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Ingela Krantz

Publications and source records attributed to Ingela Krantz.

12 recordsLinked to original sources
PubMed2006

School-based prevention of schistosomiasis: initiating a participatory action research project in northern Tanzania.

The main aim of this project was to undertake participatory action research in two primary schools in northern Tanzania in order to create enabling environments for the schoolchildren and other community members to adapt practices relevant for reducing the transmission of schistosomiasis. This paper describes the process of initiating the project. The school activities started in 2002 by screening all schoolchildren (n=1146) in the two schools for schistosomiasis and intestinal helminths and treating those infected. This was interspersed with school essay writing, video recorded dramas and household sanitation observations. The first activities made the researchers realise that they had to focus more on the teachers and change their perspective from one of "helping the research team with their project" to become full partners in the research process. Preliminary results are the actions taken by the teachers to develop a curriculum for enhanced schistosomiasis education in primary schools, making household sanitation surveys part of school activities, better links between the school and the community, and actions taken by community members to create safe swimming places. The experiences and lessons learned so far are discussed.

Adult↗
PubMed2006

Female genital schistosomiasis as an evidence of a neglected cause for reproductive ill-health: a retrospective histopathological study from Tanzania.

BACKGROUND: Schistosomiasis affects the reproductive health of women. Described sequelae are ectopic pregnancy, infertility, abortion, and cervical lesions and symptoms mimicking cervical cancer and STIs. There are indications that cervical schistosomiasis lesions could become co-factors for viral infection such as HIV and HPV. METHODS: In a retrospective descriptive histopathological study clinical specimens sent between 1999 and 2005 to the pathology department of a consultant hospital in Tanzania were reviewed to analyse the occurrence and features of schistosomiasis in female genital organs. RESULTS: During the study period, schistosomiasis was histopathologically diagnosed in 423 specimens from different organs (0.7% of all specimens examined in the study period), out of those 40% were specimens from female and male organs. The specimens were sent from 24 hospitals in 13 regions of mainland Tanzania. Female genital schistosomiasis was diagnosed in 125 specimens from 111 patients. The main symptoms reported were bleeding disorders (48%), ulcer (17%), tumor (20%), lower abdominal pain (11%) and infertility (7%). The majority of cases with genital schistosomiasis were diagnosed in cervical tissue (71 cases). The confirmation of cervical cancer was specifically requested for 53 women, but the diagnosis could only be verified for 13 patients (25%), in 40 cases only severe cervical schistosomiasis was diagnosed. Vulval/labial schistosomiasis was seen in specimens from young women. Infertility was reported in four patients with schistosomiasis of the Fallopian tubes. CONCLUSION: Genital schistosomiasis adds to the disease burden of women in all age groups. Pathological consequences due to the involvement of different genital organs can be damaging for the affected women. Clinical unawareness of genital schistosomiasis can lead to misdiagnosis and therefore false and ineffective therapy. In endemic areas cervical schistosomiasis should be considered as differential diagnosis of cancer.

Adolescent↗
PubMed2006

On the application of the von Mises distribution and angular regression methods to investigate the seasonality of disease onset.

This paper describes an approach to summarize the data arising from studies investigating the pattern of disease onset within a calendar year. Such data have been traditionally summarized into monthly counts summated over the complete years studied and patterns often examined by use of Pearson's chi(2) tests with 11 degrees of freedom. This test and others commonly used in practice are reviewed. As an alternative, we suggest that by first representing the date of onset for an individual as a point on a unit circle that the von Mises distribution with a single peak may provide a useful description of such data. Further an extension to angular regression including covariates, analogous to that used routinely in other areas of clinical research, potentially allows a more systematic and detailed investigation of possible seasonal patterns in patient subgroups. The methodology is applied to examples from the date of onset of primary angle-closure glaucoma and date of diagnosis of acute lymphoblastic leukaemia and examines in both situations how the peak onset varies with covariates. Difficulties associated with convergence to the maximum likelihood estimates of the associated parameters are described. Finally, we emphasize the need for individualized (rather than grouped) patient data to be available for study, a clear specification of the particular 'onset' time studied, and suggest that further case studies are required to evaluate the approach.

Adult↗
PubMed2005

Variation in the seasonal diagnosis of acute lymphoblastic leukemia: evidence from Singapore, the United States, and Sweden.

