Pub Date : 2006-01-01DOI: 10.1179/atm.2006.100.1.91
E. Leontsini
This CD-ROM forms part of the evergrowing series entitled Topics in International Health. It is an interactive tutorial tool on dengue, consisting of a series of separate tutorials on all of the main topics, such as epidemiology, case management or social, economic and behavioural aspects, as well as an extensive image collection from a broad variety of dengue programmes in South–east Asia and the Americas. Each tutorial runs independently and concludes with a summary and a review test. There is cross-reference of certain screens and support materials in more than one tutorial, when the content applies to more than one topic. The lay-out is user-friendly, in that the screens are not overloaded with information, secondary windows pop up for further information, and photographs, graphs and video clips are widely used to illustrate the text. When running the tutorial from the compact disc (CD), the transition from screen to screen within a session appears to be instantaneous, but it takes a couple of ‘long’ seconds to switch tutorials or to turn a video clip on. At whom is the CD aimed? The tutorial will be very useful to the dengue novice, as it provides well-rounded information on all of the key aspects. To those dengue specialists preparing presentations for a summer course or a workshop, the CD provides a basis on which to work, both textual and visual, and the summaries and tests help to focus on the main messages to be presented. The co-ordinators who are responsible for actually heading a sound programme of dengue prevention and control will, however, still need to consult additional sources — not because the information per se is missing but because of inadequate prioritization and discordance with the visuals in its support. One explanation for the latter is that many of the support materials weren’t developed specifically for this tutorial but have been ‘borrowed’ from previously existing sources. Some of the visuals are really excellent: the animation of Aedes acquiring and transmitting dengue viruses while biting, for example, or the video of an adult mosquito emerging out of a pupa, were particularly illustrative. Many of my students, I find, are unable to spot mosquito larvae, despite the generalized infestation by Aedes albopictus of the Baltimore area where I live and teach. I looked for a good slide of mosquito larvae as they appear to the naked eye or a video of their fine movements but couldn’t find either in this CD. What I will do, instead, is borrow from the video clip of guppies eating larvae, in the Prevention and Control tutorial (vector control screen 3 on biological control). I also did not find a screen explaining how the dengue mosquito has to lay its eggs on container walls, differentiating its larval habitats from those of Anopheles and Culex species. I have often witnessed newspapers (and occasionally even healthcommunication materials) incorrectly portraying cesspools and puddles as the source of dengue mosquitoes; a
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Fellow of the Institute of Science Technology Laboratory Technologist at the London School of Hygiene and Tropical Medicine (1963–1969, 1975–1989), the Nuffield Institute of Comparative Medicine, London (1969–1973), and the Department of Pathology, Radcliffe Infirmary, Oxford (1973–1975) Teaching Laboratory Supervisor and Tutor at the Liverpool School of Tropical Medicine (1989–2000) Scientific Administrator at the Medical Research Council Laboratories, The Gambia, West Africa (2000–2004)
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{"title":"Professor R. W. Ashford","authors":"","doi":"10.1179/atm.2004.98.1.3","DOIUrl":"https://doi.org/10.1179/atm.2004.98.1.3","url":null,"abstract":"","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79001140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-01-01DOI: 10.1179/000349803125002562
{"title":"David Francis Clyde M.D., Ph.D., D.T.M.&H. (1925–2002)","authors":"","doi":"10.1179/000349803125002562","DOIUrl":"https://doi.org/10.1179/000349803125002562","url":null,"abstract":"","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73023052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-10-01DOI: 10.1179/atm.2002.96.7.751
M. Service
