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Biomedical subjects

A O Wilson

Publications and source records attributed to A O Wilson.

At least 19 recordsLinked to original sources
PubMed1997

Morbidity and disability in elderly Zimbabweans.

BACKGROUND: the population aged over 60 years in Zimbabwe is expanding. Despite the likely increased demand on medical services that this will bring, little is known about the health needs of this elderly population. OBJECTIVE: to record the prevalence of disability (impairment of activities of daily living), subjective morbidity (symptoms), the social circumstances and the utilization of health services in a group of elderly Zimbabweans. DESIGN: cross-sectional community survey. SETTING: a remote rural area in North Eastern Zimbabwe and two urban townships located approximately 80 km from Harare. SUBJECTS: 278 subjects (154 women, 174 rural), aged > 60 years (range 60-92) living at home. METHOD: subjects were selected by random cluster sampling. They were assessed in a structured interview and underwent physical examination including visual acuity, inspection for cataracts and assessment of mobility. RESULTS: less than 4% experienced difficulty with self-maintenance activities of daily living, but 30% had difficulty with instrumental activities. The former were all visually impaired and both visual and mobility problems contributed to the latter. Elderly people experienced many symptoms but had inadequate access to health services and used medication infrequently. Subjects were mainly self-sufficient for financial income and 60% still worked. They had declining resources with age and received little help from the social welfare department. Their health and functional abilities deteriorated with age but it was older subjects who had most difficulty getting to the clinic. Simple measures such as cataract surgery and analgesics were available only to the minority or not at all. CONCLUSIONS: this study highlights problem areas where simple, low-cost measures could make a difference to the morbidity and disability of elderly Zimbabweans.

Activities of Daily Living↗
PubMed1997

Diet and nutritional status in elderly Zimbabweans.

BACKGROUND: nutritional studies in developing countries tend to focus on women of reproductive age and children. Little is known about the diet or nutritional status of elderly Africans. OBJECTIVE: to record the diet, anthropometric, haematological and biochemical measurements which might reflect nutrition and social factors in a group of elderly Zimbabweans. DESIGN: cross-sectional community survey. SETTING: a remote rural area in north-eastern Zimbabwe and two urban townships located approximately 80 km from Harare. SUBJECTS: 278 subjects (154 women, 174 rural), aged >60 years (range 60-92), living at home. METHOD: subjects were selected by random cluster sampling. Diet was assessed by a food frequency questionnaire. Anthropometric measurements were body mass index (BMI), waist : hip ratio (WHR), triceps and subscapular skinfold thickness (SFT). Laboratory analysis included serum albumin, calcium, haemoglobin, alkaline phosphatase (ALP), cholesterol, triglycerides, vitamin B12 and red blood cell folate levels. RESULTS: the staple diet was maize meal and vegetables; 74 (27%) ate a protein-containing meal less than once a week; 135 (49%) took milk less than once a week and 27% had serum Ca2+ < 2 mmol/l. The frequency of eating meat, milk, bread and fried food varied with income and education and declined with age. For all anthropometric measurements median values were higher in the urban area (BMI 21.1 vs 18.3, WHR 0.98 vs 0.9, triceps SFT 10 vs 6.7 mm; P < 0.001 for all) and related to the frequency of eating meat and fried food. The BMI was higher in those with more years of education. Within the rural area physical measurements were higher in a more prosperous area. Serum lipid concentrations were higher in urban residents (median cholesterol 4.4 vs 3.9 mmol/l, triglycerides 1.8 vs 1.5 mmol/l; P < 0.001 for both) and correlated with BMI, WHR and triceps SFT. Vitamin B12 concentrations were higher in urban residents, whereas folate concentrations were higher in rural residents. CONCLUSIONS: dietary patterns, anthropometric measurements and biochemical values in a group of randomly-selected elderly Zimbabweans are influenced by area of residence, age, income and educational level.

Aged↗
PubMed1997

Hypertension management in Zimbabwe--awareness, treatment and blood pressure control. A community-based study.

