Tropical medicine & international health : TM & IH
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Trop. Med. Int. Health · Jan 2000
Validity of data-derived algorithms for ascertaining causes of adult death in two African sites using verbal autopsy.
background Verbal autopsy (VA) is used to ascertain causes of death using information obtained from bereaved relatives. Causes of death can be ascertained from VA questionnaires by a panel of physicians or from predefined algorithms. In a previous study, we developed data-derived algorithms using VA data from 796 adult deaths in hospitals in Tanzania, Ethiopia, and Ghana (primary sites). ⋯ The algorithm for diarrhoeal diseases did not agree closely with the physicians in Morogoro or Navrongo. conclusions In general, our data-derived algorithms for assigning causes of death due to injuries, meningitis, and TB/AIDS estimated a similar CSMF as the physicians in the secondary sites. Recommendations for further validation and refinement are discussed. Computerized algorithms offer a potentially quick, affordable, and feasible method for assigning causes of death in mortality surveillance or studies using VA.
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Trop. Med. Int. Health · Dec 1999
Survey of surgical emergencies in a rural population in the Northern Areas of Pakistan.
To determine the incidence of specific surgical emergencies in a mountainous rural community in the Northern Areas of Pakistan and to assess use of existing health services, and outcomes related to acute surgical illness events. ⋯ The incidence rates for broad categories of serious acute surgical illness in the study population far exceeded the rates of acute surgical intervention. Mortality rates were correspondingly high. Such evidence points to a large unmet surgical need and ought to spur improvements in the health service.
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Trop. Med. Int. Health · Nov 1999
Dengue: an evaluation of dengue severity in French Polynesia based on an analysis of 403 laboratory-confirmed cases.
We conducted a retrospective study of 403 laboratory-confirmed dengue cases hospitalized in Tahiti between August 1989 and March 1997. According to standard WHO criteria, 337 of these cases were dengue fever (DF) and 64 were dengue haemorrhagic fever (DHF). Of the 10 fatal cases, 6 were DF and 4 were DHF. ⋯ Of the latter, 17 patients had been classified as DF and 33 as DHF by the WHO criteria. From this analysis, haemorrhages and decreased platelets counts associated with hepatic disorders are the main criteria associated with the severe dengue cases. Thus in our study population, the WHO classification does not account for the overall severity of dengue; hepatic failure should be considered as a specific severe form of dengue since plasma leakage, which is the pathophysiological hallmark of DHF, is only one of the pathogenic mechanisms leading to severity.
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Trop. Med. Int. Health · Oct 1999
Spatial implications of the tuberculosis DOTS strategy in rural South Africa: a novel application of geographical information system and global positioning system technologies.
We used GIS/GPS technology to document and quantify improved access to tuberculosis treatment through a community-based programme in Hlabisa, South Africa. We plotted tuberculosis supervision points used by the district health system in 1991 (programme's first year) and 1996 (programme fully established), and quantified access by using GIS to measure the mean distance from each homestead in the district to hospital, clinics, community health workers (CHW) and volunteer supervisors. ⋯ Adding volunteers further decreased the distance to 800 m. GIS/GPS effectively documents and quantifies the impact of community-based tuberculosis treatment on access to treatment.