Les Moustiques d’Europe: Logiciel d’Identi sh genus Poecilia is mis-spelt Poccilia. Aedes aegypti is erroneously included in the list of species cation et d’Enseignement/The Mosquitoes of Europe: an Identi cation and Training Programme. occurring in Britain, probably based on a hoax in 1919 which saw this species temporarily included F. Schaffner, G. Angel, B. Geoffroy, J.-P. Hervy, A. Rhaiem & J. Brunhes (2001). in a list of British mosquitoes. Incidentally, the initial of the senior author (Francis SchaVner) is Paris: IRD Éditions. ISBN 2 7099 1485 9. Price 65.00 (in France) or 54.35 (elsewhere) given as E on the jewel-case’s insert, not F as it should be! A frustration is that the software only (CD-ROM). seems to operate in full-screen mode, and the icon of a printer which appears on the screen can This CD-ROM has bilingual (French and English) text. The identi cation of the larvae apparently only be used to print country-wise lists of mosquitoes or the bibliography. I could only and adult males and females of each of the 100 species of mosquitoes (in the genera Anopheles, print out the excellent illustrations by using an additional graphics package, such as Corel Draw. Aedes, Ochlerotatus, Culex, Culiseta, Coquillettidia, Orthopodomyia and Uranotaenia) that occur in at Neither I nor a colleague could print out some of the text. least one of 37 European countries is presented. There are species lists for each country and maps So what is the relevance of this compact disc to tropical medicine? Well, the excellent, labelled showing the distribution of the species within Europe. The known vectors of larial worms (e.g. photographs of the taxonomic features used for the identi cation of mosquito genera and species Diro laria), arboviruses (e.g. West Nile, Tahyna, Inkoo), and the pathogens causing human or and those of the morphological characters used to distinguish anopheline mosquitoes from culicine avian malaria and miscellaneous infections such as tularaemia and myxomatosis are listed, are especially useful for anyone involved in mosquitoes or mosquito-borne infections. They together with their biology. In addition there are notes on suspected, potential and experimental would be ideal for teaching purposes. Also, the concise accounts of mosquito control (e.g. genetic, ( laboratory) vectors. There are also accounts of various control strategies, a good bibliography biological, environmental and physical ) included on the CD-ROM apply to tropical as well as of some 250 references, with publications dating from 1920–2000, and about 800 original illustemperate areas. In summary, although this very useful trations, most of which are very good. The CD-ROM does have a few shortcomings, howCD-ROM has been designed for those interested in European mosquitoes, it has broader appeal ever. There are some minor problems with the translation into English, for example. ‘Much detail’ and relevance. is used when ‘more detail’ is meant, and ‘ou’ is som
欧洲蚊子:逻辑学上的d 'Identi š sh属Poecilia是拼写错误的Poccilia。埃及伊蚊被错误地列入《欧洲蚊子:鉴定教育和培训规划》物种目录。发生在英国，可能是基于1919年的一个骗局，这个物种暂时包括F. Schaffner, G. Angel, B. Geoffroy, j . p .。Hervy, A. Rhaiem & J. Brunhes(2001)。在英国蚊子的名单上顺便提一下，资深作者(Francis SchaVner)的首字母是Paris: IRD Éditions。Isbn 2 7099 1485价格65.00(在法国)或54.35(在其他地方)，在珠宝盒的插片上显示为E，而不是应该是F !令人沮丧的是只有软件(CD-ROM)。这张CD-ROM有双语(法语和英语)文本。幼虫的鉴定显然只用于印制国别蚊子清单或参考书目。我只能和100种(按蚊属)蚊子中的每一种的成年雄性和雌性，通过使用附加的图形包，如Corel Draw，打印出优秀的插图。伊蚊(Aedes, Ochlerotatus, Culex, Culiseta, Coquillettidia, Orthopodomyia和Uranotaenia)出现在我和我的同事都无法打印出一些文本。37个欧洲国家中至少有一个出现。每个国家都有物种列表和地图那么这个光盘和热带医学有什么关系呢?好的，最好的，标记显示了物种在欧洲的分布。列出了已知的疟蚊病媒(例如用于鉴定疟蚊属和种的分类特征照片)、虫媒病毒(例如西尼罗河病毒、塔希纳病毒、印古病毒)和引起人类疾病的病原体，以及用于区分疟蚊与禽类疟疾和诸如土拉病和黏液瘤病等杂项感染的形态学特征照片。对任何接触蚊子或蚊子传播感染的人都特别有用。他们和他们的生物结合在一起。此外，还有“疑似”、“潜在”和“实验”的注释，这将是理想的教学目的。此外，对蚊虫控制(例如遗传(实验室)媒介)的简明说明。还有各种防治策略的说明，CD-ROM中包括一个很好的参考书目(生物、环境和物理)，适用于热带地区，以及大约250个参考文献，出版物日期为1920-2000年，以及大约800个原始的温带地区。综上所述，虽然这很有用的传统，其中大部分都很好。CD-ROM确实有一些缺点，但是CD-ROM是为那些对欧洲蚊子感兴趣的人设计的，它有更广泛的吸引力。例如，在翻译成英语时还存在一些小问题。“有很多细节”和相关性。表示“更多细节”时使用，“ou”有时代替“or”。食肉的M. W. Service
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Pub Date : 2002-07-01DOI: 10.1179/000349802125001276
I. Imam
Abstract The frequency of stroke and stroke-associated mortality are higher in Blacks than in other races. Several of the known risk factors for stroke, such as hypertension, diabetes and obesity, are more common in Blacks than Whites, and sickle-cell disease and HIV infection are stroke risk factors with particular relevance to Africans. Although the facilities for accurate stroke diagnosis and classification are unavailable in most parts of Africa, careful analysis of the clinical features can minimize the rates of misdiagnosis and misclassification. The high levels of stroke-attributable morbidity and mortality observed in Africans could be markedly reduced by instituting primary and secondary preventive measures and by educating health-care professionals on stroke-management strategies.
