Bibliography of Gambian Related Publications

Health

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Title: AIDS: Cures? Crisis!
Date: 2007
Source: Journal of the Royal Society of Medicine, Jun 2007; 100: 294 - 296
Author(s): Dawn Starin
Abstract: There were no guns. And there was no AIDS. At the present time only about 1-2...lowest percentages of adults living with AIDS in sub-Saharan continental Africa. There......
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Title: C-Reactive Protein And Haptoglobin In The Evaluation Of A Community-Based Malaria Control Program
Date: 1996
Source: TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE v. 90 no. 1 96 JAN-FEB p. 10-14
Author(s): MCGUIRE, W; DALESSANDRO, U; OLALEYE, B O; THOMSON, M C; LANGEROCK, P; GREENWOOD, B M; KWIATKOWSKI, D
Abstract: When cross-sectional surveys are used to evaluate malaria intervention programmes in the community, the prevalence of morbidity is difficult to assess because of the fluctuating nature of malarial fever. We have therefore investigated the impact of bed net usage on 2 surrogate markers of malarial morbidity: ii) elevated C-reactive protein (CRP) (>8 mg/L) plus detectable parasitaemia, as an indicator of malaria-induced acute-phase response; and (ii) reduced haptoglobin levels (<180 mg/L), which in this population indicates malaria-induced intravascular haemolysis. Among 1505 Gambian children 1-5 years old, examined on a single occasion at the end of the malarial transmission season, 5% had parasitaemia plus fever, while 24%. had parasitaemia plus elevated CRP, and 35% had low haptoglobin. The proportion of children who had parasitaemia plus elevated CRP was significantly lower among those who had slept under insecticide-treated bed nets than among those who did not use a bed net (16% vs. 34%, P<0.003), and the proportion with low haptoglobin differed similarly (24% vs. 49%, P<0.003). Use of an untreated bed net had a weaker effect on both indices (22% had parasitaemia plus elevated CRP, 34% had low haptoglobin). CRP and haptoglobin are simple and inexpensive to measure in large numbers of people, and these results suggest that they could be useful for the assessment of malaria intervention programmes.

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Title: C-Reactive Protein And Haptoglobin In The Evaluation Of A Community-Based Malaria Control Program
Date: 1996
Source: TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE v. 90 no. 1 96 JAN-FEB p. 10-14
Author(s): MCGUIRE, W; DALESSANDRO, U; OLALEYE, B O; THOMSON, M C; LANGEROCK, P; GREENWOOD, B M; KWIATKOWSKI, D
Abstract: When cross-sectional surveys are used to evaluate malaria intervention programmes in the community, the prevalence of morbidity is difficult to assess because of the fluctuating nature of malarial fever. We have therefore investigated the impact of bed net usage on 2 surrogate markers of malarial morbidity: ii) elevated C-reactive protein (CRP) (>8 mg/L) plus detectable parasitaemia, as an indicator of malaria-induced acute-phase response; and (ii) reduced haptoglobin levels (<180 mg/L), which in this population indicates malaria-induced intravascular haemolysis. Among 1505 Gambian children 1-5 years old, examined on a single occasion at the end of the malarial transmission season, 5% had parasitaemia plus fever, while 24%. had parasitaemia plus elevated CRP, and 35% had low haptoglobin. The proportion of children who had parasitaemia plus elevated CRP was significantly lower among those who had slept under insecticide-treated bed nets than among those who did not use a bed net (16% vs. 34%, P<0.003), and the proportion with low haptoglobin differed similarly (24% vs. 49%, P<0.003). Use of an untreated bed net had a weaker effect on both indices (22% had parasitaemia plus elevated CRP, 34% had low haptoglobin). CRP and haptoglobin are simple and inexpensive to measure in large numbers of people, and these results suggest that they could be useful for the assessment of malaria intervention programmes.

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Title: Child-Mortality Following Standard, Medium Or High-Titer Measles Immunization In West-Africa
Date: 1996
Source: INTERNATIONAL JOURNAL OF EPIDEMIOLOGY v. 25 no. 3 96 JUN p. 665-673
Author(s): KNUDSEN, K M; AABY, P; WHITTLE, H; ROWE, M; SAMB, B; SIMONDON, F; STERNE, J; FINE, P
Abstract: Background. The World Health Organization (WHO) recommended the use of high titre measles vaccine in 1989. Subsequent long term follow-up of several trials yielded results suggesting higher mortality among children inoculated with medium and high titre vaccines compared to standard titre vaccines, although none of the individual trials found significant differences in mortality. Methods. Long term survival after standard, medium and high titre measles Vaccines has been investigated in a combined analysis of all West African trials with mortality data. In trials from Guinea-Bissau, The Gambia and Senegal, children received medium or high titre vaccines from 4 months of age and were compared to control groups recruited at the same time later receiving standard titre vaccine from 9 months of age. All children were followed up to at least 3 years old. Results. Combining trials of high titre vaccines showed higher mortality among the high titre group compared to the standard group: mortality ratio (MR) = 1.33 (95% CI : 1.02-1.73). Mortality among recipients of medium titre vaccines was not different from that in the standard vaccine group, MR = 1.11 (95% CI : 0.54-2.27). In a combined analysis by sex, the adjusted mortality ratios comparing high titre vaccine with standard vaccine were 1.86 (95% CI : 1.28-2.70) for females and 0.91 (95% CI : 0.61-1.35) for males. The trials were not designed to study long term mortality. Adjustments for several possible sources of bias did not alter the results. Conclusions. The combined analysis showed a decreased survival related to high titre measles vaccine compared with standard titre vaccines, though solely among females. As a result of these studies from West Africa and a study from Haiti, WHO has recommended that high titre measles vaccine no longer be used.
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Title: Costs, Effects And Cost-Effectiveness Analysis Of A Mobile Maternal Health-Care Service In West Kiang, The Gambia
Date: 1996
Source: HEALTH POLICY v. 35 no. 2 96 FEB p. 123-143
Author(s): FOXRUSHBY, J A; FOORD, F
Abstract: The costs, effects and cost-effectiveness of a new mobile maternal care service offered in The Gambia at a government-run health centre in Karantaba were compared with the usual pattern of maternal care offered (at Ngayen Sanjal). Routinely collected data were supplemented by research on time allocation of staff by activity, use of drugs, medical consumables and vehicles, out-of-pocket payments by patients and a range of effectiveness indicators, To account for a differential effect on hospital referrals, maternity care at the main referral hospital was assessed. In 1991, the annual total cost of maternity care at Karantaba was US$64 800 compared with US$25 300 at Ngayen Sanjal. The largest proportion of this difference was attributed to training. Whilst average cost/attendance was higher at Karantaba, the marginal cost of expanding the service to other villages was lower than the marginal cost at Ngayen Sanjal. Incremental cost-effectiveness of the mobile service at Karantaba was calculated according to best and worst case scenarios which showed that the extra cost/extra death averted per year ranged between US$459 and US$2134. Using discounted life years gained reduced the figures to US$42.9 and US$206.3. Various suggestions are offered for reducing the cost of the new service, and a number of methodological points are raised for discussion.
