMT declined from 6 week to 2 year testing points for both sites but maintained the protective level. These effectiveness trials gave a conclusive evidence of the protection conferred by the Vi polysaccharide vaccine in children older than 5 years of age. Targeted vaccination programme in high endemic areas, as stipulated in the WHO Position Paper, suggest the potential for effective control of typhoid fever in places like India and Pakistan with the school-based Vi vaccination.

Thesis (Ph. D.)--Georgia State University, 2007. / Title from file title page. Wendy H. Venet, committee chair; Stuart Galishoff, Charles G. Steffen, committee members. Electronic text (338 p.) : digital, PDF file. Description based on contents viewed Feb. 4, 2008. Includes bibliographical references (p. 308-338).

p. 1-69 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-11T19:49:38Z No. of bitstreams: 1 MP Cristiane Penaforte MP.pdf: 718797 bytes, checksum: c2cc2e88d1b7f14401ea20964a258cdf (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:21:05Z (GMT) No. of bitstreams: 1 MP Cristiane Penaforte MP.pdf: 718797 bytes, checksum: c2cc2e88d1b7f14401ea20964a258cdf (MD5) / Made available in DSpace on 2013-05-04T17:21:05Z (GMT). No. of bitstreams: 1 MP Cristiane Penaforte MP.pdf: 718797 bytes, checksum: c2cc2e88d1b7f14401ea20964a258cdf (MD5) Previous issue date: 2005 / A febre tifóide (FT) é uma doença de distribuição universal, associada às precárias condições higiênico-sanitárias. Nas regiões Norte e Nordeste do Brasil a doença é endêmica, com ocorrência freqüente de surtos. A vigilância epidemiológica (VE) da FT representa importante ferramenta para detecção oportuna de surtos visando impedir ou dificultar a sua propagação. Objetivos: Avaliar o sistema de vigilância da febre tifóide no Brasil, entre os anos de 2001 a 2003. Métodos: Um estudo descritivo foi realizado baseado nas Diretrizes dos Centers for Disease Control and Prevention (CDC, EUA) publicado em 1988. A fonte de dados incluiu informações do Sistema de Informação de Agravos de Notificação (Sinan) e o Sistema de Informação sobre Mortalidade (SIM). Os atributos avaliados foram qualitativos (simplicidade, flexibilidade, aceitabilidade) e quantitativos (sensibilidade, valor preditivo positivo- VPP, representatividade, oportunidade). Resultados: O sistema de vigilância é complexo envolvendo vários níveis de gestão para transferência dos dados, com mais de 30 mil unidades notificadoras vários formulários para notificação de caso ou surto. A ficha individual de investigação apresenta mais de 70 campos. A aceitabilidade é baixa pela ausência de preenchimento de campos importantes para a VE: 54% das variáveis estavam incompletas em mais de 50% dos dados. A flexibilidade do sistema não foi possível avaliar pela ausência de informações. A sensibilidade do Sinan para óbitos foi baixa (19%) e ambos os sistemas detectaram apenas 54% dos óbitos estimados (N=52). O VPP dos casos encerrados pelo critério laboratorial foi abaixo: 29% em 2001, 44% em 2002 e 41% em 2003. O sistema foi oportuno, com uma mediana de 07 dias para a notificação após o início dos sintomas, < de 01 dia para a investigação e 25 dias para o encerramento dos casos. O sistema é representativo pela alta cobertura do Sinan e SIM no país, no entanto, há limitações quanto ao subregistro de casos. Conclusão: Apesar do baixo desempenho, o sistema de vigilância da FT é útil para análise das informações de morbidade e mortalidade e o efeito das medidas de controle e prevenção. Porém, o sistema precisa melhorar a sensibilidade e aceitabilidade para alcançar seus objetivos mais eficientemente. Desta forma, recomendamos capacitação dos profissionais de saúde na detecção, notificação e investigação de FT. / Salvador

This thesis represents the first anthropological perspective to be offered on the nature of the Klondike Gold Rush population. In order to better understand the experience of the average gold rusher, morbidity and mortality patterns are examined for the residents of the Yukon Territory following the discovery of gold in the region (1898-1904). Infectious diseases such as measles, pneumonia, smallpox and typhoid fever are the primary focus of this study, however local factors such as the severe climate and the seclusion of the gold fields from the outside world also offers an interesting opportunity to examine the consequences of leading a particularly harsh and physically demanding lifestyle in an inhospitable environment. / October 2008