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M W Borgdorff

Publications and source records attributed to M W Borgdorff.

84 records · Page 5Linked to original sources
PubMed1993

HIV-1 infection as a risk factor for the development of tuberculosis: a case-control study in Tanzania.

A population-based case-control study was carried out in Mwanza Region, Tanzania, to determine the relative and population attributable risk of human immunodeficiency virus type 1 (HIV-1) infection for developing active tuberculosis. Cases were 441 consecutively diagnosed patients with tuberculosis (all types), aged 15-54 years. Controls were a representative population sample of 4161 people, drawn in a stratified cluster sample from urban areas, roadside settlements, and rural villages. HIV-1 infection was determined by ELISA and if the ELISA result was indeterminate by Western Blot. The HIV-1 prevalence in cases was 23.0% in rural, 32.1% in roadside, and 54.1% in urban areas, while in controls these prevalences were 3.4%, 7.2% and 12.1% respectively. The relative risk (RR) of HIV-1 infection for the development of active tuberculosis was estimated to be 8.3 (95% confidence interval [CI] 6.4-11.0). This risk varied little by sex or residence, but appeared to be more pronounced in the age group 25-34 years. The case detection rate of tuberculosis in those aged 15-54 years was 125/100,000 people per year. The population attributable risk was 36/100,000 people per year, implying that 29% of tuberculosis cases at present may be attributable to HIV-1 infection. It is concluded that HIV-1 infection is a major contributing factor to the increased case detection rate of tuberculosis observed over the past 10 years in Mwanza Region. If the prevalence of HIV-1 continues to increase, the incidence of tuberculosis will continue to rise as well.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1993

Blood transfusion practices in Mwanza Region, Tanzania. Bugando Medical Centre.

OBJECTIVE: To determine what proportion of blood transfusions given in Mwanza Region, Tanzania could be avoided. METHODS: A total of 1029 patients who received a blood transfusion in one of eight hospitals were analysed. Two sets of criteria for avoidable blood transfusions were determined, on the basis of a literature review. RESULTS: The following percentages of blood transfusions in five groups of patients were found to be avoidable: operated patients, 8-24%; pregnant women, 8-10%; children aged under 5 years, 31-52%; children aged 5-14 years, 23-25%; and adults, 16-25%. Overall, 23-39% of blood transfusions were avoidable. At least 75% of all avoidable blood transfusions were to children aged under 5 years. CONCLUSIONS: The largest reduction of blood transfusions can be achieved in children aged under 5 years, especially in infants aged less than 1 year. Following this study, blood transfusion prescribers drew up provisional guidelines on blood transfusions, which have been introduced in all hospitals in Mwanza Region. An evaluation study has been carried out and is being analysed.

Adolescent↗
PubMed1993

Are some blood transfusions avoidable? A hospital record analysis in Mwanza Region, Tanzania.

Records of 497 patients who received a blood transfusion in Mwanza Region, Tanzania, were analyzed in order to estimate the proportion of avoidable blood transfusions. This was part of a more comprehensive study which aims at the reduction of transfusion-associated HIV transmission. Blood transfusion recipients were divided into the following groups: operated patients (12%), pregnant women (8%), under-fives (62%), children aged 5-14 years (5%) and adults (13%). Two sets of criteria were applied to estimate the number of avoidable blood transfusions. The total proportion of avoidable blood transfusions using these criteria were 32 and 56%, respectively. If the strictest criteria were applied the proportion of avoidable blood transfusions in operated patients was 44%, in pregnant women with chronic anaemia 18%, in under-fives 62%, in children 31% and in adults 51%. It was concluded that a major reduction in the number of blood transfusions could be achieved, in particular in under-fives.

Adolescent↗
PubMed1993

HIV-1 infection as a risk factor for leprosy; a case-control study in Tanzania.

A case-control study was carried out in Tanzania to determine the relative risk of those with HIV-1 infection for getting leprosy. Cases were 93 consecutively diagnosed patients with leprosy aged 15-54 years from the Mwanza Region. Controls were a representative population sample of 4161 people drawn from a stratified cluster sample from urban areas, roadside settlements, and rural villages. HIV-1 infection was determined by enzyme-linked immunosorbent assay (ELISA); Western blot was used when the ELISA result was indeterminate. The HIV-1 prevalence in leprosy cases was 10% in rural (7 of 72) and in roadside and urban areas (2 of 21); in controls these prevalences were 3.4% and 9.9%, respectively. The relative risk of HIV-1 infection for the development of leprosy was estimated to be 2.2 [95% confidence interval (CI) = 1.0-4.7; p = 0.07]. HIV-1 infection was significantly associated with multibacillary (MB) leprosy (odds ratio 4.6; CI = 1.3-13.2) but not with paucibacillary leprosy (odds ratio 1.4; 95% CI = 0.4-3.8). The population etiological fraction for the development of MB leprosy attributable to HIV-1 infection in this population is estimated to be 13% (95% CI = 4%-23%). We conclude that HIV-1 is a risk factor for the development of MB leprosy. The impact of the HIV-1 epidemic on the incidence of leprosy so far has been limited since HIV-1 occurs mainly in urban areas and leprosy in rural areas.