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Pub Date : 2002-07-01DOI: 10.1179/000349802125001186
D. Newsom, J. Kiwanuka
Abstract The on-going HIV epidemic has generally increased fear of needle-stick injuries (NSI) and renewed interest in the problem such injuries pose in Africa. The aims of the present study were to evaluate the frequency of NSI, explore the circumstances surrounding each injury and estimate the corresponding infection risk, among healthcare workers (HCW) in Uganda. Questionnaires, asking the recipients how many NSI they had suffered in the past year, how each of these NSI had occurred, what (perceived) risk of infection was associated with each injury, and what their practical and psychological reactions were, were sent to the HCW associated with the Mbarara Teaching Hospital in Uganda. Of the 280 individuals who received questionnaires, 180 (64%) responded and 100 (55% of the respondents) each reported suffering at least one NSI in the previous year. The total number of NSI reported (336) represented an incidence of 1.86 NSI/HCW-year. Interns suffered more NSI (annual mean=4.8) than any other occupational group. Most NSI occurred when patients moved during procedures, when HCW re-sheathed needles, or during suturing (each reported by 55 HCW—30% of those responding). Following NSI, 60 HCW said they squeezed the site of the injury and washed it with bleach, 43 believed they had a 10% risk of HIV infection, 87 felt anxious, 54 felt depressed, 40 prayed, 24 had an HIV test, and four were counselled. To estimate actual infection risk, 435 patients were screened for antibody to HIV (1 and 2) and for the surface antigen of the hepatitis B virus (HBSAg); 26% and 2.8% were found seropositive, respectively. These seroprevalences were multiplied by previously determined probabilities of transmission to give estimated risks of infection (following a single NSI) of 0.08% for HIV and 0.135% for hepatitis B. During 3 years of training as a clinician (i.e. 2 years as a medical student and 1 year as an intern), more than six in 1000 individuals would be infected with HIV as a result of NSI and almost 10 in 1000 would be infected with hepatitis B virus by the same route. NSI are common, preventable sources of infection and stress for HCW in Africa.
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Pub Date : 2002-07-01DOI: 10.1179/000349802125001221
Tanya Marchant, J. A. Armstrong Schellenberg, T. Edgar, C. Ronsmans, R. Nathan, S. Abdulla, O. Mukasa, H. Urassa, C. Lengeler
Abstract Anaemia in pregnancy is associated with maternal morbidity and mortality and is a risk factor for low birth-weight. Of 507 pregnant women recruited in a community, cross-sectional study in southern Tanzania, 11% were severely anaemic (<8g haemoglobin/dl). High malarial parasitaemia [odds ratio (OR)=2.3] and iron deficiency (OR=2.4) were independent determinants of anaemia. Never having been married (OR=2.9) was the most important socio-economic predictor of severe anaemia. A subject recruited in the late dry season was six times more likely to be severely anaemic than a subject recruited in the early dry season. Compared with the women who were not identified as severely anaemic, the women with severe anaemia were more likely to present at mother-and-child-health (MCH) clinics early in the pregnancy, to seek medical attention beyond the MCH clinics, and to report concerns about their own health. Pregnancy-related food taboos in the study area principally restrict the consumption of fish and meat. Effective anti-malaria and iron-supplementation interventions are available but are not currently in place; improvements in the mechanisms for the delivery of such interventions are urgently required. Additionally, opportunities for contacting the target groups beyond the clinic environment need to be developed.
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Pub Date : 2002-07-01DOI: 10.1179/000349802125001285
T. A. Ghebreyesus, K. Witten, A. Getachew, M. Haile, M. Yohannes, S. Lindsay, P. Byass
Abstract Schistosomiasis continues to be a major public-health problem, not least in association with water-resource developments. The impact of microdam construction in the northern Ethiopian highlands, in relation to possible increased risks of Schistosoma mansoni infection, has now been assessed. The results of incidence studies, carried out on 473 individuals sampled across eight microdam sites at altitudes of 1800-2225m above sea level, indicated an overall annual incidence of 0.20 infections/person at risk. A multivariate Poisson regression model showed altitude and sex to be significant risk factors for infection, whereas proximity to a microdam was not significant, except possibly at very high altitudes. It was concluded that altitude was the major factor in this environment and that therefore, at least in terms of public-health planning, microdams should be sited as high as local geography permits.
