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Biomedical subjects

E Wollast

Publications and source records attributed to E Wollast.

At least 19 recordsLinked to original sources
PubMed1992

[Estimate of seroprevalence of HIV infection in Belgium using the back calculation method].

An estimation of HIV seroprevalence in Belgium in June 1990 was made by the "back calculation method". The theoretical calculation of the number of virus carriers gave a range of values from 5,750 to 16,800 carriers. The upper part of this range seems to be more consistent with data from epidemiologic monitoring (range of values from 8,900 to 16,800 carriers). HIV prevalence rate in Belgium in June 1990 would is estimated between 0.9/1000 and 1.7/1000. The detection rate of the infection among HIV positives individuals should be at least 34%.

Belgium↗
PubMed1989

Perinatal geography of Belgium.

The use of routinely collected perinatal data allows calculation of health indicators at regional levels. It helps the health managers in making decisions and provides etiological clues for epidemiology. The information is more easily assimilated with the use of maps. In Belgium, the rates of perinatal mortality, low-birthweight and preterm births vary widely between the districts. Southern districts maintain the highest rates of low-birthweight and preterm births. Even though these two factors account for most perinatal mortality cases, within 20 years, a disproportion of perinatal mortality rates between the north and the south of the country was progressively inversed to the disadvantage of the north. Advances in perinatology of some major services of the southern part may explain a good deal of this change. Discrepancies between low-birthweight and preterm rates in some districts may be explained by biomedical characteristics of ethnic groups concentrated in these areas.

Belgium↗
PubMed1989

Organization of prenatal care in Belgium.

Prenatal care in Belgium is characterized by regional variations between the Flemish- and French-speaking communities. Generally, care in the former area is provided by a general practitioner or a gynecologist/obstetrician in private practice, and in the latter by a gynecologist/obstetrician on a private or public basis. The level of use of prenatal care observed is, on average, high, but variations do exist according to the socioeconomic and cultural characteristics of the families and the health care services which they frequent.

Belgium↗
PubMed1989

[Follow-up of a cohort of premature infants: identification of factors associated with hospital death].

A cohort of premature babies (i.e. under 2.000 g and/or less than 32 weeks of gestation) born in Brussels in 1987, was followed-up during and after their stay at the neonatal unit. Among the 181 babies, 27 hospital deaths were recorded (a rate of 14.9%). Some of the variables significantly associated with hospital deaths (p less than 0.005) are well known, i.e.: birthweight, gestational age, respiratory distress, intraventricular hemorrhage. The strength of the link is measured by the relative risk (RR). For each factor with a significant RR, the positive predictive value (PPV) was also calculated. Not surprisingly, respiratory distress and intraventricular hemorrhage have the highest RR and PPV. More interesting, however, is the relatively high RR of Apgar score at five minutes (the value of which is determined at an early stage). Furthermore, the positive predictive value reaches a level of 35% and may therefore be used for the early detection of babies with a high risk of hospital death.

Birth Weight↗
PubMed1989

A versatile approach to health system evaluation.

Although problems in the relationships between different levels of health care systems in developing countries have a significant influence on efficiency, they have not been clearly defined. In the present article a simple method is described for assessing certain aspects of these problems. It is shown that data collected in a hospital can be used not only to highlight inadequate management of patients at the community level, but also to identify deficiencies at the community/hospital interface. The method is inexpensive and easy to understand, and could easily be adapted for every interface in a system and for all stages of health service development.

Chad↗
PubMed1987

[Avoidable mortality in Belgium].

The concept of avoidable mortality leads to an attempt at using specific mortality rates as output measures of health services. The analysis covered 43 Belgian districts between the years 1974 and 1978. Two Belgian areas were compared along a dimension defined by two axes of a correspondence factor analysis: Flanders which is associated with low SMR of avoidable mortality and Wallonia which has high rates. The persistence of high mortality in Wallonia was confirmed. Factorial scores for each district were used as indexes for geographical heterogeneity. Variations in these indices, including patient consultation rates and technical medical procedures, remained even after adjustment for socio-economic differences.

Adolescent↗
PubMed1987

[Episiotomy and prevention of complete and complicated tears. A study in 3 European countries].

