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Biomedical subjects

M Tanner

Publications and source records attributed to M Tanner.

At least 181 records · Page 10Linked to original sources
PubMed1995

Traditional healers in Tanzania: the perception of malaria and its causes.

The coordination of traditional and western medicine is still in its infancy in most African countries. Although there is much discussion about the contribution of traditional medicine and its practitioners, especially on the primary health care level, it has rarely be done in practice. This is probably due to the lack of knowledge of how to do it, because a serious attempt to include traditional medicine in health planning would presuppose that it is known what traditional medicine has specifically to offer for certain diseases/illnesses and how traditional healers manage such conditions. The aim of this study was to investigate the management of malaria by traditional healers in different areas in Tanzania. This included looking at the perception, the causation concepts and the knowledge about prevention of the disease/illness of malaria. For this purpose traditional healers were interviewed in different rural and urban places in Tanzania: in the Kilombero valley (Kilombero/Ulanga District), on the main island of Ukerewe (Ukerewe District), in the region near Bukoba town (Bukoba District) and in the settlement of Dar es Salaam (largest town of Tanzania). The results of the study show that most of the interviewed traditional healers were very familiar with the signs and symptoms relating to malaria, as it is defined by western medicine. Many healers were aware of different manifestations of malaria and attributed to them different local names, which match the scientific terms which describe the different types of Plasmodium falciparum malaria, such as cerebral malaria, clinical malaria or febrile type, and gastrointestinal type, respectively. Differences compared to western medical knowledge were found for concepts of causation, and in the fact that severe malaria in children may not be perceived as being associated with malaria.

Adult↗
PubMed1995

Traditional healers in Tanzania: sociocultural profile and three short portraits.

Traditional healers are an important part of African societies, but unfortunately the knowledge of the extent and character of traditional healing and the people involved in the practice is limited and impressionistic. They are frequently ignored in studies of user/provider patterns, although they cover the health needs of a substantial proportion of the population. For future health planning it is necessary to know what the reasons are that even in big cities, where western health care services are available, traditional healers flourish, and even compete with each other for certain aspects. The aim of this study was to investigate certain aspects of the profession of traditional healing in general in different areas in Tanzania in order to get an idea about the kind of traditional medical services which are available, and about the people who provide such services. For this reason traditional healers were interviewed with a semi-structured questionnaire in different rural and urban places: in the Kilombero valley (Kilombero/Ulanga district), on the main island of Ukerewe (Ukerewe District), and in the region near Bukoba town (Bukoba District), and in the settlement of Dar es Salaam (largest city of Tanzania). The results of the study show that traditional healers are a very heterogeneous group of persons not having much in common relating to their religion, sex and level of education. The traditional practice is very often taken over from a family member, but also other reasons for becoming a healer, like initiation through ancestor spirits, are very frequently given. More than 50% of the respondents practice full time. These full time practitioners are mainly found among men and in the younger age group. Treatment of in-patients, who can stay in special patient-houses, is offered by half of the traditional healers. Divination used as a diagnostic tool was found mainly among men. Referral of patients to the hospital was mentioned by almost all respondents in cases where they failed with their own treatment or when they knew that the patient would be better treated in the hospital or dispensary.

Adult↗
PubMed1995

A physical map of chromosome 20 established using fluorescence in situ hybridization and digital image analysis.

The physical locations of 46 cosmid clones and 21 P1 clones were determined along the chromosome 20 axis relative to the p terminus (FLpter) using fluorescence in situ hybridization (FISH) and digital image microscopy. The cosmid clones were selected from the chromosomally enriched library LA20NC01. Nine P1 clones were selected from a pooled DuPont genomic library using PCR with primer pairs selected to amplify genetically mapped sequence-tagged sites. This information was used to relate the physical map to the genetic map. Twelve P1 clones were selected from the same library using PCR primer pairs that amplified known genes. Two of these, E2F and BCLX, had not been mapped previously.

Base Sequence↗
PubMed1995

A side-by-side comparison of dust collection methods for sampling lead-contaminated house dust.