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Title: Dietary Supplementation And Rapid Catch-Up Growth After Acute Diarrhea In Childhood
Date: 1996
Source: BRITISH JOURNAL OF NUTRITION v. 76 no. 4 96 OCT p. 479-490
Author(s): HOARE, S; POPPITT, S D; PRENTICE, A M; WEAVER, L T
Abstract: Diarrhoea is a major cause of short-term growth faltering in children of the developing world. If catch-up weight gain is delayed by inadequate dietary intake, or by further bouts of diarrhoea, progressive growth failure occurs. To test the hypothesis that early refeeding is as effective as later feeding after acute diarrhoea with weight loss, we measured the effects of a timed dietary intervention on weight gain after acute diarrhoea in underweight Gambian children, Thirty-four children aged 4-22 months with weight loss following acute diarrhoea were given a high-energy-protein supplement for 14 d beginning either immediately after rehydration or a fortnight later, With a 50 % increase in energy intake and a 100 % increase in protein intake there was a rapid and highly significant (P < 0.001) gain in weight within a fortnight whether the supplement was given immediately or 2 weeks after presentation, Rates of weight increase were similar whether supplementation was provided early or late, but over the full 28 d (of intervention and non-intervention) children who received late supplementation had greater overall weight gain (P < 0.02) than those supplemented early, Vigorous and early feeding with a high-energy-protein supplement should be central to the management of malnourished children with acute diarrhoea in developing countries, and may be as important as control of diarrhoea in preventing malnutrition and growth failure, This may be achieved in the community using locally available foods, in the face of continuing diarrhoea.
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Title: Free-Living Energy-Expenditure Assessed By 2 Different Methods In Rural Gambian Men
Date: 1996
Source: EUROPEAN JOURNAL OF CLINICAL NUTRITION v. 50 no. 5 96 MAY p. 284-289
Author(s): HEINI, A F; MINGHELLI, G; DIAZ, E; PRENTICE, A M; SCHUTZ, Y
Abstract: Objective: To assess total free-living energy expenditure (EE) in Gambian farmers with two independent methods, and to determine the most realistic free-living EE and physical activity in order to establish energy requirements for rural populations in developing countries. Design: In this cross-sectional study two methods were applied at the same time. Setting: Three rural villages and Dunn Nutrition Centre Keneba, MRC, The Gambia. Subjects: Eight healthy, male subjects were recruited from three rural Gambian villages in the sub-Sahelian area (age: 25 +/- 4 y; weight: 61.2 +/- 10.1 kg; height: 169.5 +/- 6.5 cm, body mass index: 21.2 +/- 2.5 kg/m(2)). Intervention: We assessed free-living EE with two inconspicuous and independent methods: the first one used doubly labeled water (DLW) (H-2(2) O-18) over a period of 12 days, whereas the second one was based on continous heart rate (HR) measurements on two to three days using individual regression lines (HR vs EE) established by indirect calorimetry in a respiration chamber. Isotopic dilution of deuterium ((H2O)-H-2) was also used to assess total body water and hence fat-free mass (FFM). Results: EE assessed by DLW was found to be 3880 +/- 994 kcal/day (16.2 +/- 4.2 MJ/day). Expressed per unit body weight the EE averaged 64.2 +/- 9.3 kcal/kg/d (269 +/- 38 kJ/kg/d). These results were consistent with the EE results assessed by HR: 3847 +/- 605 kcal/d (16.1 +/- 2.5 MJ/d) or 63.4 +/- 8.2 kcal/kg/d (265 +/- 34 kJ/kg/d). Physical activity index, expressed as a multiple of basal metabolic rate (BMR), averaged 2.40 +/- 0.41 (DLW) or 2.40 +/- 0.28 (HR). Conclusions: These findings suggest an extremely high level of physical activity in Gambian men during intense agricultural work (wet season). This contrasts with the relative food shortage, previously reported during the harvesting period. We conclude that the assessment of EE during the agricultural season in non-industrialized countries needs further investigations in order to obtain information on the energy requirement of these populations. For this purpose the use of the DLW and HR methods have been shown to be useful and complementary.
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Title: Geographical perspectives on bednet use and malaria transmission in the Gambia, West Africa.
Date: 1996
Source: Social Science & Medicine; July 1996, v43, n1, p101(12)
Author(s): Thomson, Madeleine; Connor, Stephen; Bennett, Steve; D'Alessandro, Umberto; Milligan, Paul; Aikins, Moses; Langerock, Patricia; Jawara, Musa; Greenwood, Brian
Abstract: Insecticide-impregnated bednets are now widely accepted as an important tool in reducing malaria-related deaths in children in Africa. Defining the circumstances in which net treatment programmes are likely to be effective is essential to a rational development of this control strategy. In The Gambia a National Impregnated Bednet Programme was introduced into the primary health care system in 1992. Prior to its introduction baseline epidemiological and entomological studies were conducted throughout the country. These studies showed that in areas where mosquito biting nuisance was high, people protected themselves with bednets and that where mosquito densities (and therefore bednet usage) was low malaria prevalence rates were relatively high. Since the national programme is designed to assist only those people who already own a bednet (by providing the insecticide) an understanding of the factors which determine bednet ownership is needed to help evaluate the programme's effectiveness and provide guidelines for increasing bednet usage. Village scale bednet usage rates and malaria prevalence rates obtained from the baseline survey were correlated with certain geographical variables: dominant ethnic group, area, habitat, distance from the River Gambia and distance from the 'bluffline' (the interface between the sandstone soils and alluvial soils which border the fiver system). In a multiple regression analysis, bednet usage was independently associated with area (P < 0.001), ethnic group (P = 0.010), habitat (P = 0.006) and distance from the river (P = 0.013). A negative association of bednet usage with malaria prevalence persisted after allowing for the other variables. Malaria prevalence was not independently associated with area, ethnic group, habitat or distance from the river. Our analysis showed that the impregnated bednet programme is likely to be most effective in villages which are sited near to or on the alluvial soils in the middle and lower fiver zones. These villages, which were originally settled for easy access to the river (for transport) and its swampy margins (for rice production) are within the flight distance of mosquitoes that have their breeding sites on the poorly drained alluvial soils. Variation in malaria prevalence rates (after bednet usage has been taken into account) may be related to factors such as poverty and access to health care, and/or to localized differences in the ecology of The Gambia, which determine the duration and intensity of transmission. If the National Bednet Programme is to be effective throughout The Gambia it is vital to develop promotional activities which will encourage bednet usage in areas where nuisance biting by mosquitoes is low. Key words - malaria, Anopheles gambiae, The Gambia, impregnated bednets, rice COPYRIGHT Pergamon Press Ltd. 1996
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Title: Implementing A Nationwide Insecticide Impregnated Bednet Program In The Gambia
Date: 1996
Source: HEALTH POLICY AND PLANNING v. 11 no. 3 96 SEP p. 292-298
Author(s): CHAM, M K; DALESSANDRO, U; TODD, J; BENNETT, S; FEGAN, G; CHAM, B A; GREENWOOD, B M
Abstract: Earlier studies in The Gambia suggested that the use of impregnated bednets might prove to be a useful malaria control strategy. Based on the results of these studies, in 1992 the Government of The Gambia was encouraged to initiate a National Impregnated Bednet Programme (NIBP) as part of the National Malaria Control Programme Strategy. This paper describes the implementation process/procedure of the NIBP. Evaluation results showed that, overall, 83% of the bednets surveyed had been impregnated, and 77% of children under the age of five years and 78% of women of childbearing age were reported to be sleeping under impregnated bednets.
