PubMed Health⌕ Search

Biomedical subjects

C C Daly

Publications and source records attributed to C C Daly.

At least 19 recordsLinked to original sources
PubMed2000

Prevalence of hepatitis C infection in Malawi and lack of association with sexually transmitted diseases.

To investigate the role of sexual transmission for Hepatitis C virus (HCV) we studied its prevalence in sub-Saharan Africa where sexually transmitted diseases (STDs) are prevalent. Overall, HCV prevalence was 3.9% and similar in 206 STD patients, 127 dermatology patients, and 100 blood donors. No association with HIV or syphilis was observed. Despite high prevalence of STDs, sexual transmission does not appear to significantly contribute to HCV transmission in Malawi.

Cohort Studies↗
PubMed1999

Trichomonas vaginalis as a cause of urethritis in Malawian men.

BACKGROUND AND OBJECTIVES: Trichomonas vaginalis is one of the most common sexually transmitted infections. In Malawi, rates of trichomoniasis in women are high. The prevalence of T. vaginalis infection in men is expected to be high but has not previously been documented. GOALS: We sought to determine the prevalence of trichomoniasis in Malawian men with and without urethritis, to evaluate a polymerase chain reaction detection assay for T. vaginalis in urethral swabs and to examine the effect of T. vaginalis infection on excretion of human immunodeficiency virus (HIV) in semen. STUDY DESIGN: Men presenting at the Sexually Transmitted Diseases (STD) and Dermatology Clinics in Malawi were enrolled in a cross-sectional study. We compared a polymerase chain reaction-based test for T. vaginalis detection with wet-mount microscopy and culture of urethral swabs. HIV serology was determined by enzyme-linked immunosorbent assay (ELISA), and HIV-1 RNA concentrations in semen were measured by quantitative nucleic acid sequence-based analysis. RESULTS: T. vaginalis was detected in 51 of 293 men. The estimated prevalence among symptomatic men was 20.8% and among asymptomatic men, 12.2%. Polymerase chain reaction performed with a sensitivity of 0.82 (95% CI: 0.66-0.92) and specificity of 0.95 (95% CI: 0.91-0.97) compared to wet-mount microscopy and culture. There was no difference in the rate of HIV seropositivity in men with and without T. vaginalis infection. However, in men with symptomatic urethritis, the median HIV RNA concentration in seminal plasma from men with T. vaginalis was significantly higher that in seminal plasma from HIV-positive men without trichomonas.

Animals↗
PubMed1998

A cost comparison of approaches to sexually transmitted disease treatment in Malawi.

Since syndromic management of STDs requires treatment with at least two antibiotics per patient, one of the concerns raised by adoption of the syndromic approach is the cost of drugs, especially for developing countries with limited drug budgets. The objective of the current study is to compare the cost-effectiveness of syndromic management to current national practice for the management of STDs in Malawi. The actual cost of observed antibiotic treatment for 144 patients receiving same day treatment for two STD syndromes in Malawi was determined using prices from the Malawi government supply catalogue. This was then compared to the calculated cost of treatment had the same patients been managed syndromically according to national guidelines. The cost of drug treatment under current practice was similar to the cost of syndromic treatment. However, at least one-third of observed patients did not receive effective treatment for either likely cause of their STD syndrome and wastage accounted for 54% of total observed drug cost. Overall, syndromic management of STDs in Malawi would result in more effective treatment of STDs at no additional cost. Since the indirect costs of low treatment efficacy were not taken into account in this analysis, a net saving is likely to be realized with the adoption of syndromic management.

Anti-Bacterial Agents↗
PubMed1997

Reduction of concentration of HIV-1 in semen after treatment of urethritis: implications for prevention of sexual transmission of HIV-1. AIDSCAP Malawi Research Group.

