PubMed Health⌕ Search

Biomedical subjects

H G Küstner

Publications and source records attributed to H G Küstner.

13 recordsLinked to original sources
PubMed1991

The cholera epidemic in South Africa, 1980-1987. Epidemiological features.

During the cholera epidemic in South Africa, 1980-1987, 25,251 cases of cholera were bacteriologically proven. The case-fatality rate was 1.4%. Outbreaks occurred in the summer rainfall season. Age-specific attack rates followed the pattern typically found during the 'epidemic phase' of the disease in most years. The vast majority of patients were black South Africans living in rural areas with an average annual rainfall in excess of 600 mm. The containment strategy employed is summarised. Despite the apparent eradication of the disease, it is strongly recommended that vigilance should be maintained and investigations of all possible sources of infection and all human contacts of any new proven case should be carried out speedily and thoroughly.

Adolescent↗
PubMed1989

The Tuberculosis Control Programme, 1985-1986. Results of the data-capturing programme instituted by the Department of National Health and Population Development and the Standing Committee on Epidemiology of the Regional Health Organisation for southern Africa.

The Tuberculosis Control Programme during 1985 and 1986 in the seven health regions of the RSA is described. This information has not previously been available. In 1986 the total tuberculosis case load exceeded 90,000. Of about 56,000 patients in whom the outcome was known, nearly 44,000 were discharged from the programme cured, about 9,500 absconded from therapy and 3,000 died. About 222,000 suspects or contacts of cases were investigated. Analysis of the data by health region revealed regional differences of prevalence rates, predominance of inpatient or outpatient treatment, cure rates, the ratio of new tuberculosis suspects or contacts found for every new confirmed case, and the cost of the programme per case and per capita of the population. Although these data must be interpreted cautiously, it is hoped that they will be valuable to all health workers fighting this major infectious disease in South Africa.

Data Collection↗
PubMed1988

Decline in the ischaemic heart disease mortality rates of South Africans, 1968-1985.

The age-adjusted ischaemic heart disease (IHD) mortality rates (MRs) of white, Asian and coloured South Africans aged 35-74 years were studied for the period 1968-1985. Asians have the highest IHD MR in the RSA, followed by whites, coloureds and then blacks. Asian female have much higher rates than females in the other groups, especially in the older age groups. Asian males have noticeably higher rates in the younger age groups. Coloured females aged 35-44 years have a surprisingly high rate. Declines of 36.5% (from 482 to 306/100,000) for whites between 1970 and 1985, 27.5% (from 583 to 422/100,000) for Asians between 1973 and 1985, and 19.5% (from 287 to 231/100,000) for coloureds between 1976 and 1985 were observed. Rates declined among both males and females as well as in all the age groups studied. Trends in IHD MRs for black South Africans were studied for 1978-1985. The MRs for IHD among blacks are very much lower than those for South African Asians, coloureds and whites. The age-adjusted IHD MR for all South Africans was 162/100,000 in 1978 and had dropped to 121/100,000 in 1985, a 25.3% decline.

Adult↗
PubMed1988

Comparison of the decline in the ischaemic heart disease mortality rate in the RSA with that in other Western countries.

South African age-adjusted ischaemic heart disease (IHD) mortality rates (MRs) in the age group 35-74 years were compared with equivalent IHD MRs of five Western countries for the period 1968-1983. South African Asians had higher IHD MRs than all the other countries studied, and South African whites had among the highest despite the declines in rates over the period studied. Although the younger South African age groups had the greatest decline in IHD MRs, in the age group 35-44 years and 45-55 years South African rates still remain higher than those for the five other Western countries studied. Overall, the South African whites' ranking, compared with the other Western countries studied, had changed from the 2nd highest in 1970 to 4th position for males and 3rd for females in 1982.

Adult↗
PubMed1988

Legionnaires' disease in a Johannesburg teaching hospital. Investigation and control of an outbreak.