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Title: Strengthening Health Management Experience Of District Teams In The Gambia
Date: 1996
Source: HEALTH POLICY AND PLANNING v. 11 no. 1 96 MAR p. 64-71
Author(s): CONN, C P; JENKINS, P; TOURAY, S O
Abstract: The lack of basic management skills of district-level health teams is often described as a major constraint to implementation of primary health care in developing countries. To improve district-level management in The Gambia, a 'management strengthening' project was implemented in two out of the three health regions. Against a background of health sector decentralization policy the project had two main objectives: to improve health team management skills and to improve resources management under specially-trained administrators. The project used a problem-solving and participatory strategy for planning and implementing activities. The project resulted in some improvements in the management of district-level health services, particularly in the quality of team planning and coordination, and the management of the limited available resources. However, the project demonstrated that though health teams had better management skills and systems, their effectiveness was often limited by the policy and practice of the national level government and donor agencies. In particular, they were limited by the degree to which decision making was centralized on issues of staffing, budgeting, and planning, and by the extent to which national level managers have lacked skills and motivation for management change. They were also limited by the extent to which donor-supported programmes were still based on standardized models which did not allow for varying and complex environments at district level. These are common problems despite growing advocacy for more devolution of decision making to the local level.
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Title: The Ecology Of Malaria As Seen From Earth-Observation Satellites
Date: 1996
Source: ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY v. 90 no. 3 96 JUN p. 243-264
Author(s): THOMSON, M C; CONNOR, S J; MILLIGAN, P J M; FLASSE, S P
Abstract: Data from sensors on board geostationary and polar-orbiting, meteorological satellites (Meteosat and NOAA series) are routinely obtained free, via local reception systems, in an increasing number of African countries. Data collected by these satellites are processed to produce proxy ecological variables which have been extensively investigated for monitoring changes in the distribution and condition of different natural resources, including rainfall and vegetation state. How these data products (once incorporated, along with other data, into a geographical information system) could contribute to the goals of monitoring patterns of malaria transmission, predicting epidemics and planning control strategies is the subject of the present review. By way of illustration, an analysis of two of these products, normalized difference vegetation index (NVDI) and cold-cloud duration (CCD), is given in conjunction with epidemiological and entomological data from The Gambia, a country where extensive studies on malaria transmission have been undertaken in recent pears. Preliminary results indicate that even simple analysis of proxy ecological variables derived from satellite data can indicate variation in environmental factors affecting malaria-transmission indices. However, it is important to note that the associations observed will vary depending on the local ecology, season and species of vector. Whilst further quantitative research is required to validate the relationship between satellite-data products and malaria-transmission indices, this approach offers a means bl which detailed knowledge of the underlying spatial and temporal variation in the environment can be incorporated into a decision-support system for malaria control.
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Title: The Impact Of A National Impregnated Bed Net Program On The Outcome Of Pregnancy In Primigravidae In The Gambia
Date: 1996
Source: TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE v. 90 no. 5 96 SEP-OCT p. 487-492
Author(s): DALESSANDRO, U; LANGEROCK, P; BENNETT, S; FRANCES, N; CHAM, K; GREENWOOD, B M
Abstract: In 1992, the Gambian national impregnated bed net programme (NIBP) introduced insecticide treatment of bed nets into half of the primary health care villages in The Gambia. One component of the evaluation of this programme was the determination of whether it had any impact on the outcome of pregnancy in primigravidae. From February 1992, 651 primigravidae were recruited into the study. Less than 50% of them used an insecticide-treated bednet. During the rainy season the prevalence of Plasmodium falciparum among primigravidae was lower, fewer babies were classified as premature, and the mean birth weight was higher in villages where treated bed nets were used than in control villages. Therefore, during the rainy season, despite the low use of insecticide-treated bed nets by Gambian primigravidae, the NIBP had some impact on the outcome of pregnancy, particularly on the percentage of premature babies, and this was probably due to the decreased risk of malaria infection achieved during this period.
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Title: A Comparison Of The Efficacy Of Insecticide-Treated And Untreated Bed Nets In Preventing Malaria In Gambian Children
Date: 1995
Source: TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE v. 89 no. 6 95 NOV-DEC p. 596-598
Author(s): DALESSANDRO, U; OLALEYE, B O; MCGUIRE, W; THOMSON, M C; LANGEROCK, P; BENNETT, S; GREENWOOD, B M
Abstract: An evaluation of the Gambian national insecticide impregnated bed net programme, which has introduced insecticide treatment of bed nets into all primary health care (PHC) villages in The Gambia, provided an opportunity to compare the individual risk of malaria in children who slept under untreated or insecticide-treated bed nets. 2300 children 1-4 years old were selected for a survey at the end of the 1992 rainy season, 1500 from PHC villages and 800 from non-PHC villages. All malariometric indices were lower, and the mean packed cell volume was higher, in children who slept regularly under treated or untreated bed nets than in those who did not use a net. This study suggested that untreated bed nets provide some individual protection against malaria, although not as efficiently as that provided by insecticide-treated bed nets which were particularly effective at preventing infections accompanied by high parasitaemia.
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Title: Insecticide Susceptibility Status In Individual-Species Of The Anopheles-Gambiae Complex (Diptera, Culicidae) In An Area Of The Gambia Where Pyrethroid Impregnated Bednets Are Used Extensively For Malaria Control
Date: 1995
Source: BULLETIN OF ENTOMOLOGICAL RESEARCH v. 85 no. 2 95 JUN p. 229-234
Author(s): HEMINGWAY, J; LINDSAY, S W; SMALL, G J; JAWARA, M; COLLINS, F H
Abstract: Pyrethroid-impregnated bednets are being used nationwide in The Gambia. The future success of this malaria control programme depends partly on the vectors remaining susceptible to those insecticides used for treating the nets. The present study was carried out on the south bank of the river Gambia, during the first large scale trial of nets in this country. Thus this area represents a sentinel site for detecting insecticide resistance in local vectors. This study gives an example of how a system of early detection for resistance problems can be set up in a relatively complex situation where multiple vectors and non-vectors are present. Samples of the Anopheles gambiae complex were caught indoors using light traps in twelve villages used in the bednet study. In all villages A. gambiae sensu stricto Giles was the predominant member of the complex as determined using the rDNA-PCR diagnostic assay. Limited bioassays with DDT and permethrin, and biochemical assays for a range of insecticide resistance mechanisms suggest that the A. gambiae complex remains completely susceptible to all major classes of commonly used insecticides including pyrethroids. Biochemical assays suggest that a low frequency of: DDT resistance may occur in A. melas Theobald. This is based on elevated glutathione S-transferase levels coupled with increased levels of DDT metabolism and does not involve cross-resistance to pyrethroids. Therefore we do not envisage a decline in the efficacy of treated nets against malaria vectors in the study area in the immediate future, although monitoring should be continued whilst wide-scale use of impregnated bednets is operational.
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Title: Mortality And Morbidity From Malaria After Stopping Malaria Chemoprophylaxis
Date: 1995
Source: TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE v. 89 no. 6 95 NOV-DEC p. 629-633
Author(s): GREENWOOD, B M; DAVID, P H; OTOOFORBES, L N; ALLEN, S J; ALONSO, P L; SCHELLENBERG, J R A; BYASS, P; HURWITZ, M; MENON, A; SNOW, R W
Abstract: Gambian children who had received malaria chemoprophylaxis for a variable period of time during their first 5 years of life were followed to determine whether they experienced a rebound in mortality or in morbidity from malaria during the period after chemoprophylaxis was stopped. The risk of dying between the ages of 5 years, when chemoprophylaxis was stopped, and 10 years was no higher among children who had received chemoprophylaxis with Maloprim(R) (pyrimethamine plus dapsone) for some period during their first 5 years of life than among children who had received placebo (21 vs. 24 deaths) and the beneficial effect of chemoprophylaxis on mortality observed during the first 5 years of life was sustained. The incidence of clinical attacks of malaria during the year after medication was stopped was significantly higher among children who had previously received Maloprim(R) for several years than among children who had previously received placebo. However, at the end of this year, there was no significant difference in spleen rate, parasite rate or packed cell volume between the 2 groups of children. Thus, stopping chemoprophylaxis after a period of several years increased the risk of clinical malaria but did not result in a rebound in mortality in Gambian children. However, the number of deaths recorded was small, so a modest effect on mortality cannot be excluded.