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Pub Date : 2002-07-01DOI: 10.1179/000349802125001249
D. Fryauff, B. Leksana, S. Masbar, I. Wiady, P. Sismadi, Augustina I. Susanti, H. Nagesha, Syafruddin, S. Atmosoedjono, M. Bangs, J. Baird
Abstract Nias Island, off the north-western coast of Sumatra, Indonesia, was one of the first locations in which chloroquine-resistant Plasmodium vivax malaria was reported. This resistance is of particular concern because its ancient megalithic culture and the outstanding surfing conditions make the island a popular tourist destination. International travel to and from the island could rapidly spread chloroquine-resistant strains of P. vivax across the planet. The threat posed by such strains, locally and internationally, has led to the routine and periodic re-assessment of the efficacy of antimalarial drugs and transmission potential on the island. Active case detection identified malaria in 124 (17%) of 710 local residents whereas passive case detection, at the central health clinic, confirmed malaria in 77 (44%) of 173 cases of presumed 'clinical malaria'. Informed consenting volunteers who had malarial parasitaemias were treated, according to the Indonesian Ministry of Health's recommendations, with sulfadoxine-pyrimethamine (SP) on day 0 (for P. falciparum) or with chloroquine (CQ) on days 0, 1 and 2 (for P. vivax). Each volunteer was then monitored for clinical and parasite response until day 28. Recurrent parasitaemia by day 28 treatment was seen in 29 (83%) of the 35 P. falciparum cases given SP (14, 11 and four cases showing RI, RII and RIII resistance, respectively). Recurrent parasitaemia was also observed, between day 11 and day 21, in six (21%) of the 28 P. vivax cases given CQ. Although the results of quantitative analysis confirmed only low prevalences of CQ-resistant P. vivax malaria, the prevalence of SP resistance among the P. falciparum cases was among the highest seen in Indonesia. When the parasites present in the volunteers with P. falciparum infections were genotyped, mutations associated with pyrimethamine resistance were found at high frequency in the dhfr gene but there was no evidence of selection for sulfadoxine resistance in the dhps gene. Night-biting mosquitoes were surveyed by human landing collections and tested for sporozoite infection. Among the five species of human-biting anophelines collected, Anopheles sundaicus was dominant (68%) and the only species found to be infective—two (1.2%) of 167 females being found carrying P. vivax sporozoites. The risk of malarial infection for humans on Nias was considered high because of the abundance of asymptomatic carriers, the reduced effectiveness of the available antimalarial drugs, and the biting and infection 'rates' of the local An. sundaicus.
{"title":"The drug sensitivity and transmission dynamics of human malaria on Nias Island, North Sumatra, Indonesia","authors":"D. Fryauff, B. Leksana, S. Masbar, I. Wiady, P. Sismadi, Augustina I. Susanti, H. Nagesha, Syafruddin, S. Atmosoedjono, M. Bangs, J. Baird","doi":"10.1179/000349802125001249","DOIUrl":"https://doi.org/10.1179/000349802125001249","url":null,"abstract":"Abstract Nias Island, off the north-western coast of Sumatra, Indonesia, was one of the first locations in which chloroquine-resistant Plasmodium vivax malaria was reported. This resistance is of particular concern because its ancient megalithic culture and the outstanding surfing conditions make the island a popular tourist destination. International travel to and from the island could rapidly spread chloroquine-resistant strains of P. vivax across the planet. The threat posed by such strains, locally and internationally, has led to the routine and periodic re-assessment of the efficacy of antimalarial drugs and transmission potential on the island. Active case detection identified malaria in 124 (17%) of 710 local residents whereas passive case detection, at the central health clinic, confirmed malaria in 77 (44%) of 173 cases of presumed 'clinical malaria'. Informed consenting volunteers who had malarial parasitaemias were treated, according to the Indonesian Ministry of Health's recommendations, with sulfadoxine-pyrimethamine (SP) on day 0 (for P. falciparum) or with chloroquine (CQ) on days 0, 1 and 2 (for P. vivax). Each volunteer was then monitored for clinical and parasite response until day 28. Recurrent parasitaemia by day 28 treatment was seen in 29 (83%) of the 35 P. falciparum cases given SP (14, 11 and four cases showing RI, RII and RIII resistance, respectively). Recurrent parasitaemia was also observed, between day 11 and day 21, in six (21%) of the 28 P. vivax cases given CQ. Although the results of quantitative analysis confirmed only low prevalences of CQ-resistant P. vivax malaria, the prevalence of SP resistance among the P. falciparum cases was among the highest seen in Indonesia. When the parasites present in the volunteers with P. falciparum infections were genotyped, mutations associated with pyrimethamine resistance were found at high frequency in the dhfr gene but there was no evidence of selection for sulfadoxine resistance in the dhps gene. Night-biting mosquitoes were surveyed by human landing collections and tested for sporozoite infection. Among the five species of human-biting anophelines collected, Anopheles sundaicus was dominant (68%) and the only species found to be infective—two (1.2%) of 167 females being found carrying P. vivax sporozoites. The risk of malarial infection for humans on Nias was considered high because of the abundance of asymptomatic carriers, the reduced effectiveness of the available antimalarial drugs, and the biting and infection 'rates' of the local An. sundaicus.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83273824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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