The Environmental Protection Agency is required to set a standard for lead-contaminated house dust, but whether dust lead loading (micrograms/ft2) or concentration (micrograms/g) is more predictive of children's blood lead levels, which dust collection method should be used, and which surfaces should be sampled are unknown. Using a random sample of sequential births, we enrolled 205 urban children, 12 to 30 months of age, who had lived in the same house since at least 6 months of age. Samples of dust were obtained from predetermined surfaces in each child's residence using a wipe method and two vacuum methods, the Baltimore repair and maintenance method (BRM) and the dust vacuum method (DVM). Other potential sources of environmental exposure also were analyzed for lead, including soil, water, and paint. In general, dust lead loading is more predictive of children's blood lead levels than is dust lead concentration. Dust lead loading as measured with the BRM sampler explained more of the variation in children's blood lead levels than did wipe loading and DVM loading (13.7, 10.1, and 5.9%, respectively, adjusted for other significant predictors). The partial correlation between BRM lead loading and children's blood lead was significantly different than that for DVM lead loading, but it was not significantly different than that for wipe lead loading. Of the four surfaces measured, noncarpeted floors and interior window sills or wells were significantly associated with children's blood lead levels in multiple regression models. These data indicate that dust lead loading is more predictive of children's blood lead levels than is dust lead concentration and that, to determine if a housing unit is safe for children, noncarpeted floors and interior window sills or window wells should be measured using either the BRM or wipe sampling method.

Air Pollution, Indoor↗
PubMed1995

[Von Recklinghausen neurofibromatosis and dermal melanocytic nevi].

Neurofibromas, café au lait macules and freckles in the axillary or inguinal regions are common manifestations of von Recklinghausen's neurofibromatosis (NF-1). Less known is the simultaneous appearance of dermal melanocytic naevi. We describe the case of a 21-year-old Vietnamese woman who showed generalized, multiple neurofibromas, a solitary plexiform neurofibroma in the left gluteal region and Lisch nodules. In addition, there were several large grey-blue macules histologically characterized by fusiform pigment-bearing cells in the dermis, which we diagnosed as persistent aberrant mongolian spots. In the right zygomatic region she presented a grey-blue, hair-bearing macule, which we saw as a variant of Ota's naevus. A genetic background for this coincidence of a systemic with a local phakomatosis can be supposed, as both Schwann's cells and melanocytes are derived from the neural crest. Such pathologic rearrangement in the embryogenesis of the cellular elements could be important for the pathogenesis of NF-1 and dermal melanocytic nevi.

Adult↗
PubMed1995

Mapping the densities of malaria vectors within a single village.

Small scale spatial variation and temporal heterogeneity in mosquito densities can have important consequences for disease transmission, but the extreme variation which is observed in populations of malaria vectors makes it difficult to obtain good predictions of densities for short time periods over limited areas. We have applied Bayesian techniques derived for use in cancer epidemiology in order to map densities of Anopheles gambiae s.l. and A. funestus in a Tanzanian village where there is intense transmission of Plasmodium falciparum malaria. Estimates derived in this way should prove useful in vector population biology and in improving estimates of exposure-response relationships of the human host to malaria. The same methods can be applied in other fields of animal ecology.

Animals↗
PubMed1995

In vivo amplification of the androgen receptor gene and progression of human prostate cancer.

Overexpression of amplified genes is often associated with the acquisition of resistance to cancer therapeutic agents in vitro. We have identified a similar molecular mechanism in vivo for endocrine treatment failure in human prostate cancer which involves amplification of the androgen receptor (AR) gene. Comparative genomic hybridization shows that amplification of the Xq11-q13 region (the location), is common in tumours recurring during androgen deprivation therapy. We found high-level AR amplification in seven of 23 (30%) recurrent tumours, but in none of the specimens taken from the same patients prior to therapy. Our results suggest that AR amplification emerges during androgen deprivation therapy by facilitating tumour cell growth in low androgen concentrations.

Aged↗
PubMed1995

Immunological markers of childhood fevers in an area of intense and perennial malaria transmission.

In order to describe presumed paediatric malaria on a cell-immunological basis, the soluble receptors of IL-2 (sIL-2R) and tumour necrosis factor (sTNF-R55 and sTNF-R75) were quantified in highly exposed young Tanzanian children. Sera were obtained from 66 acute and 72 reported febrile patients during health post consultations and follow-ups and from 68 community controls. Levels of sIL-2R, sTNF-R55 and sTNF-R75 were significantly elevated during fever attacks, especially in very young children. Soluble TNF-R75 levels were most stable and those of sTNF-R55 least. Levels of sTNF-R55 were related to the magnitude of fever and thus appeared to reflect attack severity. Levels of sTNF-R75 were highly significantly associated with parasite density, indicating that this response is malaria-specific. The present study indicates that sTNF-R75 levels could become a useful immunological tool in malaria intervention studies, as they reflect changes in malaria-specific immune responses. Future studies should validate this potential in different endemic settings.