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Title: Movement Of Anopheles-Gambiae Sl Malaria Vectors Between VIllages In The Gambia
Date: 1995
Source: MEDICAL AND VETERINARY ENTOMOLOGY v. 9 no. 4 95 OCT p. 413-419
Author(s): THOMSON, M C; CONNOR, S J; QUINONES, M L; JAWARA, M; TODD, J; GREENWOOD, B M
Abstract: Movement of mosquitoes belonging to the Anopheles gambiae complex (mixed wild populations of An. arabiensis, An. gambiae and An. melas) between three neighbouring rural villages in The Gambia was investigated by mark-release-recapture. A total of 12,872 mosquitoes were collected in bednets, marked with a magenta fluorescent powder and released over a 15-day period in one of the villages. A further 15,507 mosquitoes were collected in exit traps, marked with a yellow powder and released over the same period. Mosquitoes were captured daily in all three villages using pyrethrum spray catches, as well as bednet and exit trap catches. The catching period extended for 6 days after the last day of release. Of the mosquitoes released, 372 (1.3%) were recaptured 2-21 days later. Of these recaptures, 272 were caught in the release village, and 98 were caught in other villages situated 1-1.4 km away. The 'movement index' between villages was calculated as 17.2% (12.2-22.4% confidence limits) for mosquitoes released after feeding and 20.1% (14.7-25.3%) for those released unfed. These results suggest that movement of mosquitoes between neighbouring villages in The Gambia seriously affects the entomological evaluation of pyrethroid-impregnated bednet programmes in areas where treated and untreated villages are interspersed.
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Title: Small step in Aids war. (search for a cure for Aids)
Date: 1995
Source: The Financial Times; Jan 28 1995, n32586, pWFT3(1)
Author(s): Cookson, Clive
Abstract: There is no better treatment for Aids than Wellcome's AZT which has toxic side effects, though it appears to perform better with other drugs. Aids researchers are more confident that the disease can be controlled. There is hope that a vaccine could be developed after reports from the Gambia that three prostitutes appear to have developed immunity. There may also be a chance to develop treatment for Kaposi's Sarcome, since the virus causing the disease has been isolated.
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Title: Socioeconomic Determinants Are Not Major Risk-Factors For Severe Malaria In Gambian Children
Date: 1995
Source: TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE v. 89 no. 2 95 MAR-APR p. 151-154
Author(s): KORAM, K A; BENNETT, S; ADIAMAH, J H; GREENWOOD, B M
Abstract: Only a small proportion of subjects infected with Plasmodium falciparum develop severe disease. Why this should be is not fully understood. To investigate the possible importance of socio-economic variables on the severity of malaria in Gambian children we undertook a case-control study of 384 children with severe or mild malaria. Few differences were found between the 2 groups. Children with severe malaria had a longer duration of symptoms when recruited than mild cases but this difference was largely accounted for by the fact that most children with severe disease were recruited at a referral hospital, whilst mild cases were recruited at a primary health care facility nearer their home. There was no difference between groups in the time before mothers sought some form of health care. Mothers of children with severe disease were less ready to take their child to hospital than mothers of mild cases, suggesting that education on the importance of taking a child with features of malaria to a health centre as soon as possible might have some effect on the development of severe disease. However, overall, the results of this study suggested that socio-economic and behavioural factors are not the major determinants for severe malaria in African children.
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Title: Socioeconomic Risk-Factors For Malaria In A Periurban Area Of The Gambia
Date: 1995
Source: TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE v. 89 no. 2 95 MAR-APR p. 146-150
Author(s): KORAM, K A; BENNETT, S; ADIAMAH, J H; GREENWOOD, B M
Abstract: Successful control of malaria depends upon a detailed knowledge of its epidemiology, including knowledge of the social and economic factors that influence its prevalence. Little is known about the socio-economic factors that influence the prevalence of malaria in tropical Africa. Therefore, we undertook such a study in over 350 Gambian children with malaria resident in a peri-urban area with seasonal transmission, using the case-control approach. Malaria was associated with poor quality housing and crowding and with travel to rural areas, where the level of malaria transmission is higher than in urban centres. No association was found between the risk of malaria and the overall education level of parents or guardians of study children. However, the knowledge of malaria possessed by mothers of cases of malaria was less than that of controls, suggesting that further education of the study community on the causation of malaria and on ways of preventing it could be of value.
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Title: The Microeconomics Of The Aids Epidemic In Africa
Date: 1995
Source: POPULATION AND DEVELOPMENT REVIEW v. 21 no. 4 95 DEC p. 835
Author(s): PHILIPSON, T; POSNER, R A
Abstract: The AIDS epidemic has ravaged sub-Saharan Africa, particularly the Central and Eastern regions. Although data are poor, the authors contend that a rational-choice approach, which has proved illuminating with respect to AIDS in the United States, can be fruitfully applied to the African experience as well. They suggest that differences in the prevalence of prositution and other nonmonogamous sexual activity, the prevalance of other sexually transmitted diseases, and the real economic costs of condoms can be used to explain differences between the US and African patterns of the epidemic, including the positive correlation in Africa between income and the likelihood of being infected by the AIDS virus, in contrast to the negative correlation in the United States. They also argue that some of the policy interventions that seem promising in the US context, such as partner notification, are unlikely to be effective in Africa, and that the most effective method of controlling the African epidemic might be through measures that increase economic equality between women and men.
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Title: Aids in the Gambia.
Date: 1994
Source: Africa Report; Jan-Feb 1994, v39, n1, p52(2)
Author(s): da Costa, Peter
Abstract: The latest National AIDS Control Program figures for Gambia showed that 42% of AIDS cases tested positive for HIV-1, 53% for HIV-2 and 5% for both viruses. Previous figures showed that 60%, 36% and 4% of AIDS cases were caused by HIV-2, HIV-1 and combined HIV-1 and HIV-2, respectively. The increasing prevalence of HIV-1, which is more virulent and is responsible for most cases of AIDS worldwide, is causing alarm in Gambia's medical community. Tourists and Gambians travelling abroad may have brought HIV-1 into the country, while sex workers are responsible for increased transmission rates.
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Title: Constructing natural fertility: the use of western contraceptive technologies in rural Gambia.
Date: 1994
Source: Population and Development Review; March 1994, v20, n1, p81(33)
Author(s): Bledsoe, Caroline H.; Hill, Allan G.; D'Alessandro, Umberto; Langerock, Patricia
Abstract: Many Gambian women utilize Western contraceptive measures to achieve a two-year minimum birth interval despite which the birth intervals and total fertility profiles remain largely unaltered. Some traditional contraceptive methods are still used despite the appreciation of the efficacy of modern methods. Contraceptives are used as a means of fine-tuning birth timing rather than for stopping further growth of the family.
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Title: New vaccine for malaria in Africa test; prevention is likely, a scientist reports. (test in Gambia, directed by Dr. Brian Greenwood, of the Spf66 vaccine, developed by Dr. Manual Patarroyo) (International Pages)
Date: 1994
Source: The New York Times; Sept 22 1994, v144, pA6(N) pA17(L), col 6
Author(s): French, Howard W.