OBJECTIVE: To evaluate the level of awareness of hypertension, treatment and blood pressure control in rural and urban communities in Zimbabwe. DESIGN: Community-based cross-sectional survey. SUBJECTS AND SETTING: 749 male and female heads of households aged > 34 years recruited from alternate households of randomly selected villages in two adjacent rural areas and randomly selected streets in an urban area. MAIN OUTCOME MEASURES: Blood pressure, awareness of hypertension, treatment and control for those on drug therapy. RESULTS: 250 subjects were found to have a diastolic blood pressure (DBP) > 94 mmHg or were on treatment with a DBP < 95 mmHg. Only 56 (22.4%) were on treatment. Of those not on treatment, 73.9% were not aware that they were hypertensive, while only 26.1% were aware but were untreated. Of those on treatment, control was inadequate in 24 (52.2%). CONCLUSION: Awareness is low and treatment and control of hypertension are inadequate in this population. There is an urgent need to set up a national policy for the prevention and control of hypertension in Zimbabwe. The main focus should be on prevention, as this may be more cost-effective for a developing country with limited resources.

Adult↗
PubMed1997

Anaemia, macrocytosis, vitamin B12 and folate levels in elderly Zimbabweans.

OBJECTIVES: To establish the ranges of full blood count (FBC), vitamin B12 and folate levels and to determine the prevalence of occult haematological abnormalities in older Zimbabweans. STUDY DESIGN: Community based cross sectional survey. SUBJECTS: 278 randomly selected healthy Zimbabweans aged > 65 years. INTERVENTIONS/STUDY FACTORS: Haemoglobin level, MCV, folate, B12 alcohol consumption. RESULTS: The median Hb was males 14.0 (range 8 to 18.3), females 13.1 g/dl (7.9 to 18.1). 23% were anaemic (Hb < 13 g/dl in males, < 12 g/dl in females), 3% with microcytic and 20% with macrocytic indices. Overall 13% had low vitamin B12 and 30% had low folate levels. Folate levels were significantly lower in urban subjects and B12 levels were significantly lower in rural subjects. Fifty four subjects (21%) had an MCV > 100 fl. In this group, low folate levels were found in 22, low B12 levels in nine, excessive alcohol in eight and two subjects had elevated TSH. The MCV was higher in urban subjects. CONCLUSIONS: This study has revealed a large amount of occult haematological abnormality and interesting differences between rural and urban subjects. It focuses attention on low levels of folate, which should be preventable by simple nutritional education, as an extensive problem in the community.

Aged↗
PubMed1996

Abbreviated Mental Test (AMT) in the elderly: shortcoming of an adapted AMT in Zimbabwe.

OBJECTIVE: To measure the abbreviated mental test (AMT)-and to determine factors which might influence this in a group of Zimbabwean elders. DESIGN: Community based cross sectional survey. SETTING: Randomly selected households within randomly selected villages and two high-density urban areas in north eastern Zimbabwe. SUBJECTS: 278 subjects aged 60 to 92 years (124 male, 154 female). INTERVENTIONS: A questionnaire, including the AMT, was administered, at home, by trained research nurses. MAIN OUTCOME MEASURES: AMT-literacy rates, visual acuity, social and demographic information. RESULTS: 128 (46pc) scored less than seven, a level normally associated with significant mental impairment. Only one subject was actually disoriented in time and place. Multiple regression analysis confirmed that increasing age, female sex, rural evidence, lack of formal education, reduced visual acquity and not currently living with a spouse were all independent factors associated with low AMT score. CONCLUSION: It was apparent that the AMT was not a valid tool for screening for confusion in Zimbabwean elderly, since the prevalence of senile-dementia is increasing in the developing world. It is important to develop a screening test for use in Zimbabwe which is sensitive but is independent of these confounding variables.

Aged↗
PubMed1996

Determinants of happiness and life satisfaction in elderly Zimbabweans.