This study investigated, by summing data over successive years, the evidence for the seasonal diagnosis of acute lymphoblastic leukemia. To do so, the authors estimated the dates of peak diagnosis over a range of geographic locations including Singapore (1968-1999), Hawaii and mainland United States (1973-1999), and western Sweden (1977-1994) at latitudes of 1.16 degrees N to 58.24 degrees N. In contrast to other studies, the authors used case-by-case information on dates, gender, and age rather than grouped data for analysis. The seasonal pattern was estimated by fitting a von Mises distribution to the data from each location. No seasonal pattern was found in Singapore, which is close to the equator and does not have marked climatic changes. Likewise, seasonality was not demonstrated in Hawaii or mainland United States despite a 26.18 degrees range of latitudes. In contrast, a significant peak (early January) was observed for western Sweden that appeared strongest for males (December 22, 95% confidence interval: November 16, January 16) and those less than age 20 years (January 14, 95% confidence interval: December 8, March 27). Thus, despite a wide geographic range of localities, there is little evidence of any seasonality in the diagnosis of acute lymphoblastic leukemia in most populations studied and no strong evidence of any influence of climate (as expressed by latitude).

Adolescent↗
PubMed2005

Acceptance and outcome of herpes simplex virus type 2 antibody testing in patients attending an STD clinic--recognized and unrecognized infections.

The majority of herpes simplex virus type 2 (HSV-2) genital infections are asymptomatic. We wanted to evaluate the acceptance of HSV-2 antibody testing among people attending an STD clinic and to estimate, after counselling, the percentage of recognized and unrecognized HSV-2 infections. First visitors to an STD clinic were invited to participate by answering a questionnaire and taking a blood test for HSV-2 antibodies. HSV-2 seropositive individuals, who were unaware of having genital herpes, were offered an HSV-2 counselling visit and follow-up. Of 1769 patients offered testing, 57% accepted. Of 152 (15%) HSV-2 seropositive individuals, 41% had a self-reported history of genital herpes, approximately 30% had genital symptoms and 30% had no genital symptoms. The percentage of patients reporting genital symptoms was much higher in HSV-2 seropositives (45%) without a history of genital herpes than in an HSV-2 seronegative group (28%). HSV-2 antibody testing should be performed generously in all cases of uncharacteristic genital symptoms.

Adult↗
PubMed2004

A six-year follow-up of schoolchildren for urinary and intestinal schistosomiasis and soil-transmitted helminthiasis in Northern Tanzania.

Two cross-sectional studies with a 6-year interval were undertaken in two primary schools in neighbouring villages in Mwanga District, Tanzania, to determine the prevalence of schistosome and soil-transmitted helminth infections before and 6 years after treatment. Within this interval, health-related interventions such as one mass treatment of the villagers, health education, improvement of sanitation and access to safe water were undertaken in the villages. In 1996, urinary schistosomiasis occurred in Kileo (n=284) and Kivulini (n=350) in 37.0 and 86.3% of the schoolchildren. Intestinal schistosomiasis was found in 22.9 and 43.5% of the children. The infection with soil-transmitted helminths ranged between 2.7 and 18.1% in both villages. After 6 years, the prevalence of urinary schistosomiasis in schoolchildren remained nearly constant in Kileo (33.5%; n=544), but dropped from 86.3% to 70.0% in Kivulini (n=514). In the latter village the proportion of children heavily infected with Schistosoma haematobium (> or = 50 eggs/10 ml urine) decreased from 53.8% to 34.4%. With the exception of hookworm infection, soil-transmitted helminthiasis and intestinal schistosomiasis were significantly less seen in 2002 compared to the baseline. The previous chemotherapy of schoolchildren and villagers in 1996 and 1998, respectively, might have led to a reduced transmission of schistosomiasis in the following years. However, the reduction of prevalence of soil-transmitted helminthiasis is more likely to be the result of health-related interventions.

Adolescent↗
PubMed2004

["Proportion of contact"--an alternative attempt to estimate health care needs].