Abstract:
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Title: Psychosis and cannabis.
Date: 1994
Source: British Journal of Psychiatry 1994 Apr Vol 164 566
Author(s): Lindesay, James
Abstract: Comments on M. Rolfe et al's (see PA, Vol 81:25457) case-control study of psychosis and cannabis use. It is suggested that some psychotic patients may have elected to use cannabis in an effort to control their symptoms. No causal conclusions should be drawn from these cross-sectional data. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)
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Title: Social science methods used in a study of prostitutes in the Gambia.
Date: 1994
Source: Challenge and innovation: Methodological advances in social research on HIV/AIDS. Social aspects of AIDS. (Mary Boulton, Ed.) pp. 149-158. Published: Taylor & Francis, London, England
Author(s): Pickering, Helen
Abstract: (from the chapter) the objectives of the study of prostitution in The Gambia discussed in this chapter were broadly epidemiological, but in the course of reviewing some of the problems that arose I aim to show that social research into HIV/AIDS and other health problems most usefully steers a course between the 2 methodological extremes (i.e., the use of questionnaire-based surveys vs sexual diaries) / illustrate in particular the danger of relying, as many epidemiological studies do, almost entirely on findings from questionnaire-based survey data
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Title: Studies Of Tuberculosis In The Gambia: A. The Geographical Distribution Of Sensitivity To Skin Test Antigens In The Gambia. B. A Trial Of The Effects Of Prior Vaccination With Bcg And Of Immunotherapy With Mycobacterium Vaccae On The Outcome Of Treatment
Date: 1994
Source: Thesis (PH.D.)--OPEN UNIVERSITY (UNITED KINGDOM), 1994. ; This item is not available from University Microfilms International. Source: Dissertation Abstracts International, Volume: 57-04, Section: C, page: 1260.
Author(s): CORRAH, PRINCE TUMANI
Abstract: This thesis deals with two studies of tuberculosis in The Gambia. The first was a nationwide skin test survey to determine the geographical distribution of sensitivity to skin test antigens in The Gambia. Twenty-two new tuberculins were tested in 6,211 school children in four north-south transects of The Gambia. In children without BCG scars, tuberculin positivity varied from place to place. The enhancing effect of BCG on positivity was greatest at the eastern end of the country and at the south of each transect. Leprosin A positivity was higher on the north bank of the two middle transects and on the south of the easternmost transect. It is not known whether the regions where most children are sensitised to the two major pathogens are also the regions from where most cases of disease arise. There was little sensitization to eight of the reagents prepared from environmental mycobacteria, and positivity to the remaining twelve showed geographical variation. This study has confirmed that tuberculosis and leprosy are common infections in The Gambia and that of the forty known environmental mycobacteria, twelve are commonly encountered in The Gambia. In the second study, the effects of prior vaccination with BCG and of immunotherapy with Mycobacterium vaccae were assessed in 285 adult patients with proven pulmonary tuberculosis who were treated with either short or long term chemotherapy. Killed M. vaccae was given as a single injection six weeks after the onset of chemotherapy in a double blind controlled study. No deaths were recorded in 84 patients with BCG scars, whereas 35 out of 180 (19.4%) patients without BCG scars died (X$`sp2`sb `rm M-H $ adjusted for age = 13.6, p $<$ 0.001). In the group of 75 patients who survived the first 6 months of long term chemotherapy, all the 33 who received immunotherapy survived whereas 6 out of 42 who received placebo injection died (p = 0.03, Fisher's Exact test). This study has shown that BCG significantly reduces mortality in patients treated for pulmonary tuberculosis and that immunotherapy with M. vaccae as an adjunct to chemotherapy reduces mortality in patients treated with long term chemotherapy.
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Title: Determinants of condom use in 24000 prostitute/client contacts in The Gambia.
Date: 1993
Source: AIDS 1993 Aug Vol 7(8) 1093-1098
Author(s): Pickering, Helen; Quigley, Maria; Hayes, Richard J.; Todd, Jim
Abstract: Used longitudinal data gathered over 14 mo to investigate the influence of individual socio-demographic factors and the circumstances of sexual contacts on condom use among a cohort of prostitutes in The Gambia. A total of 24,181 sexual contacts were recorded from 181 prostitutes. Condom use was reported for 84% of contacts with clients and 4% of the contacts with regular partners. Upper class bars had the highest level of condom use. Condom use decreased with the class of location and was lowest in the rural markets. Condoms were used for 91% of contacts with the 1st client and declined to only 37% with the 10th or later clients. Condom use was not related to socio-demographic characteristics of the prostitutes. The client's level of education was significantly related to condom use. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)
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Title: Determinants Of Early Childbearing Among Young Female Adults In The Gambia (Childbearing, Women, Young Adults).
Date: 1993
Source: Thesis (PH.D.)--THE UNIVERSITY OF WESTERN ONTARIO (CANADA), 1993. 271 p.; Source: Dissertation Abstracts International, Volume: 54-11, Section: A, page: 4266.
Author(s): JENG, MOMODOU S.
Abstract: This thesis examines the determinants of childbearing among young Gambian women aged 13 to 24 and ranks the respective components (or groups of variables) in order of importance. An empirical analysis is done using bivariate and multi-variate statistical techniques. Based on these analyses, it is found that the factors of the empirical model (combining the reference group theory and a Bongaarts-type framework) vary in their effect on the fertility of young women. The most important of the socioeconomic, demographic and cultural (SEDC) variables are educational attainment, employment status, looking for work, area of residence, age, number of siblings, rank of siblings, number of desired children, and religion. However, it is an important finding of this thesis that fertility is higher among young women in urban than non-urban areas in The Gambia. This is in contrast with earlier findings that fertility level tend to be higher in rural than urban areas. Although this finding is unexpected, it is not implausible. It can be attributed to changes in the behavioural and sociocultural profile of young Gambian women, as well as improvements in nutritional levels, better medical and health conditions, and developments in reproductive technology. Also, it is clear from this thesis that childbearing is influenced by both knowledge of contraception and reproductive health as well as opinions and beliefs about relationships, sex, and marriage. Practices such as the sexual activity of friends and attendance of educational programmes affect childbearing as well. Yet, these KAP variables can affect fertility only through the proximate determinants which have direct effects. Except for age at first menstruation which serves as proxy for biological maturity of girls, all of the proximate determinants have been found to be important in predicting early childbearing. As for the outcome of ranking the major components of the model in order of importance, the proximate determinants are found to be more influential than the other major components that indirectly affect early childbearing. Also, the socioeconomic, demographic and cultural (SEDC) variables are more important than those of knowledge, attitude and practice (KAP). The thesis concludes with suggestions for future research and a review of policies and programmes of relevance in The Gambian context. ISBN: 0315839287
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Title: Is health a sustainable state? A VIllage study in The Gambia.
Date: 1993
Source: The Lancet; May 22 1993, v341, n8856, p1327(4)
Author(s): Weaver, L.T.; Beckerleg, S.
Abstract: The UK's Medical Research Council started making annual visits to Keneba in 1949 to assess the health of the population. Keneba is a village in The Gambia, a country in western Africa. The Dunn Nutrition Unit assumed responsibility for these visits after 1974. A clinic was opened to provide health care to the residents of Keneba and two neighboring villages. Maternal and infant health are the main focus of the services provided by the clinic. Another focus is to promote family planning and education about birth control. Residents of Keneba grow various crops during the rainy season with groundnuts being the main cash crop. The death rate among children under five dropped since the arrival of the Dunn Nutrition Unit, but the birth rate has remained high. Outmigration from Keneba and the surrounding areas has increased. Whether health is sustainable in this part of The Gambia depends on a delicate balance between a variety of factors.
