SUNScholar - Browsing by Author "Donald, P. R."

Browsing by Author "Donald, P. R."

Now showing 1 - 20 of 29

Adolescent tuberculosis
(Health & Medical Publishing Group, 1996-3) Donald, P. R.; Beyers, Nulda; Rook, G. A. W.
INTRODUCTION: One of the most intriguing features of the epidemiology of tuberculosis is the well-known variation in the age incidence of disease and the variation in the nature of the disease with age. During infancy and early childhood, tuberculous disease is particularly liable to follow infection and high morbidity and mortality are experienced. Disseminated forms of disease, such as miliary tuberculosis and tuberculous meningitis, are particularly likely to develop.
Alfal-Fetoproteien in neonatale geelsug
(HMPG, 1978-08) Malan Christina; Donald, P. R.; Odendaal , H. J.; Shanley , B. C.
The relationship between the concentration of alphal-fetoprotein (AFP) in cord blood and neonatal jaundice has been examined in 259 neonates. Cord blood AFP varies inversely with gestational age, as does the incidence of severe jaundice. Among babies born at term a higher mean AFP concentration in cord blood was found in the group which subsequently developed marked hyperbilirubinaemia. On average, the full-term babies with a cord blood AFP level above 130 mg/l developed more pronounced jaundice than the rest. We conclude that cord blood AFP concentrations reflect the maturity of the liver in both premature and full-term infants. It is a better criterion than the estimation of gestational period by physical examination of the baby.
Arginine vasopressin concentrations in the cerebrospinal fluid of children
(1991) Cotton, M. F.; Donald, P. R.; Aalbers, C.
Cerebrospinal fluid (CSF) arginine vasopressin (AVP) levels are reported in a group of 22 children (median age 24 months) investigated for possible bacterial meningitis and subsequently found not to be suffering from this disease. The mean CSF AVP concentration was 0.80 ± 0.33 pg/ml. The results obtained in patients suffering from febrile convulsions (mean 0.71 pg/ml), other convulsive disorders (mean 0.80 pg/ml) and miscellaneous infectious diseases (mean 0.85 pg/ml) did not differ significantly from one another. Our findings confirm the presence of AVP in the CSF of children and provide reference values for further investigations into the functions of CSF AVP in children.
Bacteriologically confirmed pulmonary tuberculosis in childhood : clinical and radiological features
(Health & Medical Publishing Group, 1985) Donald, P. R.; Ball, J. B.; Burger, P. J.
Over a 4-year period 185 cases of pulmonary tuberculosis in children were confirmed by culture of Mycobacterium tuberculosis, usually from gastric aspirate. The majority of cases occurred in boys (62%) and the younger age groups were more commonly affected - 26% of patients were less than 1 year old and 65% less than 3 years of age. At the time of presentation 40% of the 151 children tested had a negative tuberculin test. A chest radiograph was available in 136 cases. The commonest changes seen were lymphadenopathy (63%) and segmental lesions (56%). The latter affected mainly the right lung and in particular the right middle lobe. Cavitating tuberculous disease was present in 19 children, including 5 aged less than 1 year.
BCG vaccination status of children with tuberculous meningitis and the use of unsupervised isoniazid prophylaxis
(Health & Medical Publishing Group, 1995-03) Donald, P. R.; Van Zyl, L. E.; De Villiers, J.
ENGLISH ABSTRACT: From 1985 to 1992, 193 children with tuberculous meningitis (TBM) with a median age of 26 months were admitted to the Department of Paediatrics and Child Health, Tygerberg Hospital. Of these children 143 (74%) were documented to have received BCG, either by reference to 'Road to Health' cards or by contact with local authority clinic staff. In a further 18 children a BCG scar was visible. Therefore at least 161 of the children (83%) had received BCG vaccination. As the Western Cape has also been shown to have the highest incidence of TBM in South Africa, there is concern that BCG as currently used does not have a significant protective effect against disseminated tuberculosis. Seventy-seven children (40%) were also reported to have a close household contact who had been treated for pulmonary tuberculosis within the previous 24 months. Only 17 of these children (22%), however, were prescribed prophylactic isoniazid and only 7 of these completed 3 months or more prophylaxis.
Cerebrospinal fluid lactate and lactate dehydrogenase activity in the rapid diagnosis of bacterial meningitis
(Health & Medical Publishing Group, 1986) Donald, P. R.; Malan, C.