The Swedish Health and Medical Care Act declares that health and medical care should be planned according to the needs of the population. Assessments of health care needs should begin with the total need of health care for any given population since the different forms of health care are dependent on each other. In Sweden, information on utilisation of care could estimate immediate short term health care needs. Individual self-perceived ill health is a reasonable basis for measures of health care needs, allowing for the fact that individuals often are in contact with several different forms of health care. Information regarding the 1.5 million individuals of the Västra Götaland Region and the associated utilisation of different forms of health care were collected for 2000 and 2001 . The proportion of contact is defined as the proportion of unique individuals from a specified geographical area who have been in contact with the health care system during a specified period of time. Each form of health care and the combinations thereof are regarded as a distinct category. The proportion of contact could be regarded as an estimate of the immediate overall self-perceived health care need and a reasonable measure for further studies on how to allocate resources.

Female↗
PubMed2004

Ethics and vaccination.

BACKGROUND: Immunization programmes are ethically defensible and society has a significant role to play in providing vaccination against measles and safeguarding herd immunity to optimize its individuals' capabilities. Since preventive actions interfere with individuals who consider themselves as healthy, public health strategies - as distinct from advice in a clinical consultation - require something approaching certainty as to benefits and possible side effects of an intervention. The principle of individual autonomy, a fundamental value in bioethics, often makes discussions covering ethical issues in public health interventions difficult and non-productive as to practical solutions. In encounters intended to provide information on vaccination, discussions regarding risks tend to simplify the issue into an individual one: either the child gets measles or not, or is affected by side effects or not. METHOD AND CONCLUSIONS: A model is suggested for identification and analysis of the ethical conflicts in measles vaccination programmes, which contains two different dimensions: the affected persons and the relevant ethical principles. Justice as solidarity, not utility, should be paired with autonomy in ethical deliberations on preventive health interventions such as a vaccination programme for measles. If the goal is solidarity rather than conformity, the parents must be free to decide what they think is right, because that is what moral responsibility is all about. Solidarity, however, could never be accepted as an argument without parents trusting the messages from the health institutions and availability of reasonable societal support for those who claim an association between vaccinations and possible side effects.

Child Welfare↗
PubMed2003

Prevalence of herpes simplex virus antibodies in childhood and adolescence: a cross-sectional study.

The changing spectrum of herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) infections makes it important to define the seroepidemiology of HSV. The object of this study was to determine the prevalence of HSV-1 and HSV-2 immunoglobulin G antibodies in a young Swedish population by investigating 2106 serum samples from people aged 0-19 y. Sera were tested in HSV type-specific enzyme-linked immunosorbent assays using glycoprotein G-1 (gG-1) and glycoprotein G-2 (gG-2) as antigens. The overall seroprevalence was 31% (95% CI 29-33) for HSV-1 and 0.5% (95% CI 0.2-0.9) for HSV-2. The HSV-1 seroprevalence was higher with increasing age, and significantly higher in the age cohort 15-19 y compared with 1-4-y-olds (37% vs 24%). The HSV-1 infection seemed to be acquired early in life. In the age cohort 1-2 y, the prevalence was over 20%, presumably reflecting an established viral infection. In adolescence the HSV-1 seroprevalence may reflect both oral and sexual transmission. The seroprevalence in the oldest age cohort did not differ significantly from that seen in a Swedish study in which sera were sampled from young girls in the 1970s.

Adolescent↗
PubMed2002

Self-reported herpes labialis in a Swedish population.

In a cross-sectional study, the occurrence of a self-reported history of labial herpes was evaluated. The study population comprised a stratified random sample of 5,000 individuals, aged 0-60 y, from south-west Sweden. A questionnaire, together with written and photographic descriptions of labial herpes lesions, was sent to the participants. Of 5,000 questionnaires sent out, 3597 (72%) were returned. In answer to the question "Have you ever had herpes?" the point estimate was 26.6% (95% confidence interval [CI] 25.1%-28.1%) and for the question "Have you had herpes in the last 2 y?" it was 19.4 (95% CI 18.0-20.8). The proportion of individuals who had had herpes was higher for the older age groups. About 5% of children aged < or = 5 y had experienced labial herpes. Herpes was more frequently reported by females than males: odds ratio 1.29 (95% CI 1.10-1.51). Compared to previous studies in Sweden, our data do not indicate that the occurrence of labial herpes lesions has decreased.

Adolescent↗