OBJECTIVE: To assess determinants of happiness and life satisfaction in elderly Zimbabweans. DESIGN: Community based cross sectional survey. SETTING: Randomly selected villages and two urban areas in north eastern Zimbabwe. SUBJECTS: 278 subjects aged 60 to 92 years (124 male, 154 female). METHOD: One subject per randomly selected household was interviewed, at home, by a trained interviewer to complete a questionnaire. RESULTS: Independent determinants of happiness were: rural residence, whether children gave material support and satisfaction with financial circumstances. [Adjusted odds ratios and confidence intervals 0.25 (0.13 to 0.49), 0.45 (0.22 to 0.94) and 0.11 (0.01 to 0.87) respectively]. Independent determinants of life satisfaction were: feeling better off than their neighbours, receiving adequate respect from their children and satisfaction with financial circumstances. [Adjusted odds ratios and confidence intervals 0.73 (0.59 to 0.91), 0.13 (0.03 to 0.59) and 0.24 (0.1 to 0.61) respectively]. CONCLUSIONS: We have demonstrated that, despite physical hardship, the majority of Zimbabwean elders are happy and 50% are satisfied with their lives and we have identified independent determinants of happiness and life satisfaction in this group. Characterization of these determinants allows us to predict that social changes such as rural/urban migration, declining family support and diminishing respect from children will have a negative effect on happiness and life satisfaction in our elders. It is important that, when planning intervention programmes for the elderly, these facets of wellbeing are not neglected.

Aged↗
PubMed1991

A study of well-being of elderly people in three communities in Zimbabwe.

The purpose of this research was to assess the well-being of elderly people in three different community types in Zimbabwe. Well-being was defined as general health, health resource access, nutrition, habits, and physical function. Major health problems, hygiene, nutrition and access to health care did vary between communities, but there was a low level of physical dependency throughout. The findings suggest that once a critical decline in fitness occurs, elderly people may rapidly die as a result of diminished medical and physical support. These findings are relevant to future plans for elderly care services in Zimbabwe.

Activities of Daily Living↗
PubMed1991

Elderly support and intergenerational transfer in Zimbabwe: an analysis by gender, marital status, and place of residence.

This paper describes elderly support and intergenerational transfer by gender, marital status, and place of residence for 150 elderly persons in Zimbabwe. The survey was conducted in September 1988, and includes information on background characteristics, income, and cash support from all sources, noncash support, and the support of elders to others. Conclusions and implications are discussed.

Aged↗
PubMed1986

Acute chylous peritonitis with associated intestinal tuberculosis.

Acute chylous peritonitis is a rare condition that may be a sign of occult disease. However, in the majority of cases an underlying cause has not been demonstrated. The following is a case report of a five-year-old boy with acute chylous peritonitis with associated intestinal tuberculosis.

Appendicitis↗
PubMed1985

The Scottish survey of new chronic in-patients: two year follow up.

'New chronic inpatients' (patients aged 18-64 years in hospital more than one but less than six years) were followed-up two years after identification in the catchment areas of 14 psychiatric hospitals, serving 56% of the Scottish population. Nine per cent had died, 71% remained in-patients, and 20% had been discharged; 40% of those discharged had no contact with after-care services, and 37% of those remaining in hospital did not need in-patient care. Discharged patients were younger, had been in hospital a shorter time, and less often had organic brain disease. Only 13% of patients who, when first identified, had been rated at a low functioning level had been discharged; 64% of those remaining in-patients at follow up had such a rating.

Adolescent↗
PubMed1984

The Scottish survey of chronic day-patients.

All chronic day-patients (n = 422), defined as patients aged 18-64 years attending a day facility of a psychiatric hospital or general hospital psychiatric unit continuously for more than a year, were identified in hospitals and units serving 56% of the Scottish population. The number of day patients was 14.8 per 100,000 of the general population, but the range between hospitals was very great--0 to 37.7 per 100,000--indicating the patchy development of such care. A typical day patient was a rather chronic middle-aged male schizophrenic, who lived on his own or with ageing parents. Most patients' accommodation was satisfactory, but the occupational activity of more than a third was inappropriate; 18% could have attended a local authority sheltered workshop if one had been available.

Adolescent↗
PubMed1983

The Scottish survey of 'new chronic' inpatients.

All 'new chronics' (N = 571), defined as patients aged 18-64 years in hospital more than one but less than six years, were identified in 14 psychiatric hospitals serving 56 per cent of the Scottish population. The bed occupancy was 20/100,000 of the general population (range between hospitals 12-29/100,000). First admissions (5.8 beds/100,000) were clearly distinguished from readmissions. Although for the whole group schizophrenia was the most common diagnosis the majority of first admissions had organic brain disease. First admissions were more disabled and most were well placed in hospital. Thirty-eight per cent of all patients did not need inpatient care; 20 per cent could have been accommodated in staffed hostels. Widespread differences, especially in numbers, found between hospitals may have been due in part to different attitudes among staff towards the prospect of patients' discharge.

Adolescent↗