The value of cerebrospinal fluid (CSF) lactate and lactate dehydrogenase (LD) activity in the rapid diagnosis of meningitis was investigated in three groups of patients - a 'no meningitis', an aseptic meningitis and a bacterial meningitis group. The sensitivity achieved in the detection of bacterial meningitis by CSF lactate values of 2,85 mmol/l (93,8%) and 3,9 mmol/l (89,6%) was greater than that reached by conventional chemical investigations using a CSF protein value of 1 g/l (81,5%) or a CSF glucose value of 2,2 mmol/l (68,8%) as the indicator. The sensitivity of an absolute CSF LD value of 40 U/l (86,3%) in the detection of bacterial meningitis was slightly lower than that of a CSF protein value of 1 g/l (87%) and better than the sensitivity of either a CSF/serum LD ratio of 0,1:1,0 (83,9%) or a CSF glucose level of 2,2 mmol/l (76,3%). As with conventional CSF chemistry, both investigations may give normal values in the presence of bacterial meningitis.
The child health card : a cornerstone of preventive and promotive paediatrics
(Health & Medical Publishing Group, 1984) Donald, P. R.; Kibel, M. A.
When properly used, the child health card is a relatively cheap and effective measure in the promotion of health and in the early detection and prevention of disease in infants and children. It serves as a record of birth data, growth in mass, immunization, neurological development and episodes of illness; it can also facilitate advantageous family spacing. At present the card is not achieving its full potential in southern Africa. We suggest the active promotion of its benefits to the public and especially to potential mothers via school education.
Criteria for the notification of childhood tuberculosis in a high-incidence area of the Western Cape Province
(Health & Medical Publishing Group, 1990) Stoltz, A. P.; Donald, P. R.; Strebel, P. M.; Talent, J. M. T.
The medical records of 124 children notified from Ravensmead Clinic, Parow, as having tuberculosis during 1987 were reviewed in order to determine the strength of the evidence on which the diagnosis was made. Arranging the diagnostic criteria in an hierarchical manner, as suggested by the World Health Organisation, the cases were categorised as suspect, probable or confirmed. Twenty-five were suspect cases (20%), 89 probable cases (72%) and the remaining 10 confirmed cases (8%). These findings indicated that notifications from the clinic were being made in accordance with internationally accepted practice. The use of the WHO approach for the categorisation of childhood tuberculosis cases is recommended for both clinical and epidemiological purposes.
Detection of bacterial antigens in cerebrospinal fluid by a latex agglutination test in 'septic unknown' meningitis and serogroup B meningococcal meningitis
(Health & Medical Publishing Group, 1989) Muller, P. D.; Donald, P. R.; Burger, P. J.; Van der Horst, W.
The latex agglutination test (Wellcogen) was evaluated specifically in cases of 'septic unknown' meningitis, with CSF findings characteristic of bacterial meningitis but with no bacterial organisms grown on CSF culture or seen on microscopy after Gram staining. In only 4 (12%) of 33 cases of 'septic unknown' meningitis were antigens identified in the CSF. This kit contains for the first time reagents for the detection of serogroup B Neisseria meningitides antigens and was also evaluated for this bacteria. Only 6 (27%) of 22 serogroup B N. meningitides cases were identified.
Early bactericidal activity of ethambutol, pyrazinamide and the fixed combination of isoniazid, rifampicin and pyrazinamide (Rifater) in patients with pulmonary tuberculosis
(Health & Medical Publishing Group, 1996) Botha, F. J. H.; Sirgel, F. A.; Parkin, D. P.; Van de Wal, B. W.; Donald, P. R.; Mitchison, D. A.
The early bactericidal activity (EBA) of ethambutol, pyrazinamide and the fixed combination of isoniazid, rifampicin and pyrazinamide (Rifater: Mer National) was evaluated in patients with pulmonary tuberculosis who were sputum-positive on microscopy for acid-fast bacilli. Twenty-eight patients (mean age 33 years and weight 51 kg on average; range 40-59 kg) were studied. The fall in viable counts of Mycobacterium tuberculosis in sputum collections during the 2 days following the start of treatment was estimated from counts of colony-forming units (CFUs) of M. tuberculosis per ml of sputum cultured on selective 7H10 agar medium. The EBA for ethambutol determined in 9 patients was 0.245 ± 0.046, log10 CFU/ml sputum/day, that for pyrazinamide was 0.003 ± 0.014 log10 CFU/ml sputum/day and that for Rifater 0.558 ± 0.054 log10 CFU/ml sputum/day. The results obtained are similar to those reported in a previous study of the first 2 days of treatment, but in smaller numbers of patients, and confirm the moderate EBA of ethambutol while pyrazinamide is again shown to have very little EBA. Rifater has a marked EBA which may be due mainly to the action of isoniazid. This methodology may be valuable in the rapid evaluation of the bactericidal activity of new antituberculosis agents and the comparison of different dose sizes of agents of the same class.
