Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

The thesis is concerned with what should be done to decrease the incidence of human salmonellosis in Canada. The present high incidence of Salmonella contaminated poultry is reviewed and evidence is given that links Salmonella contaminated poultry carcasses at the retail level to human salmonellosis. The question is raised as to whether control or eradication should be the goal in Canada, and present regulations involving various levels of Governments are examined. The incidence of Salmonella contaminated poultry in some other countries is reviewed, together with some of the Salmonella control programmes that have been instituted by these countries. Finally, certain recommendations are made, as to what could be done in Canada to decrease the incidence of human salmonellosis. These recommendations stress the need for further research to develop ways of decreasing the incidence of Salmonella contaminated poultry at the retail level. The colonization of the gut of day-old chickens with the intestinal flora of adult chickens is a method that shows promise. The use of radiation and chlorination of the poultry carcasses would also help to reduce the incidence of carcass contamination. If Canada is determined to reduce human salmonellosis, then steps must be taken to coordinate the many different branches of both the Federal and Provincial Governments, and regulations, when promulgated, must be enforced. Caterers and those cooking in their own homes must be educated on correct food handling practices and cooking techniques. Human salmonellosis will probably never be eradicated, but its present incidence could certainly be reduced. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Objective: To determine whether dosage adjustment of enoxaparin during pregnancy, in order to maintain a peak anti-Xa of 1.0-1.2 U/ml, is safe for women with mechanical prosthetic heart valves (MPHV). Methods: This was a prospective observational study performed at Charlotte Maxeke Johannesburg Academic Hospital from 2007 to 2009. 15 women with MPHVs were treated with enoxaparin with dosage adjustment throughout pregnancy to achieve a peak anti-Xa of 1.0-1.2 U/ml. Main outcomes measured were prosthetic valve thrombosis, bleeding and maternal mortality. Results: There was no maternal mortality. None of the women developed valvular thrombosis during pregnancy. Two women developed epistaxis and another developed spotting per vagina. There was no foetal mortality. Conclusion: Our data show that enoxaparin may be administered safely during pregnancy to pregnant women with mechanical prosthetic heart valves when there is dosage adjustment throughout pregnancy in order to maintain an anti-Xa of 1.0-1.2 U/ml.

A dissertation submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg in fulfillment of the requirements for the degree of Master of Science in Medicine, Johannesburg , 2013 / South Africa’s Prevention of Mother-to-Child Transmission (PMTCT) programme is critical for eliminating vertical HIV transmission and reducing infant mortality. Early treatment of HIV-infection to curb infant deaths requires earlier diagnostic testing than the currently recommended six-week test. This study describes the continuum of PMTCT care at a Johannesburg hospital to identify interventions for improvement and investigates birth HIV testing for infants. Data from a cohort study at the hospital evaluating diagnostic assays in HIV-exposed infants were collated with routine clinical data, validated and analysed. Among 838 mother-infant pairs, 38% of mothers attended antenatal clinics early enough to receive optimal antenatal prophylaxis. Only 72% of infants accessed six-week testing at the hospital; a further 10% underwent testing elsewhere. Of 38 HIV-infected infants, 29 were infected in-utero and could have been identified at birth (sensitivity of 76.3% for birth testing), compared to only 26 (68%) diagnosed by six-week testing at the hospital. Majority (88%) of these 26 infants accessed antiretroviral therapy, but treatment was only initiated at a median age of 16.0 weeks and 43% of HIV-infected infants who initiated treatment had defaulted or died before the end of the study. Mathematical modelling demonstrated that birth testing would be superior to a six-week test to maximise infants diagnosed and life years saved, with the ideal algorithm being a birth and ten-week test. The PMTCT programme can be enhanced by earlier antenatal care for women and earlier infant diagnosis. Birth testing would diagnose HIV-infection before infants die or default from the PMTCT programme, thereby enabling effective monitoring of MTCT, and would allow earlier treatment initiation to reduce early infant mortality.