Adolescent↗
PubMed1992

The epidemiology of HIV-1 infection in urban areas, roadside settlements and rural villages in Mwanza Region, Tanzania.

OBJECTIVE: To determine the prevalence of HIV-1 infection and to identify the most important risk factors for infection. DESIGN: A cross-sectional population survey carried out in 1990 and 1991 in Mwanza Region, Tanzania. METHODS: Adults aged 15-54 years were selected from the region (population, 2 million) by stratified random cluster sampling: 2434 from 20 rural villages, 1157 from 20 roadside settlements and 1554 from 20 urban wards. Risk factor information was obtained from interviews. All sera were tested for HIV-1 antibodies using enzyme-linked immunosorbent assay (ELISA); sera non-negative on ELISA were also tested by Western blot. RESULTS: The response rate was 81%. HIV-1 infection was 1.5 times more common in women than in men; 2.5% of the adult population in rural villages, 7.3% in roadside settlements and 11.8% in town were infected. HIV-1 infection occurred mostly in women aged 15-34 years and men aged 25-44 years. It was associated with being separated or widowed, multiple sex partners, presence of syphilis antibodies, history of genital discharge or genital ulcer, travel to Mwanza town, and receiving injections during the previous 12 months, but not with male circumcision. CONCLUSION: This study confirms that HIV-1 infection in this region in East Africa is more common in women than in men. The results are consistent with the spread of HIV-1 infection along the main roads. There is no evidence that lack of circumcision is a risk factor in this population.

Adolescent↗
PubMed1990

Cost and output of mobile clinics in a commercial farming area in Zimbabwe.

Mobile clinics may be useful to improve the geographic accessibility of health services, but their cost may be higher than that of static clinics. In this paper it is determined to what extent mobile clinics in a commercial farming area in Zimbabwe improve geographic accessibility. The opportunity cost of mobile clinics, comprising cost of staff time and transport is estimated. Staff time appears to be more efficiently utilized in mobile clinics than in static clinics. The cost of transport comprises the cost to the health service and that to the population using the service. The consequences of two extreme assumptions are determined. If the first assumption (outreach does not increase coverage) were true, total transport cost would increase if outreach were discontinued. If the second assumption (outreach increases coverage by the number of attendances at mobile clinics) were true, a substantial increase in coverage would be obtained in particular for growth monitoring, immunizations and child spacing, without increasing the cost per contact. It is concluded that outreach clinics should continue in this commercial farming area. The sites of the mobile clinics are being reconsidered as a result of this study.

Agriculture↗
PubMed1988

Estimating vaccination coverage: routine information or sample survey?

The manager of a district immunization programme needs to regularly assess vaccination coverage. This case study from Zimbabwe describes how routine information can be used for this purpose. The number of children and their location in the district was estimated from several sources using a variety of methods. This suggested that under-enumeration at the 1982 census was probably as high as a third and was a particular problem among children aged under 1 year. Routinely collected figures of the number of vaccinations were then used to calculate coverage levels for different health unit catchment areas within the district. These levels varied considerably and were lowest in areas with significant numbers of Apostolics, a group who often reject immunization on religious grounds. Comparisons between estimates of coverage obtained from routine information and a sample cluster survey raised several issues. These included accuracy of routine information, precision of sample surveys, estimating differential coverage in the district, management uses of estimates and the cost of data collection.

Adolescent↗
PubMedDate not supplied

Mycobacterium tuberculosis Beijing genotype emerging in Vietnam.

To assess whether the Mycobacterium tuberculosis Beijing genotype is emerging in Vietnam, we analyzed 563 isolates from new cases by spoligotyping and examined the association between the genotype and age, resistance, and BCG vaccination status. Three hundred one (54%) patients were infected with Beijing genotype strains. The genotype was associated with younger age (and hence with active transmission) and with isoniazid and streptomycin resistance, but not with BCG vaccination.

Adult↗