BACKGROUND: Transmission of HIV-1 is predominantly by heterosexual contact in sub-Saharan Africa, where sexually transmitted diseases (STDs) are also common. Epidemiological studies suggest that STDs facilitate transmission of HIV-1, but the biological mechanism remains unclear. We investigated the hypothesis that STDs increase the likelihood of transmission of HIV-1 through increased concentration of the virus in semen. METHODS: HIV-1 RNA concentrations were measured in seminal and blood plasma from 135 HIV-1-seropositive men in Malawi; 86 had urethritis and 49 controls did not have urethritis. Men with urethritis received antibiotic treatment according to the guidelines of the Malawian STD Advisory Committee. Samples were analysed at baseline and at week 1 and week 2 after antibiotic therapy in urethritis patients, and at baseline and week 2 in the control group. FINDINGS: HIV-1-seropositive men with urethritis had HIV-1 RNA concentrations in seminal plasma eight times higher than those in seropositive men without urethritis (12.4 vs 1.51 x 10(4) copies/mL, p = 0.035), despite similar CD4 counts and concentrations of blood plasma viral RNA. Gonorrhoea was associated with the greatest concentration of HIV-1 in semen (15.8 x 10(4) copies/mL). After the urethritis patients received antimicrobial therapy directed against STDs, the concentration of HIV-1 RNA in semen decreased significantly (from 12.4 x 10(4) copies/mL to 8.91 x 10(4) copies/mL at 1 week [p = 0.03] and 4.12 x 10(4) copies/mL at 2 weeks [p = 0.0001]). Blood plasma viral RNA concentrations did not change. There was no significant change in seminal plasma HIV-1 RNA concentrations during the 2-week period in the control group (p = 0.421). INTERPRETATION: These results suggest that urethritis increases the infectiousness of men with HIV-1 infection. HIV-1-control programmes, which include detection and treatment of STDs in patients already infected with HIV-1, may help to curb the epidemic. Targeting of gonococcal urethritis may be a particularly effective strategy.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Development of an antimicrobial susceptibility surveillance system for Neisseria gonorrhoeae in Malawi: comparison of methods.

Susceptibility of Neisseria gonorrhoeae to gentamicin, the primary treatment for gonorrhea in Malawi since 1993, was determined by using agar dilution MICs, E-test MICs, disc diffusion, and clinical cure rate. Agar dilution MICs were slightly higher in 1996 than in 1993 isolates, with a concomitant drop in the clinical cure rate. E-test MICs were substantially lower than agar dilution determinations, with only 77.4% within 1 log2 concentration.

Anti-Bacterial Agents↗
PubMed1997

Quality of case management of sexually transmitted diseases: comparison of the methods for assessing the performance of providers.

This article examines the reliability and validity of direct observation of patient-provider encounters, interviews with providers, and use of patients simulating sexually transmitted diseases (STD) as methods for assessing the quality of STD case management in developing countries. Data were collected during an STD health facility survey in Malawi; the performance of 49 providers was observed, and the providers were also interviewed; 20 of them were visited by a simulated patient complaining of urethral discharge. Agreement (based on the kappa statistic) was generally poor between direct observation and provider-interview data, and also between direct observation and simulated-patient data. In contrast, percentage agreements between direct observation and simulated-patient data were often high. Multiple observations on providers indicated that a provider's behaviour is not consistent across several patients. Simulated-patient data are probably the best in reflecting normal performance, but their feasibility for routine quality assessment is limited because the provider's behaviour is not consistent and would require multiple data points. Direct observation data are the best option for assessing quality if the results are assumed to reflect better than normal levels of quality of care. Data from interviews with providers should be viewed with caution, because they may reflect provider knowledge and not necessarily performance.

Case Management↗
PubMed1996

Prevalence and duration of insensibility following electrical stunning in calves.

Sixty-one calves were electrically stunned with 100-250 V currents (103-1806 mA) and the prevalence and duration of insensibility was assessed from their physical behaviour, the presence of epileptiform activity in their electrocorticograms, and the absence of visual evoked responses in their electrocorticograms. A current applied at 100 V across the head for 3 s failed to induce insensibility in all cases. Currents at 150-250 V induced insensibility in all calves and the shortest duration of insensibility was 44 s. It is recommended that a 150-200 V current would be appropriate for commercial use.