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Title: One bite is one too many.
Date: 1993
Source: Economist; Aug 21, 1993, v328n7825, p. 33-34 (UK 43-44) (2 pages)
Author(s):
Abstract: According to estimates published by the World Health Organization on August 20, 1993, between 1.4m and 2.8m Africans south of the Sahara now die of malaria each year. In fighting the spread of malaria, some of the most promising results come from recent experiments carried out in villages in Gambia using an insecticide solution.
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Title: Psychosis and cannabis abuse in The Gambia: A case-control study.
Date: 1993
Source: British Journal of Psychiatry 1993 Dec Vol 163 798-801
Author(s): Rolfe, M.; Tang, C. M.; Sabally, S.; Todd, J. E.
Abstract: Conducted a case-control study of 210 patients admitted to a psychiatric unit to determine the association between psychosis and cannabis abuse in Gambia and the importance of other risk factors. Urine was tested for cannabinoid substances, and 38% were positive compared with 12% of matched nonpsychotic control Ss. Analysis of the matched pairs showed that a positive urinary cannabinoid test, cigarette smoking, alcohol consumption, travel to Europe, and family history of mental illness were all significant risk factors for psychotic illness; Koranic education reduced the risk. There was a positive correlation among the psychotic patients between a positive urinary cannabinoid test and the use of alcohol, ataya tea, and cigarette smoking; a family history of mental illness showed a negative correlation. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)
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Title: Sexual activity, family life education, and contraceptive practice among young adults in Banjul, The Gambia.
Date: 1993
Source: Studies in Family Planning; Jan-Feb 1993, v24, n1, p50(12)
Author(s): Kane, Thomas T.; De Buysscher, Rose; Taylor-Thomas, Tunde; Smith, Tamara; Jeng, Momodou
Abstract: This report presents results from a 1986-87 two-stage probability sample survey of 2,507 young men and women aged 14-24 living in the Greater Banjul region of The Gambia. Although premarital sexual activity was common and began at an early age, lack of knowledge and limited access to modern contraceptives were obstacles to the use of family planning. Of all ever sexually active single persons, only 21 percent of the young women and 7 percent of the young men had practiced contraception at the time of first intercourse. Almost half of the sexually active young adults had ever used contraceptives, with oral contraceptives and condoms being the methods most widely known and used. Results of logistic regression analyses show that attendance at family life education lectures in school had significant positive relationships to both knowledge and use of contraceptives among the young people surveyed. The study presents encouraging evidence that acceptance of modern contraceptive use is beginning to take hold among young people in urban Banjul. COPYRIGHT Population Council Inc. 1993
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Title: The effects of post-test counselling on condom use among prostitutes in The Gambia.
Date: 1993
Source: AIDS 1993 Feb Vol 7(2) 271-273
Author(s): Pickering, Helen; Quigley, Maria; Pepin, Jacques; Todd, Jim
Abstract: Explored the effect of counseling on condom use among 31 female prostitutes in The Gambia. After being tested for HIV, all 12 HIV-positive and 19 HIV-negative Ss were counseled to use condoms for all sexual contacts. Most Ss reported high rates of condom use before counseling. In the 1st mo after counseling, the overall condom use among HIV-positive Ss increased by a mean of 2%, but then fell by a mean of 7.8% 2 to 5 mo after counseling. Condom use by HIV-negative Ss increased 1.9% in the 1st mo after counseling, and then decreased 5.5% in 2 to 5 mo. Six Ss increased their use of condoms, but 13 Ss reduced their use of condoms. The distribution of free condoms in places where prostitutes are known to work, rather than the provision of lengthy individual counseling, is recommended for areas with scarce resources. (PsycINFO Database Copyright 1994 American Psychological Assn, all rights reserved)
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Title: Association between Hiv-2 infection and genital ulcer diseases among male sexually transmitted disease patients in The Gambia.
Date: 1992
Source: AIDS 1992 May Vol 6(5) 489-493
Author(s): Pepin, Jacques; Quigley, Maria; Todd, James; Gaye, Isatou
Abstract: Studied the interaction between human immunodeficiency virus (HIV)-2 infection and other sexually transmitted diseases (STDs) by comparing the demographic and behavioral characteristics of 21 HIV-2 infected STD patients with those of 414 seronegative STD patients. HIV-2 infection was associated with the presence of antibodies against Haemophilus ducreyi and Treponema pallidum. HIV-2 infection was more common among Ss who were functionally uncircumcised than Ss who were functionally circumcised. Results show that genital ulcer diseases (e.g., syphilis, chancroid) are probably cofactors that facilitate HIV-2 transmission in West Africa. (PsycINFO Database Copyright 1992 American Psychological Assn, all rights reserved)
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Title: Beri-beri: age-gender bias in the Gambia.
Date: 1992
Source: Social Science & Medicine; June 1992, v34, n11, p1295(3)
Author(s): Barrett, Hazel R.; Browne, Angela W.
Abstract: This paper investigates a suspected outbreak of beri-beri which occurred in The Gambia in 1988. The outbreak was spatially specific and had a distinct age and gender bias, with young men aged 15-49 being the group mainly affected. The age and gender bias of the outbreak is particularly interesting as women and children in the developing world are usually more susceptable to conditions associated with malnourishment, than men. The authors investigate the peculiar nature of the outbreak and find that they cannot easily explain the apparent age and gender bias. The authors note that at the time of the outbreak medical treatment took precedence over socio-economic investigations. This makes it difficult to ascertain why certain age and gender groups were affected and thus to target them for future preventative health education programmes. This case study therefore concludes, that where possible, medical investigations must be combined with socio-economic studies if future outbreaks of this kind are to be avoided. COPYRIGHT Pergamon Press Ltd. 1992
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Title: Prostitutes and their clients: A Gambian survey.
Date: 1992
Source: Social Science & Medicine 1992 Jan Vol 34(1) 75-88
Author(s): Pickering, H.; Todd, J.; Dunn, D.; Pepin, J.
Abstract: Investigated the social backgrounds and working behavior of 248 prostitutes (aged 15-52 yrs) in urban and rural areas of The Gambia. Ss were highly mobile, moving frequently between a number of working locations. Ss' educational level and the standard of living of their natal families were above average. Ss worked on average 4 days a wk and had between 2 and 3 clients a night. Ss reported that they started prostitution as an alternative to destitution or to prevent their children or young siblings from becoming destitute. Condoms were used in up to 80% of contacts. 795 of the Ss' clients (aged 15-60 yrs) were interviewed and found to be on average of low educational and occupational status. Half were non-Gambian and most were currently traveling or living away from home. 34 clients tested positive for human immunodeficiency virus (HIV). Those who had just used a condom were more likely to be infected than those who had not. (PsycINFO Database Copyright 1992 American Psychological Assn, all rights reserved)
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Title: Bed Nets That Beat Malaria
Date: 1991
Source: Source (UNDP), Vol. 3, No. 2 (June 1991), 26-27
Author(s): Robson, Emma
Abstract:
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Title: Risk factors for Hiv-2 infection in The Gambia.