Age Factors↗
PubMed1995

Anopheles arabiensis and An. gambiae chromosomal inversion polymorphism, feeding and resting behaviour in relation to insecticide house-spraying in Tanzania.

Differential responses of the mosquitoes Anopheles arabiensis and An. gambiae sensu stricto to house-spraying with DDT or lambda-cyhalothrin were evaluated in relation to chromosomal inversion polymorphism, feeding and resting behaviour of these malaria vectors in Tanzania. Blood-fed mosquitoes from pit traps outdoors, exit traps on windows and indoor-resting catches were identified cytogenetically and the chromosomal inversion frequencies compared between samples and species. Their outdoor-resting behaviour was assessed by a mark-release-recapture experiment and by determining the proportion of freshly blood-fed individuals in exit traps. The source of bloodmeals was analysed by an ELISA method. Endophagic females of An. arabiensis were more likely than those of An.gambiae to exit from a house on the night of blood-feeding. Only in one out of three villages was there evidence that chromosomally distinct individuals within a species had different preferences for resting sites. There were indications, but not conclusive evidence, that mosquitoes caught indoors or outdoors had a tendency to return to the same type of resting site. In villages sprayed with either insecticide, the mean age of the vector populations was greatly reduced, compared with those in the unsprayed villages. An.arabiensis females exited from DDT sprayed houses after blood-feeding, whereas with lambda-cyhalothrin those exiting were mostly unfed and there was a decline in the human blood index. The excitorepellency of DDT was perceived as a disadvantage, whereas lambda-cyhalothrin apparently had more impact on malaria transmission by An.arabiensis.

Animals↗
PubMed1995

Is fever a good sign for clinical malaria in surveys of endemic communities?

Although fever is the characteristic sign of clinical malaria, many Plasmodium falciparum malaria cases in endemic areas do not present with measurable temperature elevations. In a field study in Tanzania, malaria morbidity was defined to be any current self- or parentally reported illness associated with malaria parasite densities higher than those in healthy individuals. Without diagnosis of individual episodes, prevalences of malaria-attributable morbidity of 9.8% in infants, 1.3% in children 1-4 years of age, and 0.6% in those 5-9 years of age were estimated. No illness was considered to be due to malaria in older individuals. In infants, 66.5% of malaria-attributable morbidity episodes corresponded to axillary temperatures < 37.5 degrees C. In older children, most of the episodes due to malaria corresponded to increased temperatures. This age dependence should be considered when designing diagnostic procedures and outcome measures for epidemiologic studies of malaria.

Adolescent↗
PubMed1995

Assessing the public health importance of Schistosoma mansoni in different endemic areas: attributable fraction estimates as an approach.

Assessment of the public health importance of schistosomiasis mansoni is hampered by the nonspecificity of many of its disease symptoms. Parasitologic, clinical, and anamnestic data from two areas in Burundi were used to obtain estimates of the attributable fractions for different disease symptoms at both the population level and within different age strata. A large proportion of individuals had symptoms commonly associated with Schistosoma mansoni infection that were not attributable to this parasite. The clinical indicator with the best test efficiency was shown to be bloody diarrhea. At the population level, 35% of bloody diarrhea cases were attributable to S. mansoni, compared with only 9% of diarrhea cases without blood. The attributable fractions were age-dependent, and in the case of diarrhea (with and without blood), children had a higher proportion of cases attributable to S. mansoni infection than adults. The association between infection and disease symptoms also increased with the intensity of infection. The prevalence of morbidity attributable to S. mansoni was similar for all symptoms, and higher in children than adults. The estimation of attributable fractions provides a simple approach to quantify S. mansoni-related morbidity, which could also be extended to both S. haematobium and S. japonicum. Attributable fraction estimates for these three schistosome species in different endemic areas would greatly aid in the assessment of the health burden of this parasite and the effectiveness of control programs.

Abdominal Pain↗
PubMed1995

The right objectives in health care planning.

In Dar es Salaam, United Republic of Tanzania, the traditional epidemiological approach to health service planning has been superseded by a process-oriented approach. The implications for managers are discussed below.

Child, Preschool↗
PubMed1995

Main neurodevelopmental study of Seychellois children following in utero exposure to methylmercury from a maternal fish diet: outcome at six months.