During the period 11 November 1985 - 21 February 1986, 12 cases of Legionnaires' disease were identified at a Johannesburg teaching hospital. Only 2 patients definitely acquired the disease in hospital. Both responded well to treatment. An epidemiological investigation was initiated to determine the source of infection and mode of transmission of the causative agent (Legionella pneumophila), which may be recovered from a wide variety of water sources. Although L. pneumophila was cultured from the hospital hot-water system, there was no association between the location of patients and culture-positive water sites. Cases were clustered in the medical and surgical intensive care units. Being on a ventilator was a significant risk factor for acquiring Legionnaires' disease (relative risk 18,4; 95% confidence interval 2,4 - 142,2). The potential role of ventilators in the transmission of the disease is discussed together with the infection control measures adopted to interrupt the outbreak. To our knowledge this is the first investigation of an outbreak of Legionnaires' disease in South Africa.

Adult↗
PubMed1988

Disease outbreak investigations--objectives, methods and importance.

In South Africa approximately 100 disease outbreaks or epidemics requiring investigation and control can be anticipated each year. Outbreak investigations play a critical role in determining effective disease control strategies. The application of modern epidemiological methods to the study of disease outbreaks is discussed and problem-solving methodology, which has similarities to the approach used in clinical diagnostics, described. These methods were applied to the investigation of an outbreak of Legionnaire's disease at a Johannesburg teaching hospital.

Disease Outbreaks↗
PubMed1987

Notification of five of the EPI target diseases in South Africa. An assessment of disease and vaccination reporting.

The incidence of 5 of the 6 EPI target diseases, diphtheria, tetanus, poliomyelitis, measles and tuberculosis, in South Africa is examined. Incidence is linked to vaccination coverage and an assessment of municipal vaccination coverage and programme monitoring is made. Diphtheria incidence has decreased sharply and this is probably due to vaccination. A change in the cyclical pattern of polio incidence may be due to improved vaccination. No influence of vaccination could be detected with respect to measles, tetanus and tuberculosis. Vaccination programmes report results as 'total doses given' and not as coverage rates. Improvements in three major areas, i.e. vaccination coverage, programme monitoring and evaluation and programme co-ordination are proposed.

Diphtheria↗
PubMed1986

A comprehensive investigation of immunity to poliomyelitis in a developing country.

A comprehensive nationwide surveillance program of serologic immunity of two-year-old black children, combined with evaluation of vaccine quality and distribution, was carried out in South Africa during 1983-1984. Sera were randomly collected from urban and rural groups and cluster samples collected from the semi-urban group. The sample represented 0.23% of the total target population. Satisfactory levels of immunity were found in the urban (80%) and semi-urban (71%) groups but a disquietingly low level was found for the rural group (59%). Individual districts in the rural group could be singled out for directed cluster sampling at a later stage. History and documentation of immunization corresponded well to serologic findings and revealed also a fairly substantial level of natural immunization among individuals who, on history, had received no vaccine. Some 95% of random samples of vaccine recalled from the field showed satisfactory levels of potency. An immunity surveillance program such as this is ideally suited and highly cost-effective for developing countries with incomplete immunization to prevent large-scale buildup of immunity deficit. The technique, however, is too insensitive to detect localized community immunity defects.

Antibodies, Viral↗
PubMed1979

Trends in four major communicable diseases.

The official notifications of the Department of Health pertaining to typhoid fever, tuberculosis, poliomyelitis and malaria are reviewed. Major findings of the epidemiological analysis of the data include the need for establishing the exact mode of transmission of typhoid, the need for assessing upper and lower limits of the expected case load in respect of tuberculosis over the next 5--10 years, the demonstration of the dramatic decline in the number of cases of poliomyelitis and the equally dramatic upsurge of malaria in 1977 and 1978. The need for an integrated, responsive and fully co-ordinated epidemiological service for the Republic of South Africa is emphasized.

Black or African American↗
PubMedDate not supplied

Poliomyelitis outbreak in Natal/KwaZulu, South Africa, 1987-1988. 1. Epidemiology.

An epidemic of type 1 poliomyelitis occurred in Natal/KwaZulu in the eastern part of South Africa between December 1987 and November 1988. 412 poliomyelitis cases were reported, of whom 74% were younger than 5 years. The case-fatality rate was 8%. It is suggested that massive floods, experienced in the area 2 months earlier, triggered the outbreak.

Adolescent↗