Browsing by Author "Donald, P. R."
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- ItemAlfal-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.
- ItemBacteriologically 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.
- ItemBCG 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.
- ItemThe 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.
- ItemDetection 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.
- ItemEpidemiological 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 SciencesPlease refer to full text for abstract
- ItemMumps 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.
- Item'n Oorsig van die bepaling van die vroeë bakterisidiese aktiwiteit van verskeie antituberkilosemiddels(AOSIS OpenJournals, 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.Die vroeë bakterisidiese aktiwiteit (VBA) van ’n antituberkulosemiddel is die daaglikse afname van M tuberculosis in log10 kolonievormende eenhede per ml sputum, tydens die eerste twee dae van behandeling met die middel. Dit weerspieël die vermoë van ’n middel om aktief metaboliserende organismes in tuberkulose-longholtes te dood. Dit is ’n relatief goedkoop metode om in ’n klein groep pasiënte die antituberkulose-aktiwiteit van ’n middel, binne maande, in vivo te evalueer. Hierdie artikel som ons ondervinding op tydens sewe gepubliseerde VBA-studies, en die bronne van variasie in die prosedure word identifiseer. Die pasiënte in hierdie studies was gemiddeld 33 jaar oud, met ’n gemiddelde gewig van 50 kg en 55% het ekstensiewe of massiewe longaantasting gehad. Die hoogste VBA-waardes (0,50-0,66) is gevind in pasiënte wat isoniasied ontvang het, en die laagste waardes (0,05 en 0,09 respektiewelik) was gevind in pasiënte wat die aminoglikosiede amikasien en paromomisien, albei in doserings van 15 mg/kg liggaamsgewig, ontvang het. Die algehele variasie in die VBA van 248 pasiënte was 0,0312, en die variasie toegeskryf aan die proses van sputumproduksie en -versameling was 0,0223. Dit blyk dat die verskillende aspekte van sputumproduksie en -versameling, betrokke by die lewering van ’n verteenwoordigende sputummonster, ’n groter bydrae maak tot variasie tydens die prosedure as die laboratoriumaspekte van die tegniek. Die keuring van pasiënte vir insluiting in VBA-studies, en hulle vermoë om saam te werk om ’n verteenwoordigende sputummonster te produseer, is van deurslaggewende belang in die suksesvolle voltooiing van VBA-studies.
- ItemProposed 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.
- ItemThe '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.
- ItemA simple 'tally sheet' system for collecting information on the paediatric utilisation of a Western Cape day hospital(Health & Medical Publishing Group, 1992) Scorer, J.; Schaaf, H. Simon; Donald, P. R.This paper describes a simple 'tally sheet' system for collecting information on the paediatric utilisation of Bishop Lavis Day Hospital. Of 2053 children seen over a 7-week period in August and September 1988, the details of 1971 (96%) were entered on the tally sheets; age and weight were documented in 1915 (97%) cases. Only 19 patients (1%) were neonates, 370 (19%) were aged under 1 year, 1092 (57%) 1-6 years and 453 (24%) 6-13 years. One hundred and ninety-eight children (10%) had a weight for age less than the 3rd percentile and 646 (34%) a weight between the 3rd and 25th percentiles; 505 (26%) were between the 25th and 50th percentiles and 566 (30%) above the 50th percentile. Nursing personnel alone saw and treated 1067 (52%) of the children and the commonest conditions treated were upper respiratory tract infections (31%) and infective and non-infective skin conditions (18%). A similar system could be used to evaluate other aspects of health care.
- ItemSociological and anthropological factors related to the community management of tuberculosis in the Western Cape communities of Ravensmead and Uitsig(Health & Medical Publishing Group, 1997) Ellis, J. H. P.; Beyers, Nulda; Bester, D.; Gie, R. P.; Donald, P. R.Objective. To determine the socioculturel understanding of tuberculosis among patients and their household members. Design. Qualitative descriptive study. Setting. Two adjacent Western Cape suburbs with a population of approximately 35 000, a tuberculosis incidence of > 1 000/100 000 and a surface area of 2.42 km2. Subjects. Twenty-three adult patients on treatment for tuberculosis and their adult household members. Interventions. None. Methodology. Consecutive selected adult tuberculosis patients and their household members were interviewed with an open-ended interview schedule. General household and community conditions and non-verbal responses were recorded. Results. There were relatively affluent but also severely deprived households with severe overcrowding. Substance abuse was common. Patients had limited understanding and knowledge about health, hygiene and the cause of tuberculosis. There was a perception of both physical and social distance between patients and health care providers. All patients relied exclusively on the conventional biomedical curative approach of the medical system to deal with tuberculosis.
- ItemStreptomycin ototoxicity in the unborn child(1981-08) Donald, P. R.; Sellars, S. L.Streptomycin has been used in pregnant patients for more than 30 years. Some doubt, however, still exists with regard to its effects on the ear of the unborn child. Thirty-three children whose mothers had received streptomycin during pregnancy were followed up and their hearing tested. A minor degree of hearing loss which could possibly be due to the action of streptomycin was found in only 2 children.
- ItemThe use of a geographical information system (GIS) to evaluate the distribution of tuberculosis in a high-incidence community(Health & Medical Publishing Group, 1996) Beyers, Nulda; Gie, R. P.; Zietsman, H. L.; Kunneke, M.; Hauman, J.; Tatley, M.; Donald, P. R.Objective. To determine the geographical distribution of tuberculosis in the two Western Cape suburbs with the highest reported incidence of tuberculosis. Design. Descriptive illustrative study. Setting. Two adjacent Western Cape suburbs covering 2.42 km2 with a population of 34 294 and a reported tuberculosis incidence of > 1 000/100 000. Subjects. All patients notified as having tuberculosis over a 10-year period (1985-1994). Interventions. None. Outcome measure. The geographical distribution of the cases was determined using a geographical information system (GIS) and the National Population Census (1991). Results. One thousand eight hundred and thirty-five of the 5 345 dwelling units (34.3%) housed at least 1 case of tuberculosis during the past decade and in 483 houses 3 or more cases occurred. These cases were distributed unevenly through the community, with the tuberculosis incidence per enumerator subdistrict (ESD) varying from 78 to 3 150/100 000 population. Conclusion. In a small area with a high incidence of tuberculosis, the cases are spread unevenly through the community and there are certain houses where tuberculosis occurs repeatedly. This information should be used to direct health services to concentrate on certain high-risk areas.