Enzyme-linked immunosorbent assay for the detection of mycobacterial antigens in the cerebrospinal fluid in tuberculous meningitis
(Health & Medical Publishing Group, 1987) Donald, P. R.; Cooper, R. C.
Fifty-three cerebrospinal fluid specimens from meningitis patients were investigated by enzyme-linked immunosorbent assay for detection of mycobacterial antigens. After heating at 56° C for 1 hour to eliminate nonspecific interference, all 22 tuberculous meningitis (TBM) specimens had an optical density of greater than 0.05 (sensitivity 100%). Six out of 31 non-TBM cases gave false-positive results (specificity 81%).
Epidemiological study of tuberculosis in Macassar Camp
(Stellenbosch : University of Stellenbosch, 1995-12) Mohammed, Ashraf; Prinsloo, F. R.; Donald, P. R.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences
Please refer to full text for abstract
Failure to thrive and its relationship to serum vitamin A levels and diet
(Health & Medical Publishing Group, 1995) Donald, P. R.; Shires, J.; Langenhoven, M. L.; Van Staden, E.; Labadarios, D.
Serum vitamin A and retinol-binding protein (REP) levels were determined in a group of 34 children between 1 and 4 years of age with failure to thrive and in 34 age- and sex-matched controls. Both groups of children were also assessed in respect of anthropometry and diet. Vitamin A levels in patients (0-32,2 μg/100 ml; median 16,9 μg/100 ml) did not differ significantly from controls (6,4-47,2 μg/100 ml; median 16,1 μg/100 ml). Fourteen patients (42%) and 4 controls (12%) had vitamin A levels below 10 μg/100 ml. RBP levels in patients (0.45-3,50 mg/100 ml; median 2,17 mg/100 ml) also did not differ significantly from those in controls (1,21-3,66 mg/100 ml; median 2.06 mg/100 ml). No clinical features of vitamin A deficiency were detected. Weight and height for age, weight for height, mid-upper arm circumference and head circumference differed significantly between patients and controls (P < 0.0001 in each instance). Although within the recommendations for intake, patients had a significantly lower intake of the essential fatty acid C 18:2 (N=6) (linoleic acid) and vitamin A. In view of the current proposed relationship between vitamin A status and infectious diseases, the prevalence of biochemical vitamin A deficiency in children in the Cape Town community studied may contribute to the morbidity and mortality associated with infectious diseases in the area to a greater degree than has been suspected.
Methicillin-resistant Staphylococcus aureus at Tygerberg Hospital
(Health & Medical Publishing Group, 1988) Peddie, E. F.; Donald, P. R.; Burger, P. J.; Sadler, C. A.
During 1985 Staphylococcus aureus was isolated from blood culture of 74 patients at Tygerberg Hospital who were suffering from serious illness compatible with systemic spread of the organism. Twenty-six isolates (35%) were community-acquired and none were methicillin-resistant, while 48 were hospital-acquired of which 23 (48%) were methicillin-resistant. Methicillin resistance appears to be a problem confined to hospital isolates of S. aureus.
Missed opportunities in the diagnosis of pulmonary tuberculosis in children
(Health & Medical Publishing Group, 1993) Gie, R. P.; Beyers, Nulda; Schaaf, H. Simon; Donald, P. R.
In 52% of children with confirmed and probable tuberculosis the diagnosis could have been made earlier than it was. The main clinical clues which should have led to suspicion of tuberculosis were close adult contacts and previous recurrent respiratory tract infections.
Mumps meningo-encephalitis
(Health & Medical Publishing Group, 1987-3) Donald, P. R.; Burger, P. J.; Becker, W. B.
Between July 1981 and June 1985, 49 cases (36 boys (73%) and 13 girls (27%)) of mumps meningoencephalitis confirmed by culture of the virus from the cerebrospinal fluid (CSF) were seen. Patients presented particularly in the late spring and early summer. A CSF cell count > 500 x 106/l was obtained in 14 cases (28%), a total CSF protein > 0,8 g/l in 6 cases (12%) and a CSF glucose of < 2,2 mmol/l in 2 cases (4%). Two cases are reported to illustrate the diagnostic problems which the infection may cause, particularly when the CSF changes resemble those of tuberculous meningitis. In 1 case neurogenic pulmonary oedema developed after a convulsion; this caused further diagnostic uncertainty.