Journal Article↗
PubMed1996

Sexually transmitted diseases: a survey of case management in Malawi.

A national survey of sexually transmitted disease (STD) case management was carried out at 39 health care facilities in Malawi in 1994. Fifty-four health care providers were observed managing 150 patients presenting with selected STD syndromes and 103 providers were interviewed. STD case management was assessed by calculation of WHO/GPA prevention indicators (PIs) from observation data. The overall rate for PI-6, which measures correct assessment and treatment of STD patients was 11% (81% for history taking, 46% in physical examination, and 13% correct antibiotic treatment according to national guidelines). The score for PI-7, which measures overall patient counselling was 29% (65% for partner notification and 40% for condom advice). Although Haemophilus ducreyi is at least as common as Treponema pallidum as the causative agent for genital ulcers, only 16% of patients with genital ulcers were treated effectively for chancroid vs 56% for syphilis. Female patients received less comprehensive care than male STD patients. Only 20% of STD patients were offered condoms. Overall, the survey results support the policy decision to adopt syndromic management of STDs, and provide baseline information for planning and evaluation of a national control programme.

Africa↗
PubMed1995

Electroencephalographic studies on the nape shooting of sheep.

The implications of shooting animals in the area of the occipito-atlantal junction was evaluated in three sheep by recording changes in the EEG activity. In one sheep, a shot which entered the occipito-atlantal junction and fractured the first cervical vertebra failed to produce insensibility. In contrast, a shot in another sheep which struck the occipital condyles of the skull resulted in loss of cortical evoked responses, the presence of high amplitude low frequency activity and ultimately all loss of brain activity. These results provide evidence that shooting through the vertebral column does not necessarily transmit sufficient percussive forces to higher brain regions to produce immediate insensibility. This has important implications for the humane destruction of animals, particularly, as in the case of cetaceans, where the occipito-atlantal junction or a high neck position is a recommended target area.

Journal Article↗
PubMed1994

Contraceptive methods and the transmission of HIV: implications for family planning.

Heterosexual transmission is the predominant mode of spread of the Human Immunodeficiency Virus (HIV) in most of the world. Whether the use of hormonal contraceptives, IUDs and spermicides is associated with an increased or decreased risk for HIV acquisition remains controversial. Several mechanisms whereby contraceptive methods may influence the transmission of HIV have been proposed. As contraceptive use increases among women of reproductive age, the group most vulnerable to HIV infection, any associations between contraceptive method and HIV risk become even more important. The available studies of these associations are predominantly cross-sectional and give conflicting results. We review the published evidence for associations between HIV and individual contraceptive methods. At this time no definitive conclusions regarding these associations can be drawn. Further research, especially prospective epidemiological studies and basic biological research on mechanisms of heterosexual transmission and the effect of contraceptives on these mechanisms, is urgently needed.

Condoms↗
PubMed1994

Risk factors for gonorrhoea, syphilis, and trichomonas infections among women attending family planning clinics in Nairobi, Kenya.

OBJECTIVE: To identify the risk factors for gonorrhoea, syphilis, and trichomonas infections among low risk women in Nairobi, Kenya. METHOD: In a cross-sectional study, 4,404 women attending two peri-urban family planning clinics between 1989 and 1991 were interviewed using a structured questionnaire and examined for signs of sexually transmitted disease (STD) infection. Cervical cultures for gonorrhoea, PAP smear (including microscopy for trichomonas), RPR and HIV testing were done. RESULTS: Positive cervical cultures for gonorrhoea were found in 3.2% of women, positive syphilis serology in 1.9%, and positive trichomonas microscopy in 5.2%. Genital ulcers were found in 1.9% of women. Although unmarried status and reporting more than one sex partner in the previous year were both significantly associated with each disease in the crude analysis, these associations were attenuated after controlling for each other and for other risk factors. The population attributable risks (PARs) for these factors were low (7-16%) owing to the high proportion of cases who were married and monogamous. The majority of women with microbiological evidence of infection had normal pelvic examinations. Clinical diagnostic algorithms for STDs in this population had a low sensitivity and positive predictive value. Nevertheless, a strong association between HIV seropositivity and STDs was observed. CONCLUSION: The low population attributable risks found in this study suggest that behaviour change messages directed to women, particularly if they are married have a low potential for preventing STDs. The poor performance of clinical diagnostic algorithms illustrates the desirability of testing these algorithms in a variety of populations and reinforces the need for low-cost methods of microbiologic diagnosis if populations with relatively low prevalences of these infections are to be included in programmes to diagnose and treat STDs.