The rates of third-degree tears in deliveries with and without episiotomy were compared in five samples: three French samples, a Belgian one and a Dutch one. Those samples corresponded to 48,430 single vaginal deliveries. The rates of episiotomy ranged from 29.3% to 54.2%. The results demonstrate that the risk of third-degree tears in vertex uncomplicated deliveries without episiotomy is low, and that in numerous cases third-degree tears are not prevented by an episiotomy. When uncomplicated deliveries of primipara were considered, results from four of the five samples showed that third-degree tears were not significantly more frequent in deliveries without episiotomy.

Belgium↗
PubMed1986

[Evaluation of prenatal care in Belgium and comparison between public and private medical sectors].

The Belgian health system imposes no regulations regarding antenatal care. A special study was carried out by questionnaire in a sample of 32 maternity units representative of the French-speaking region to determine the coverage rate achieved by the health system. The study also compared the private and public sectors for rate of use, socioeconomic profile of users and regularity of antenatal care. Overall results show that despite the generosity of the system, a utilization rate of 98.8%, and a coverage rate of 84%, are reached. Public and private sector attendance is comparable but their respective populations are different. Regularity of antenatal care varies considerably between the two sectors. The public sector performs better in this regard, especially when it is endowed with medico-public health teams. The results suggest that the regularity of antenatal care is a better indicator of the quality of services than of their accessibility.

Belgium↗
PubMed1986

[Neonatal mortality and birth weight. Which strategy for the future?].

In this study the authors analysed the neonatal mortality rates in Belgium in 1981 and 1982. Newborns were grouped into four categories according to their birth weight: 500-1,499 gr (Cat. A), 1,500-2,499 gr (Cat B), 2,500-3,499 gr (Cat C), 3,500 gr or more (Cat D). The distribution of neonatal deaths in those four categories was 33.2% in category A, 29% in category B, 27.3% in category C and 10% in category D. A specific strategy to lower neonatal mortality in each category could be worked out. The authors analysed what priority should be given to each category according to the data found in the literature concerning the following criteria: effectiveness, cost and doing the least damages. They concluded that the present focus on category A, is over done and should not be the strategy to be used at present. The higher neonatal mortality of newborns of category C (2,500-3,499 gr) as compared with the neonatal mortality in category D (3,500 gr and more) is generally underestimated and underanalysed. Reducing this extra mortality could result in lowering Belgium neonatal mortality by 12%. The organisation and accessibility of obstetric care seem to be linked to this higher mortality. In their conclusions the authors suggest other studies and short-term objectives that should be considered in order to lead to a continued lowering in neonatal mortality.

Belgium↗
PubMed1986

[Recent trends in infant mortality. The case of Belgium].

In this study concerning the whole of Belgium, the trends in infant mortality and of its two main components, neonatal mortality (NNM) and post-neonatal mortality (PNNM) from 1960 to 1981 were studied. NNM and PNNM followed similar trends until 1975 when PNNM became steady at a rate of 4-4.5%. On the other hand, an acceleration was observed in the rate of decrease for NNM, from -52% before 1975 to -71% between 1975-1981.

Age Factors↗
PubMed1986

[Prenatal care and occupational activity].

We studied the gestational age at the first prenatal visit and the number of prenatal visits by occupational activity among 1,573 women who delivered in 32 maternity units of the Belgium's French speaking region. The comparison with non working women showed that working women consulted significantly (p less than 0.01) earlier, whatever their professional activity, their parity and their social class. They consulted significantly (p less than 0.05) more frequently in terms of reaching the expected number of consultations calculated as a function of gestational age at the first visit. This difference disappeared when parity and social class were taken into account.

Belgium↗
PubMed1985

Episiotomy and third-degree tears.

The relation of episiotomy to third-degree perineal tears was investigated in 21 278 singleton deliveries. The incidence of episiotomy was 28.4% (n = 6041). Third-degree tears occurred in 1.4% (85) of the deliveries with episiotomy and in 0.9% (132) of the deliveries without episiotomy (P less than 0.01). To avoid the effect of confounding factors, we analysed a sub-sample that included only vertex presentations with spontaneous occipitoanterior vaginal deliveries. After stratification for birthweight and parity, no relation between episiotomy and third-degree tear was found.

Birth Weight↗