Transactions of the Royal Society of Tropical Medicine and Hygiene
-
Trans. R. Soc. Trop. Med. Hyg. · Nov 2009
International Health and Tropical Medicine 08: Proceedings of a Residential Meeting of the Royal Society of Tropical Medicine and Hygiene, 17-19 September 2008, Brighton, UK.
The Royal Society of Tropical Medicine and Hygiene held a residential meeting from 17-19 September 2008. Over 250 delegates from a diverse range of backgrounds and experience convened in Brighton, UK for three days of talks and discussions on a wide variety of themes. Topics ranged from tropical and neglected infectious diseases through to other disorders that whilst not traditionally associated with low income countries pose an increasing challenge; chronic diseases, mental health disorders and problems arising from conflict and poverty combined. The meeting represented the change in focus at RSTMH from tropical infectious diseases towards global health in its broadest sense.
-
Trans. R. Soc. Trop. Med. Hyg. · Oct 2009
ReviewThe surgical management of lesions of ulcerans infections due to Mycobacterium ulcerans, revisited.
The recommended approach to the management of ulcerans disease lesions is a combined surgical/multidrug medical approach. Small lesions may resolve spontaneously, and for other early lesions cure may be effected either by medication or simple excision alone. ⋯ It is of particular value to doctors working in more isolated areas. This approach was recommended by several authors in the 1960s, but seems to have been forgotten.
-
Trans. R. Soc. Trop. Med. Hyg. · Aug 2009
Infection control education: impact on ventilator-associated pneumonia rates in a public sector intensive care unit in Pakistan.
We describe efforts towards introducing infection control (IC) practices and establishment of antimicrobial resistance (AMR) surveillance in a public sector hospital in Pakistan. The study was conducted in an eight-bed intensive care unit. IC principles, introduced through interactive sessions, were used as an intervention and their impact was observed by conducting surveillance for ventilator-associated pneumonia (VAP) before and after the intervention. ⋯ All Acinetobacter spp. and 72% P. aeruginosa were multidrug resistant. The mean stay of the nosocomially infected patients was significantly higher than for the uninfected group (6.5 vs. 2.1 days, P<0.001). Our study suggests IC education needs to be supplemented by a hospital system that facilitates IC practices and development of surveillance programmes.
-
Trans. R. Soc. Trop. Med. Hyg. · Aug 2009
Use of an early warning score and ability to walk predicts mortality in medical patients admitted to hospitals in Tanzania.
Early warning scores (EWS) are widely used in developed health-care systems to identify patients who would benefit from intensified observation or therapy. They are aggregated scales that represent the derangement of simple physiological measurements: blood pressure, pulse, respiratory rate, etc. In more resource-limited settings, where simple methods for triage are required, the validity of EWS is not known. ⋯ Ability to walk unaided into the consultation was similarly helpful in identifying patients at low risk of death (NPV 97%). There was a positive correlation between EWS and risk of mortality. Uncomplicated patient measurements may be a useful triage tool in adult patients attending clinics in sub-Saharan hospitals.
-
Trans. R. Soc. Trop. Med. Hyg. · May 2009
Randomized Controlled Trial Multicenter StudyProviding iron/folic acid tablets free of charge improves compliance in pregnant women in Senegal.
Iron (Fe) deficiency and anemia during pregnancy remain highly prevalent in Senegal because of low compliance with Fe supplementation. Improving women's access to supplements may increase compliance. Six prenatal centers in Dakar were randomly assigned to either a control group in which women received routine prenatal visits, including prescriptions to purchase iron/folic acid tablets (IFA) according to the guidelines of the current Senegalese supplementation program (n=112), or to an intervention group in which women received free IFA (n=109) in addition to routine prenatal care. ⋯ Compliance was 48% and 86% in the control and intervention groups, respectively (P<0.001). After adjustment for confounding, prevalence of anemia was 62% in the control group versus 31% in the intervention group (P<0.001); prevalence of Fe deficiency was 49% and 21% in the control and intervention groups, respectively (P<0.001). Improving access to IFA for pregnant women visiting health centers could dramatically increase their compliance, improve Fe status and decrease the incidence of anemia.