[Epidemiology and its use in assessing the practice of diabetology].
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Biomedical subjects
Publications and source records attributed to M Brodin.
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The authors report on their 4 years of experience and research in education and training of medical doctors, nurses and male nurses, in the field of community health methodology in developing countries. They start from the fact, widely recognized by national and international organizations (W.H.O.), that improvement of health status of a population demands some other activities than curative ones, i.e. comprehensive knowledge of its social and cultural environment, evaluation of its health status, organization and management of the health services, clearly defined and fully observed collaboration between various partners, population, professionals, politicians. Neither medical doctors nor nurses and male nurses have been taught and trained in these fields. The authors suggest a part-time course of three months, built round the learning of methods and techniques of socioethnology, economics, epidemiology, management of services, and communication. Taking into account the pecularities of the audiences (foreigners, or nationals), the authors propose a pedagogical pattern based on the experience of the participants, both in simulated situation (case studies) or in actual situation (survey and setting-up of a program in a community).
The Comede health care center for political refugees received 4,414 first arrivals from 70 African, Asian and South American countries in 1989. Many arrived from areas where intestinal parasitic infections are endemic, and where infections by nematodes (Ancyclostoma duodenale, Necator americanus, Ascaris lumbricoides, Trichuris trichiura, Strongyloides stercoralis), trematodes (Schistosoma hematobium, Schistosoma stercoralis) and protozoa (Entamoeba coli) cause significant morbidity. The question that arises is whether we should screen stools and urine only in the case of African refugees, or treat all refugees empirically (mass treatment program). We carried out a retrospective study of 1,425 patients seen for the first time in the Comede from August 1, 1989 to December 31, 1989. Three-quarters of the subjects were men and the mean age was 29 years. 63.2% of the subjects were from 28 African countries, 18.6% from 8 Asian countries, 10% from 5 South American countries and the West Indies, and 6.4% from 4 countries of the Mediterranean basin. 4 countries of the Mediterranean basin. All the subjects were asked to provide stool and urine specimens at the Paris City Laboratory, which were examined using the merthiolate iodo formol direct methods, two concentration methods (MIF and Kato) and Baermann's technique. Patients with infestations were prescribed appropriate treatment at a second visit, compliance with which was good (86%). The prevalence of intestinal parasite infections was 60%. Albendazole was given to 44% of patients, while 45% of African patients were given praziquantel and 2.7% tinidazole.(ABSTRACT TRUNCATED AT 250 WORDS)