Date: 1991
Source: AIDS 1991 Sep Vol 5(9) 1127-1132
Author(s): Wilkins, Andrew; Hayes, Richard; Alonso, Pedro; Baldeh, Susan
Abstract: Surveyed and tested 4,228 Ss in The Gambia for the presence of the human immunodeficiency virus (HIV). Findings show that HIV-2 was the predominant immunodeficiency virus infecting the population of The Gambia. However, HIV-1 infection was found in the younger adults, including 2 who had not travelled outside the country to regions where the HIV-1 prevalence is known to be high. The prevalence of infection was significantly increased among divorced and widowed women. Infection among men was related both to occupation and to education level. Complex social and economic factors may have made the educationally privileged an epidemiologically distinct group with regard to HIV-2 infection. (PsycINFO Database Copyright 1992 American Psychological Assn, all rights reserved)
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Title: Sante et Population on Senegambie des Origines a 1960: Bibliographie Annotee. (An Annotated Bibliography of Health and Population in Senegal and Gambia up to 1960). (book reviews)
Date: 1991
Source: Social Science & Medicine; Feb 1 1991, v32, n3, p355(1)
Author(s): Caldwell, John C.
Abstract:
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Title: Evaluation of a Primary Health Care Programme in The Gambia. II. It's Impact on Mortality and Morbidity in Young Children
Date: 1990
Source: Journal of Tropical Medicine and Hygiene. Vol. 93, No. 2 (April 1990), 87-97
Author(s): Greenwood, B.M., et al.
Abstract:
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Title: Microcomputer Support For Health Care Delivery In The Gambia.
Date: 1990
Source: Thesis (PH.D.)--UNIVERSITY OF NOTTINGHAM (UNITED KINGDOM), 1990. 293 p.; Source: Dissertation Abstracts International, Volume: 53-02, Section: B, page: 0797.
Author(s): BYASS, PETER.
Abstract: Available from UMI in association with The British Library. Requires signed TDF. Microcomputer support for health care delivery is a relatively new concept in developing countries, despite serious shortages of human expertise. In this light, the concept of microcomputer-based decision support for patient management at the rural health centre level in The Gambia is discussed and developed. Possible methodologies are devised and evaluated, taking into account constraints imposed both by feasibility of hardware for the rural African setting and by appropriate software techniques. Clinical data were collected for a pilot system, which was implemented using a Bayesian methodology, and assessed, with encouraging results. Further sources of data were then considered in order to generalise the pilot system into a prototype, which was implemented on a portable solar-powered microcomputer. The evaluation of this prototype system, and the difficulties involved in undertaking rigorous evaluations of this type of decision aid, are described and discussed. Whilst it is not proven that major health benefits would arise from the widespread introduction of such systems, the results of this preliminary study suggest that this type of approach merits further consideration and development.
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Title: The Potential for Computer-Aided Diagnosis of Tropical Diseases in Developing Countries : An Expert System Case Study.
Date: 1990
Source: European Journal of Operational Research; Nov 23, 1990, v49n2, p. 271-278 (8 pages)
Author(s): Doukidis, Georgios I.; Forster, Dayo.
Abstract: In developing countries, an environment exists in which computer-aided diagnosis of diseases could have a substantial impact. Essex (1980) developed a series of flowcharts designed for use by appropriately trained intermediate-level health personnel. Additional reference material is included with the flowcharts to advise on patient referral to a hospital, health center, or outpatient clinic, depending on the disease severity. A prototype expert system, ESTROPID (Expert System on Tropical Diseases), was developed that incorporates this methodology. The expert system is based on a representation of the flowcharts as its knowledge base and an inference mechanism that imitates the flowchart structure. ESTROPID forms part of a project designed to investigate the potential of various health information systems. The project's major objective is to implement a fully practical system geared toward the needs of Gambia.
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Title: Computer Simulation Of Trachoma.
Date: 1989
Source: Thesis (PH.D.)--UNIVERSITY OF SOUTHAMPTON (UNITED KINGDOM), 1989. 337 p.; Source: Dissertation Abstracts International, Volume: 52-01, Section: B, page: 0171.
Author(s): HAWKINS, JAMES DAVID.
Abstract: Available from UMI in association with The British Library. Trachoma is one of the world's major causes of preventable blindness. It is restricted to poor socioeconomic areas and is estimated to affect some 300-500 million people world wide with some 7 million blind as a direct consequence. Considerable money, time and effort are being invested with the objective of combating trachoma. There are several approaches being implemented, including vaccine development and antibiotic treatment, although the actual effects that these strategies will have is not known. This thesis describes the development of a trachoma simulation model based on specially collected data from a West African village with hyper-endemic trachoma--Jali, in The Gambia. This model can simulate the effects of proposed socioeconomic improvements, vaccinations or chemotherapy on various clinical states of trachoma including conjunctival scarring and server visual loss. Thus, the effects of proposed campaigns and strategies can be flexibly evaluated before implementation.
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Title: Knowledge of Aids, use of condoms and results of counselling subjects with asymptomatic Hiv2 infection in The Gambia.
Date: 1989
Source: AIDS Care 1989 Vol 1(3) 247-256
Author(s): Wilkins, H. A.; Alonso, P.; Baldeh, S.; Cham, M. K.
Abstract: A questionnaire administered to 1,898 Ss (aged 15+ yrs) seen during a serological survey in The Gambia revealed that knowledge of acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) was limited. Males, those with a secondary education, and people who lived in urban areas had a better understanding, but only 17% of rural women knew of the condition. Only 8% of Ss had used condoms in the preceding 12 mo; during this time half of them had done so on less than 5 occasions. Ss with a secondary education were more likely to have used condoms. In the majority of 31 asymptomatic seropositive Ss (aged 23-60 yrs) who met with a counselor, the information given caused anxiety rather than modification of behavior. At the time of the 2nd interview, only 1 S had discussed the situation with the partner and begun using condoms. (PsycINFO Database Copyright 1990 American Psychological Assn, all rights reserved)
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Title: Comparison of two strategies for control of malaria within a primary health care programme in The Gambia.
Date: 1988
Source: The Lancet; May 21 1988, v1, n8595, p1121(7)
Author(s): Greenwood, B.M.; Bradley, A.K.; Byass, P.; Greenwood, A.M.; Snow, R.W.; Hayes, R.J.; N'Jie, A.B.H.
Abstract:
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Title: Energy Density And Consistency Of Traditional African Weaning Foods (Gambia).
Date: 1987
Source: Thesis (PH.D.)--UNIVERSITY OF READING (UNITED KINGDOM), 1987. 194 p.; Source: Dissertation Abstracts International, Volume: 49-01, Section: B, page: 0009.
Author(s): PAVITT, FIONA.
Abstract: Available from UMI in association with The British Library. The work fell into four sections: the establishment of the flow properties of gruels prepared from cereal flours commonly used to prepare weaning foods in The Gambia, the determination of human powers of discrimination of viscosity by stirring, the contribution of ingredients and a traditional food processing method to dietary bulk and energy density and a field study in The Gambia of infant feeding practices. Gruels prepared from sorghum, rice, maize and millet flour exhibited thixotropic flow properties. Gruel viscosity was increased significantly by increasing concentration, decreasing the median particle size of the cereal flour and by reducing the temperature and shear rate at which viscosity measurements were made. To determine whether small changes in viscosity measured instrumentally would have significance in practice during weaning food preparation, difference thresholds for viscosity were determined over the viscosity range 200 to 2000 mPa s. The value of the difference threshold increased over the viscosity range studied but the value of the Weber fraction decreased. Application of this sensory data showed that the effects on the instrumentally measured viscosity of cereal gruels were sufficiently large that they should be detected by humans if assessed by stirring. When sugar or groundnut oil were added to rice flour gruels to increase their energy density, gruel viscosity was increased sufficiently to be detected instrumentally but not by human discrimination on stirring. The $`alpha$-amylase activity of sorghum germinated in the laboratory for 48 hours at 35$`sp`circ$C was increased some 400 fold. The viscosity of gruels prepared from the resulting flour was reduced from 250 mPa s to 50 mPa s, a reduction which was easily observed by eye. The feeding practices of a group of ten infants ranging from 4 to 18 months old was studied during a visit to the urban village of Bakau in The Gambia. Supplementary foods in the form of home prepared cereal gruels were fed to all infants and had been introduced from as early as one month. Sugar or groundnut meal were commonly added to gruels to improve their flavour. Viscosity measurements made on weaning gruels in The Gambia correlated well with measurements made in the Laboratory.
