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Biomedical subjects

K Styblo

Publications and source records attributed to K Styblo.

At least 19 recordsLinked to original sources
PubMed1991

Cost effectiveness of chemotherapy for pulmonary tuberculosis in three sub-Saharan African countries.

The value of programmes to control pulmonary tuberculosis in developing countries remains the subject of debate. We have examined the cost-effectiveness of chemotherapy programmes for the control of pulmonary sputum-smear-positive tuberculosis in Malawi, Mozambique, and Tanzania. Effective cure rates of 86-90% were achieved with short-course chemotherapy and of 60-66% with standard chemotherapy. The average incremental costs per year of life saved were US $1.7-2.1 for short-course chemotherapy with hospital admission, $2.4-3.4 for standard chemotherapy with hospital admission, $0.9-1.1 for ambulatory short-course chemotherapy, and $0.9-1.3 for ambulatory standard chemotherapy. Chemotherapy for smear-positive tuberculosis is thus cheaper than other cost-effective health interventions such as immunisation against measles and oral rehydration therapy. Because the greatest benefit of chemotherapy is reduced transmission of the bacillus, treating HIV-seropositive, tuberculosis smear-positive patients would be only slightly less cost-effective than treating HIV-seronegative, tuberculosis-smear-positive patients.

Ambulatory Care↗
PubMed1991

The impact of HIV infection on the global epidemiology of tuberculosis.

HIV is the strongest risk factor for tuberculous disease observed in the last 100 years in subjects infected with tubercle bacilli. Its impact upon tuberculosis incidence is so great that it has disrupted the balance between the tubercle bacillus and the community. The breakdown rate from tuberculous infection to active tuberculosis in persons infected dually is at least 30%. Although adequate chemoprophylaxis would prevent a considerable number of tuberculosis cases among these individuals, its application is not feasible in developing countries with a high prevalence of both tuberculous and HIV infections. Thus it seems that very little can be done against the increase in the incidence of tuberculosis caused by HIV. The only feasible measure to contain the transmission of tuberculous infection is to achieve a high cure rate and a high detection rate of smear-positive and other cases. This would enable us to contain-to an extent-the transmission of tuberculous infection. The results of IUATLD assisted National Tuberculosis Programmes in Tanzania and Malawi show that this can be achieved.

Adolescent↗
PubMed1990

The global aspects of tuberculosis and HIV infection.

HIV infection is the only factor which has been able to disturb the balance between the tubercle bacillus and man, in the absence of man-made interference. The impact of HIV infection on the epidemiological situation of tuberculosis is so large that, under certain conditions, the tools available at present for tuberculosis control will fail to restrain the increase in the incidence of tuberculosis caused by HIV infection. It is to be seen to what extent an efficient control programme in developing countries will be able to contain the transmission of tuberculosis infection, in particular the risk of tuberculous infection. The current risk of tuberculous infection and its trend is the most decisive factor in containing the deterioration of the epidemiological situation of tuberculosis in developing countries in the future, caused by HIV infection. In countries with high prevalence of both tuberculous and HIV infections it is imperative to achieve and maintain a high cure rate of all diagnosed smear-positive tuberculosis cases, with short-course chemotherapy. Since many tuberculosis cases among HIV-infected persons are smear-negative but culture positive, or smear-negative and culture-negative, or culture-positive or culture-negative, it is necessary, whenever possible, to improve case detection of smear-negative tuberculosis cases through screening by X-ray of the chest patients suspected of having tuberculosis, and to examine those with a pathology on the X-ray by microscopy and if possible, by culture for the tubercle bacilli. Research on the interactions of HIV and tuberculous infections is urgently needed.

Adolescent↗
PubMed1990

[Possible effects of acquired immunologic deficiency syndrome (AIDS) on tuberculosis in industrial and developing countries].

Tuberculosis is the most frequent infectious complication of AIDS and HIV infection in countries where che prevalence of tuberculous infection is high. HIV infection is the strongest risk factor for developing tuberculosis in individuals infected removly or recently with tubercle bacilli. An increased incidence of tuberculosis has been already documented in several African countries with a high prevalence of both tuberculous and HIV infections (Tanzania, Malawi). The increase in the incidence of tuberculosis is mainly due to the depression of cellular immunity caused by HIV infection in subjects infected with M. tuberculosis. The occurrence of tuberculosis in HIV-seropositive persons is more frequent in those remotely infected than in those recently infected or reinfected with M. tuberculosis. In developed countries, HIV infection will cause tuberculosis in only a relatively small number of persons, since the prevalence of tuberculosis infection is low in the age group up to approximately 45 years. HIV infection will, therefore, not substantially increase the number of tuberculosis cases.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Tuberculosis control in refugee settlements.

Tuberculosis and its management in refugees and other displaced persons in temporary settlements poses a challenge to organisations coordinating and providing care in refugee emergencies. This paper offers a consensus of the co-sponsoring agencies on practical recommendations for implementing measures aimed at both interrupting transmission of tuberculosis and treatment of individual patients.

Humans↗
PubMed1978

Reduced high-density lipoprotein in women aged 40-41 using oral contraceptives. Consultation Bureau Heart Project.

In a survey of risk factors for coronary heart-disease (C.H.D.) in a Leiden population aged 40-41 years, mean serum-high-density-lipoprotein (H.D.L.)-cholesterol was significantly higher in 447 women (47.94 mg/dl) than in 471 men (42.40 mg/dl). No association was found between serum-H.D.L.-cholesterol and systolic or diastolic blood-pressure, obesity, or electrocardiographic changes. Cigarette smoking with use of oral contraceptives were strongly associated with reduced serum-H.D.L.-cholesterol. The difference in mean serum-H.D.L.-cholesterol concentrations between women who were on oral contraceptives and those who were not was independent of the effect of smoking. The finding of a low mean serum-H.D.L.-cholesterol concentration in pill users who smoke (i.e., similar to that in men of the same age; 43.0 mg/dl and 42.4 mg/dl in women and men, respectively) is disturbing since low serum-H.D.L.-cholesterol is a major C.H.D. risk factor and because of the reported increase in mortality from circulatory diseases in women using oral contraceptives.

Adult↗
PubMed1978

Serum cholesterol analysis in the C.B. Heart Project. Intra-and inter-laboratory continuous quality control.

Standardization and quality control of measurements are of crucial importance in large medical surveys. In the C.B. Heart Project serum cholesterol analyses in the central laboratory were extensively controlled with regard to precision as well as accuracy. All measurements are carried out in side-by-side duplicate, the maximum difference allowed being 0.3 mmol/l. Bench control, aiming at maintaining linearity and precision with control limits, requires insertion of standard solutions and several serum controls into every run. Control values must fall within 2 S.D. limits from the established mean values, e.g. 4.1 +/1 0.25 mmol/l and 8.2 +/- 0.25 mmol/l. A very reliable check on the precision was obtained by blind introduction of duplicate patient specimens. Repeatability (within-run precision) as calculated each month has S.D. values of approx. 0.10--0.20 mmol/l, whereas reproducibility (long-term precision) S.D. values are 0.15--0.25 mmol/l. Accuracy is checked in the Cooperative Standardization Programme of the WHO Regional Lipid Reference Centre in Prague. This makes the C.B. Heart Progject results comparable with other standardized studies. Our bias approximates +3% and usually remains within WHO "narrow limits".

Cholesterol↗