'n Oorsig van die bepaling van die vroeë bakterisidiese aktiwiteit van verskeie antituberkilosemiddels
(AOSIS, 2003) Donald, P. R.; Sirgel, F. A.; Venter, A.; Fourie, P. B.; Parkin, D. P.; Seifart, H. I.; Van de Wal, B. W.; Maritz, J. S.
The early bactericidal activity (EBA) of an antituberculosis agent is the daily decline in log10 colony forming units of M tuberculosis per ml of sputum during the first two days of treatment with the agent. It reflects the capacity of an agent to kill the actively metabolising organisms in tuberculosis lung cavities. It offers a relatively cheap means to evaluate the antituberculosis activity of an agent in a small group of patients within a matter of months. This article summarizes the authors’ experience in seven published EBA studies and identifies sources of variation in the procedure. The patients who participated in these studies had a mean age of 33 years, a mean weight of 50 kg and there was extensive or massive involvement of the lungs in 55% of patients. The highest EBA values (0,50-0,66) were found in groups of patients receiving isoniazid and the lowest values (0,05 and 0,09 respectively), in patients receiving the aminoglycosides amikacin and paromomycin in a dose of 15 mg/kg body weight. The variation in EBA in 248 patients was 0,0312 and the variation ascribable to the process of sputum production and collection was 0,0233. This implies that the different aspects of sputum production and collection involved in obtaining a representative sputum sample are responsible for most of the variation in EBA results. The selection of patients for inclusion in EBA studies and their ability to co-operate in producing a representative sputum specimen are of critical importance in the successful completion of EBA studies.
Paediatric meningitis in the western Cape : a 3-year hospital-based prospective survey
(Health & Medical Publishing Group, 1986) Donald, P. R.; Burger, P. J.; Becker, W. B.
Between July 1981 and June 1984 1223 cases of meningitis were seen in the Department of Paediatrics, Tygerberg Hospital. The commonest form in each population group was aseptic meningitis. Positive viral cultures were obtained from the CSF in 108 cases. The median age of white children with aseptic meningitis, 64 months, was significantly greater than that of coloured children, 45 months (P > 0,0001), and black children, 26 months (P > 0,014). The commonest cause of confirmed bacterial meningitis was Neisseria meningitidis (140 cases; 11,5%), which continues to affect mainly young coloured children (median age 16,9 months). Resistance to sulphonamides was found among 21% of 114 N. meningitidis isolates. Among white children Haemophilus influenzae was responsible for 9 of the 18 cases of confirmed bacterial meningitis. Tuberculosis was responsible for 62 cases of meningitis (5%) and was a commoner cause of meningitis than either H. influenzae (47 cases) or Streptococcus pneumoniae (34 cases). Thirty-four confirmed cases of bacterial meningitis were seen in children less than 1 month old. Klebsiella species were responsible for 8 cases (24%), Escherichia coli for 6 cases (12%), group B β-haemolytic Streptococcus for 5 cases (15%) while 4 cases each were due to N. meningitidis and S. pneumoniae.
Proposed Cochrane Collaboration for tuberculosis treatment
(Health & Medical Publishing Group, 1994) Donald, P. R.
During a meeting of interested persons held at the International Centre for Health Care Research of the Karolinska Institute, Stockholm, on 24 and 25 May of this year a decision was taken to initiate a Cochrane Collaboration in the field of tuberculosis. This voluntary collaboration between individuals interested in a particular field aims to undertake systematic comprehensive reviews of all published and unpublished randomised controlled trials of different aspects of tuberculosis therapy.
The 'Road to Health' card in a paediatric outpatient department
(Health & Medical Publishing Group, 1987) Donald, P. R.; Hesseling, P. B.
The use of the 'Road to Health' card was assessed in the Paediatric Outpatient Department of Tygerberg Hospital over three annual week-long surveys. Of 621 children seen, 344 (55%) were accompanied by a card which in 231 cases (67%) was still in its original polythene bag. Mass was recorded on a mean of 6 occasions, perinatal data were noted on 80% of cards, but the passing of milestones was noted on only 25% of cards. Episodes of illness were recorded on only 40% of cards.

Browsing by Author "Donald, P. R."

Results Per Page

Sort Options