Thesis (M.Sc.D.)--Boston University, School of Graduate Dentistry, 1975. Periodontology. / Includes bibliographic references: leaves 112-131. / One hundred-twenty subjects were assigned to AP-100 enzyme mouthwash, used twice daily, in a doubleblind treatment schedule for six weeks. They were divided equally into Part A and Part B, sixty subjects each. In Part A, subjects ,vere scored, then half of them were randomly assigned to placebo and half to AP-100 enzyme. Removal of pre-existing plaque and treatment of gingivitis only were considered in this part. Part B, focused on reducing plaque accumulation and treatment of gingivitis. Therefore, all subjects in Part B underwent complete prophylaxis with a base line score equal to zero. Gingivitis only was scored in this group and the subjects were randomly assigned half to AP-100 and the other half to placebo. Plaque and gingivitis were scored at three and six weeks. [TRUNCATED]

Malaria is transmitted by the mature, blood feeding portion of mosquito vector populations. Malaria vector control programs based on indoor residual spraying (IRS) of insecticides are designed to target resting adult Anopheles mosquitoes before or after they have blood fed. When a female mosquito acquires a blood meal, she could also ingest harmful xenobiotics that are present in the blood. During the resting period after feeding, many processes are initiated in order to assist in the digestion and assimilation of the blood. Ultimately, this enables the mosquito to absorb those amino acids needed for the biosynthesis of yolk proteins, which are essential for subsequent egg maturation. Since the regulation of xenobiotic (including insecticides) detoxification enzyme systems is likely to be altered in response to the ingestion of blood, this study aimed to investigate the effect of a blood meal on insecticide tolerance in insecticide resistant and susceptible southern African strains of the major malaria vector Anopheles funestus. Through the use of CDC bottle bioassays it was demonstrated that blood fed An. funestus carrying a pyrethroid resistant phenotype are even more tolerant of pyrethroid intoxication than their unfed counterparts. Using another major malaria vector, An. gambiae, microarray analysis revealed that a general increase in delta class glutathione-s-transferase (GST) expression occured in response to a blood meal. One gene, GSTD3, was over-expressed in both blood fed An. gambiae and An. funestus. Although this gene could not be validated with real time quantitative PCR, it serves as a viable target for future investigations. Since the pyrethroid resistant phenotype of southern African An. funestus has been linked to the over-expression of the duplicate copy gene CYP6P9, the expression levels of both copies of this gene were investigated. CYP6P9 and its copy, CYP6P13, showed a small but significant increase in expression in response to a blood meal. The increased expression of these major effect genes in response to blood feeding may be responsible for the increase in insecticide tolerance seen in the bottle bioassays. In an effort to repeat these experiments on wild caught An. funestus, field material was collected from Karonga in northern Malawi. Specimens were morphologically identified as members of the An. funestus group. However, attempts to molecularly identify them to species level failed. Through the use of ITS2 and D3 sequence analysis, cytogenetics and cross mating studies it was possible to conclude that these wild caught specimens were a new species. They have been provisionally named An. funestus-like.