Adolescent↗
PubMed1992

Of fire and ash.

Explore the source record for details and available documents.

Burns↗
PubMed1989

Investigation into the principal determinants of effective captive bolt stunning of sheep.

In order to identify the physical component of captive bolt stunning responsible for abolishing visual evoked responses, experimental forms of captive bolt stunning were carried out on anaesthetised sheep. Supporting the captive bolt pistol away from the skull to permit limited penetration of the brain was found to be as effective as conventional shooting methods at abolishing visual evoked responses (responses were lost in all animals). Whereas, manual insertion of the bolt through a trephined hole or shooting through a trephined hole was significantly less effective (respectively, one of eight and four of eight animals lost responses). It is concluded that the impact of the bolt with the cranium is the principal determinant of effective stunning, rather than the penetration of the bolt into the brain tissues.

Animals↗
PubMed1988

Cortical function in cattle during slaughter: conventional captive bolt stunning followed by exsanguination compared with shechita slaughter.

Brain function was examined in adult cattle after conventional captive bolt stunning or shechita slaughter, using eight animals in each treatment. The times to loss of evoked responses (visual and somatosensory) and spontaneous activity in the electro-corticogram were used to determine the onset of brain failure. Captive bolt stunning followed by sticking one minute later resulted in immediate and irreversible loss of evoked responses after the stun. Spontaneous cortical activity was lost before sticking in three animals, and in an average of 10 seconds after sticking in the remaining five animals. The duration of brain function after shechita was very variable, and particularly contrasted with captive bolt stunning with respect to the effects on evoked responses. These were lost between 20 and 126 seconds (means of 77 seconds for somatosensory and 55 seconds for visual evoked responses) and spontaneous activity was lost between 19 and 113 seconds (mean 75 seconds) after slaughter.

Abattoirs↗
PubMed1986

Concussive methods of pre-slaughter stunning in sheep: assessment of brain function using cortical evoked responses.

Averaged cortical evoked responses were used to evaluate brain function in anaesthetised sheep. Effects on both evoked somatosensory responses (SERs) and visual evoked responses (VERs) were examined. Following capitive bolt stunning, SERs and VERs were abolished instantaneously and did not reappear for the duration of the experiment. Similar results were found when animals were shot while conscious. It was concluded that captive bolt stunning in sheep produces an immediate, profound and long lasting brain failure and is therefore an effective preslaughter stunning method.

Animals↗
PubMed1986

Concussive methods of pre-slaughter stunning in sheep: effects of captive bolt stunning in the poll position on brain function.

The effectiveness of captive bolt stunning in the poll position was evaluated in eight anaesthetised sheep. Brain function following shooting was assessed using cortical visual evoked responses (VERs). Immediately following shooting, VERs were abolished in all sheep. However, in five of the sheep, VERs gradually recovered; responses became evident in these animals in a mean (+/- SE) time of 50 +/- 16.7 seconds. These results suggest that captive bolt shooting in the poll position can be associated with rapid recovery of brain function. Because such recovery could be associated with return of sensibility, shooting in the poll position should only be used when essential (ie, in horned animals) and then always followed promptly by sticking.

Animals↗
PubMed1980

Photograms for microbiological assays.

The use of photograms provides a permanent record of microbiological assays in which diffusion of a substance in agar is measured. The accuracy of this procedure is comparable to direct measurement. This technique is inexpensive, does not require special photographic equipment, and is applicable to many tests commonly employed in clinical microbiology and immunology laboratories.

Agar↗