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Title: Learning And Acting In A Health Communication Campaign: Teaching Rural Women To Prevent Infant Dehydration Through Diarrheal Disease Control In The Gambia, West Africa.
Date: 1986
Source: Thesis (PH.D.)--STANFORD UNIVERSITY, 1986. 202 p.; Source: Dissertation Abstracts International, Volume: 47-09, Section: A, page: 3228.
Author(s): SNYDER, LESLIE BETH.
Abstract: Dehydration from diarrhea, one of the leading causes of infant deaths worldwide, can be combated by teaching mothers to give their children simple oral rehydration solutions. But past health education efforts have taught that it is quite difficult to change health behaviors. Current campaign models ignore incorrect behavior, do not specify the direct relationship between exposure and knowledge and behavior change, and do not adequately explain the conditions for behavior and knowledge maintenance over time. This dissertation focussed on four campaign outcomes: first learning correct procedures, first performing the behavior, maintaining the knowledge, and continuation of the behavior. For each outcome, the effects of campaign communication, learning incentives (through a nationwide lottery), knowledge of the principles of the treatment, wealth, age, and experience with infant diarrhea were examined. Data was collected over the two years of a multi-channel health communication campaign in The Gambia promoting an oral rehydration solution that women could make with household ingredients (water, sugar, and salt) to give children ill with diarrhea. The analysis strategy involved event history or survival analysis. We found that the outcomes should be considered separately. The factors that increased the chance of first learning to mix the formula correctly were lottery participation, continuous contact with health workers, continuous radio exposure, owning a copy of the flyer explaining mixing procedures, and not knowing the principles. The chance of maintaining knowledge of the mixing procedure increased when women were wealthier, experienced less infant diarrhea over the two years, did not claim posters or family and friends as sources of information, had social support for using the formula, did not participate in the lottery, and owned the flyer. First trying the formula was associated with less health worker contact, flyer ownership, and listening to health promotions on the radio after adoption but not before. Behavior was maintained when women were wealthier, did not cite posters, owned a flyer, heard radio promotions during the maintenance period, had social support, and knew both the principles behind the solution and how to mix it. Thus, the only consistently beneficial medium was the mixing flyer.
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Title: Constraints To Knowledge Gain And Behavior Change In Response To A Multi-Media Health Education Project In The Gambia, West Africa.
Date: 1985
Source: Thesis (PH.D.)--UNIVERSITY OF PENNSYLVANIA, 1985. 362 p.; Source: Dissertation Abstracts International, Volume: 47-01, Section: A, page: 0010.
Author(s): MCDIVITT, JUDITH ANN.
Abstract: This dissertation examines the role of information in bringing about knowledge and behavior change in health in a developing country. It specifically considers the constraints to change provided by the physical, social, and cultural context in which this information is introduced. The primary questions asked were: Under what conditions and for whom does mass-mediated health information lead to knowledge and does knowledge lead to health behavior change? Conditions hypothesized included factors at the level of the individual (e.g., access to material goods and time, contact with health workers) and compound or village characteristics (e.g., compound wealth, social support, level of development in the village). The research studied a multi-media campaign providing information about the treatment of infant diarrhea in The Gambia, West Africa. The study used survey responses from a stratified sample of 677 rural mothers. The data base included responses from interviews done before and over the first eighteen months of the campaign. The analyses were performed in steps, first testing the relationship between knowledge and practice (or mass media exposure and knowledge) while controlling for possible interviewer bias and other extraneous factors, then examining the interaction effect of the independent variable and each of the hypothesized conditioning factors. Overall, most of the conditioning relationships were not statistically significant and, of those that were, most showed a pattern opposite to that hypothesized. For knowledge and behavior, the major finding was that level of development in the village is a condition significantly affecting the relationship between knowledge about an oral rehydration solution and its use. Social support, family literacy and mother's status also provided positive, although not statistically significant, conditions. For radio exposure and knowledge, mothers with interpersonal sources of information were expected to be more likely to learn from the radio than mothers without interpersonal sources. However, radio exposure only made a significant difference in knowledge for mothers without other sources of information, indicating that the mass media can act as alternative sources of information for those without access to other sources. The most important constraint to knowledge was access to information, rather than situational factors such as wealth, education, or village characteristics. (Abstract shortened with permission of author.).
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Title: Perspectives On Measles Vaccination As A Primary Health Care Activity In Rural Gambia.
Date: 1985
Source: Thesis (PH.D.)--UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN, 1985. 84 p.; Source: Dissertation Abstracts International, Volume: 46-04, Section: B, page: 1138.
Author(s): WILLIAMS, PAP JOHN.
Abstract: The purpose of this study was to develop a perspective for assessing the current strategy of measles vaccination among rural Gambian children 0-15 years old. Measles experience and measles associated mortality over a thirty six months period were documented for three Gambian village communities that experienced measles outbreaks in 1981. There were 147 cases of measles among 1075 children 0-15 years old. Seventeen percent of all measles cases died at 36 months compared to 3 percent of the non measles cases when data were directly age adjusted. Thirty percent of the children were vaccinated against measles. Estimates of measles cases and measles associated deaths prevented by vaccination were then made. A questionnaire was administered to 135 'Compound Heads' (parents) in the study communities to ascertain why parents did or did not have their child vaccinated against measles. The major findings were as follows: (1) Parents periodically had their children vaccinated against measles during sick child visits to clinics. (2) Many parents do not have their children vaccinated against measles despite numerous child visits to clinic for a variety of reasons some of which are beyond the control of the parent. Based upon the results of this study, it was concluded that the Gambia current national strategy on delivering measles vaccinations as part of the maternal and Child Health Services is effective in immunizing children against measles.
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Title: The Ecology of Malnutrition in Eastern Africa Equatorial Guinea, the Gambia, Liberia, Sierra Leone, Malawi, Rhodesia, Zambia, Kenya, Tanzania, Uganda, Ethiopia, the French Territory of the Atars & Issas, the Somali Republic & Sudan Vol. 9
Date:
Source: ISBN: 0028490207 Trade Cloth USD 32.95 R; ;
Author(s): May, Jacques M. Editor; McLellan, Donna L. Editor
Abstract:
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Title: Traditional Birth Attendants in Rural Gambia: Beyond Health to Social Cohesion
Date: April, 2007
Source:African Journal of Reproductive Health Vol. 11 No.1 April, 2007
Author(s): By Stella Nyanzi1 , Hawah Manneh, Gijs Walraven
Abstract:This is a paper on the role of traditional birth attendants throughout Gambia.
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Title: The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey
Date: august 2001
Source:Tropical Medicine and International Health volume 6 no 8 pp 643-653
Author(s): Linda Morison, Caroline Scherf, Gloria Ekpo, Katie Paine, Beryl West, Rosalind Coleman and Gijs Walraven
Abstract: This paper examines the association between traditional practices of female genital cutting (FGC) and adult women's reproductive morbidity in rural Gambia.
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