A research report submitted to the Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, South Africa, in partial fulfilment of the requirements for the degree of Masters in Public Health-Social and Behaviour Change Communication.November 2012 / Aim of the study: The main aim of this study was to determine socio-demographic characteristics associated with being diagnosed with TB by a health care worker among adult males and females aged between18-49 years in Ntcheu district, Malawi. Method: This was a descriptive and analytical cross-sectional study. A total of 121 adult women and men were sampled using a three-stage simple sampling technique. The 2008 Population and Housing Census enumeration areas (EAs) were used as a sampling frame. The first stage involved simple sampling of two Traditional Authorities (TAs) out of nine (9). Stage two involved selection of ten villages in each sampled TA. The third level of sampling was a selection of six households from each selected village where the first dwelling was also sampled. A structured questionnaire was developed in English and translated into Chichewa. The questionnaire was administered by a trained interviewer at each respondent’s household. Three research assistants were employed to collect data. Results The awareness of TB was universal with every participant reporting that they had heard about TB. Of the 121 participants, more than half were male (53.7%; n=65).The median age of the respondents was 28 years (range 18-49 years) and approximately a third of the respondents (34.4%; n=31) had 1-2 children. The study found that higher education (p=0.01), higher ownership of household assets (p=0.01), higher average monthly household income (p=0.02) and higher socio-economic status of the respondents (p=0.01) were significantly associated with higher knowledge of causes of TB. It was found that education was also associated with knowledge of the transmission of TB (P=0.01). The lower the level of education the lower the knowledge level on the correct modes of TB transmission. There was also an association between knowledge of symptoms of TB and occupation (p=0.05). It was found that farmers were less likely to know symptoms of the disease compared to other forms of occupation namely: business persons, those participants who were employed and those not employed. The study found that women had significantly lower risk perceptions of the disease (p=0.01). No association was found between socio-economic and cultural factors of the respondent and self-reported TB diagnosis. Conclusion The findings of this study show that a comprehensive health promotion programme is required in order to address significant gaps on knowledge of causes of TB, transmission, symptoms and risk perceptions and other related socio-economic and cultural factors in Ntcheu district.

The aim o f the study w as to determ ine the know ledge and concerns about HIV/AIDS among childbearing w om en in M ahalapye, Botswana. A descriptive study design using an inri-view schedule was used. The sam ple o f 166 respondents (aged 18-29 years) w as draw n from a population o f w om en w ho attended M ahalapye clinics. D ata w ere analysed by use o f a com puter and descriptive statistics including frequencies and percentages. The dem ographic data showed that the m ajority (85.5%) o f the respondents w ere not m arried, o f w hom 78% had partners and 9% w ere cohabiting. Seventy percent had secondary education and 70.4% w ere unem ployed, hence their dependence on their partners and relatives for econom ic support. The results show ed that the respondents had a high level o f know ledge about HIV/AIDS including risk factors, m ode o f transm ission and prevention. A ll respondents (100%) seem to be aware that a person can contract H IV through having m ultiple sexual partners. The m ajority (98%) stated that H IV can be transm itted sexually and 97% said that infected pregnant w om en can transm it H IV to their babies. N inety seven percent o f w om en said that the spread o f H IV can be prevented by \ h g condom s, 21.1 % said by having sex less frequently and 98.8% said people can protect them selves from contracting H IV by through sharing utensils and food w ith an infected person, 38% believed that mosquitoes and insects can transm it H IV and 41.6% did not believe that a person infected with HIV m ight look healthy. Thirty six (21.7% ) w om en perceived them selves not to be at risk o f H IV ow ing to current m onogam ous relationships and their trust in their partners. Radio and health personnel w ere m entioned as the m ain sources o f inform ation about HIV/AIDS. All (100% ) respondents revealed that they w ere afraid o f becom ing infected w ith the virus and 98.2% said that they w ere concerned that m en do not like using condom s. Even though 93.4% said that they w ere free to discuss sexual activities w ith their partners, 83.7% said that they w ould not find it easy to reveal their H IV status to their partner for fear o f rejection and stigm atisation. The results show ed that know ledge was related to education level. A ll w om en w ho had post secondary education indicated that AIDS cannot be cured by consulting traditional doctors ( 9 -0 0v'7) and W estern doctors (p=0.046) as com pared w ith those w ho did /iOf hav-'-post secondary education. A ge and m arital status seem not to be related to know ledge (p>0.05). Educational program m es targeted at these w om en should address the m isconceptions about the m ode o f transm ission. W om en should be equipped w ith effective com m unication and decision m aking skills that w ill em power them to adopt behaviours that will protect them from becom ing infected or infecting others. Further research is needed to determ ine the extent to w hich concerns expressed by w om en in this study are expressed by other groups o f women.