Methylmercury (MeHg) is a human neurotoxin to which the developing fetal brain is especially sensitive. The lowest dose of MeHg that impairs neurodevelopment in the human fetus is not known. The Seychelles Child Development Study (SCDS) is testing the hypothesis that fetal MeHg exposure from a maternal diet high in oceanic fish is related to child neurodevelopmental outcomes. Fish is the major protein source in the Republic of Seychelles, where a cohort of 779 mother-infant pairs was enrolled in a prospective longitudinal study. Maternal total hair mercury values during pregnancy were determined by cold vapor atomic absorption and ranged from 0.5 ppm to 26.7 ppm with a median of 5.9 ppm. When the children were 6 1/2 months of age, an examiner blinded to the maternal mercury value performed a neurological examination, the Fagan test of visual recognition memory, and the Denver Developmental Screening Test-Revised (DDST-R). On the DDST-R 2% scored other than normal while 3.4% had an overall neurological score other than normal. The Fagan test of visual recognition memory showed a median score of 60.5%, and the Rose attention measure from that test showed a median score of 37.9. The association between fetal mercury exposure and neurodevelopmental endpoints was examined by multiple regression analyses. After adjusting for covariates, no association between the maternal hair mercury level during pregnancy and an adverse neurodevelopmental outcome of the child was identified at 6 1/2 months of age.

Adult↗
PubMed1995

Neurodevelopmental test selection, administration, and performance in the main Seychelles child development study.

The Seychelles Child Development Study was designed to provide data on normal neurodevelopment of Seychellois children and to examine the relationship of their neurodevelopmental outcomes to in utero fetal exposure to low concentrations of methylmercury from a maternal diet high in fish. This paper outlines the strategies used to select, modify, and field test evaluation tools used in the main longitudinal prospective study of 740 children (95% of the cohort of 779 initially enrolled in 1989). It also gives population statistics and quality assurance data for the tests administered and the evaluation of the home environments.

Child↗
PubMed1994

Detection and mapping of amplified DNA sequences in breast cancer by comparative genomic hybridization.

Comparative genomic hybridization was applied to 5 breast cancer cell lines and 33 primary tumors to discover and map regions of the genome with increased DNA-sequence copy-number. Two-thirds of primary tumors and almost all cell lines showed increased DNA-sequence copy-number affecting a total of 26 chromosomal subregions. Most of these loci were distinct from those of currently known amplified genes in breast cancer, with sequences originating from 17q22-q24 and 20q13 showing the highest frequency of amplification. The results indicate that these chromosomal regions may contain previously unknown genes whose increased expression contributes to breast cancer progression. Chromosomal regions with increased copy-number often spanned tens of Mb, suggesting involvement of more than one gene in each region.

Breast Neoplasms↗
PubMed1994

[Erythema necroticans migrans without glucagonoma].

Necrolytic migratory erythema is considered to be one of five well-defined paraneoplastic syndromes of the skin. An association with a pancreatic A-cell glucagonoma is commonly postulated. However, during the last years 10 cases of necrolytic migratory erythema with no evidence for glucagonoma have been published. We report on a 59-year-old woman who presented with typical clinical and histological findings of necrolytic migratory erythema. Staging and laboratory investigations gave no evidence of any neoplasia. A liver biopsy revealed chronic persisting hepatitis. Hepatocellular dysfunction was recently reported to be present concomitantly in a number of cases of necrolytic migratory erythema, suggesting a relation to the skin changes described here.

Biopsy↗
PubMed1994

Developing health research capability in Tanzania: from a Swiss Tropical Institute Field Laboratory to the Ifakara Centre of the Tanzanian National Institute of Medical Research.

The paper summarizes the evolution of a biomedical field research station in Tanzania, established by a European institute, into a national health research and resource centre. The Swiss Tropical Institute Field Laboratory was founded in Ifakara in the Kilombero District in southeastern Tanzania in 1957. It has evolved into the Ifakara Centre, a national but peripherally located research centre involved in applied, operational and health systems research, training, and direct health sector support activities. Since 1991, the centre has been an affiliate of the National Institute for Medical Research in Tanzania. It has achieved an autonomous status and attracts frontline priority research and high quality research teams; the ongoing phase 3 malaria vaccine trial is a recent major activity. Starting from biomedical priorities in research and training, the centre has broadened its spectrum to include social science disciplines including economics. The major determinants for this development were (i) the long-term partnership between the executing agency in the north and the partners in the south at the national level, (ii) the support of this partnership by a long-term commitment of the major funding partners, (iii) the concept that local priorities form the basis of all activities, and (iv) the linking of research and training to public health action. The last two elements are considered to be crucial for the centre's multidisciplinary approach to health research and the support of public health in Tanzania and in eastern and southern Africa.

Academies and Institutes↗