Biomedical subjects

Mohammad Ali

Publications and source records attributed to Mohammad Ali.

At least 37 records · Page 2Linked to original sources

PubMed2005

A mass vaccination campaign targeting adults and children to prevent typhoid fever in Hechi; expanding the use of Vi polysaccharide vaccine in southeast China: a cluster-randomized trial.

BACKGROUND: One of the goals of this study was to learn the coverage, safety and logistics of a mass vaccination campaign against typhoid fever in children and adults using locally produced typhoid Vi polysaccharide (PS) and group A meningococcal PS vaccines in southern China. METHODS: The vaccination campaign targeted 118,588 persons in Hechi, Guangxi Province, aged between 5 to 60 years, in 2003. The study area was divided into 107 geographic clusters, which were randomly allocated to receive one of the single-dose parenteral vaccines. All aspects regarding vaccination logistics, feasibility and safety were documented and systematically recorded. Results of the logistics, feasibility and safety are reported. RESULTS: The campaign lasted 5 weeks and the overall vaccination coverage was 78%. On average, the 30 vaccine teams gave immunizations on 23 days. Vaccine rates were higher in those aged < or = 15 years (90%) than in adolescents and young adults (70%). Planned mop-up activities increased the coverage by 17%. The overall vaccine wastage was 11%. The cold chain was maintained and documented. 66 individuals reported of adverse events out of all vaccinees, where fever (21%), malaise (19%) and local redness (19%) were the major symptoms; no life-threatening event occurred. Three needle-sharp events were reported. CONCLUSION: The mass immunization proved feasible and safe, and vaccine coverage was high. Emphasis should be placed on: injection safety measures, community involvement and incorporation of mop-up strategies into any vaccination campaign. School-based and all-age Vi mass immunizations programs are potentially important public health strategies for prevention of typhoid fever in high-risk populations in southern China.

Adolescent↗

PubMed2005

Effectiveness of mass oral cholera vaccination in Beira, Mozambique.

BACKGROUND: New-generation, orally administered cholera vaccines offer the promise of improved control of cholera in sub-Saharan Africa. However, the high prevalence of human immunodeficiency virus (HIV) infection in many cholera-affected African populations has raised doubts about the level of protection possible with vaccination. We evaluated a mass immunization program with recombinant cholera-toxin B subunit, killed whole-cell (rBS-WC) oral cholera vaccine in Beira, Mozambique, a city where the seroprevalence of HIV is 20 to 30 percent. METHODS: From December 2003 to January 2004, we undertook mass immunization of nonpregnant persons at least two years of age, using a two-dose regimen of rBS-WC vaccine in Esturro, Beira (population 21,818). We then assessed vaccine protection in a case-control study during an outbreak of El Tor Ogawa cholera in Beira between January and May 2004. To estimate the level of vaccine protection, antecedent rates of vaccination were compared between persons with culture-confirmed cholera severe enough to have prompted them to seek treatment and age- and sex-matched neighborhood controls without treated diarrhea. RESULTS: We assessed the effectiveness of the vaccine in 43 persons with cholera and 172 controls. Receipt of one or more doses of rBS-WC vaccine was associated with 78 percent protection (95 percent confidence interval, 39 to 92 percent; P=0.004). The vaccine was equally effective in children younger than five years of age and in older persons. A concurrently conducted case-control study designed to detect bias compared persons with treated, noncholeraic diarrhea and controls without diarrhea in the same population and found no protection associated with receipt of the rBS-WC vaccine. CONCLUSIONS: The rBS-WC vaccine was highly effective against clinically significant cholera in an urban sub-Saharan African population with a high prevalence of HIV infection.

Adolescent↗

PubMed2005

A multi-country cluster randomized controlled effectiveness evaluation to accelerate the introduction of Vi polysaccharide typhoid vaccine in developing countries in Asia: rationale and design.

Phase-III vaccine efficacy trials typically employ individually randomized designs intended to ensure that measurements of vaccine protective efficacy reflect only direct vaccine effects. As a result, decisions about introducing newly licensed vaccines into public health programmes often fail to consider the substantially greater protection that may occur when a vaccine is deployed in public health programmes, due to the combination of direct plus indirect vaccine protective effects. Vaccine total protection can be better evaluated with cluster randomized trials. Such a design was considered to generate policy relevant data to accelerate the rationale introduction of the licensed typhoid fever Vi polysaccharide (PS) vaccine in Asia by the Diseases of the Most Impoverished (DOMI) typhoid fever programme. The DOMI's programme multi-country study is one of the largest cluster randomized vaccine trials ever mounted in Asia, which includes approximately 200,000 individuals. Its main objective is to determine the effectiveness of a licensed Vi PS vaccine. The rationale and design of this study are discussed. Preliminary results are presented that determined the final planning of the trial before immunization. Important methodological and practical issues regarding vaccine cluster randomized designs are illustrated.

Adolescent↗

PubMed2005

Pandemic serovars (O3:K6 and O4:K68) of Vibrio parahaemolyticus associated with diarrhea in Mozambique: spread of the pandemic into the African continent.

Forty-two episodes of Vibrio parahaemolyticus infections were detected in Beira, Mozambique, from January to May 2004. The majority of the isolates (81%) belonged to the pandemic serovars (O3:K6 and O4:K68) of V. parahaemolyticus. The pandemic serovars were positive by group-specific PCR (GS-PCR) and a PCR specific for open reading frame ORF8 (ORF8-PCR), which are molecular markers of the pandemic clone, and were positive for tdh but negative for trh. The remaining 19% of the strains also possessed the tdh gene but were GS-PCR and ORF8-PCR negative and did not belong to the pandemic serovars. Patients with V. parahaemolyticus infection were older (mean age, 27 years) than patients infected by other diarrheal agents (mean age, 21 years). Ten percent of diarrhea patients from whom no V. parahaemolyticus was cultured were severely dehydrated, but none of the V. parahaemolyticus cases were severely dehydrated. This is the first report of the isolation of pandemic strains of V. parahaemolyticus in sub-Saharan Africa and clearly indicates that the pandemic of V. parahaemolyticus has spread into the African continent.

Adult↗

PubMed2005

Salmonella paratyphi A rates, Asia.

Little is known about the causes of enteric fever in Asia. Most cases are believed to be caused by Salmonella enterica serovar Typhi and the remainder by S. Paratyphi A. We compared their incidences by using standardized methods from population-based studies in China, Indonesia, India, and Pakistan.

Adolescent↗

PubMed2005

Eperisone compared to physiotherapy on muscular tone of stroke patients: a prospective randomized open study.

OBJECTIVES: To compare the effects of Eperisone, a muscle relaxant and physiotherapy on the muscular tone after stroke. METHODS: Twenty six (26) patients were included from age 15 to 75 years in an open prospective randomized study of three weeks duration and were treated with either Eperisone (n=13) or were advised to undergo formal physiotherapy (n=13) at the department of physiotherapy PIMS. The end point was observed in the form of change in the grade of tone. Safety and tolerability was assessed on the basis of adverse events. RESULTS: Eperisone was found to be comparable to physiotherapy in reducing the spasticity in patients after stroke and improved the grade of tone from 3-2 (n=2), 4-3 (n=2), 2-1 (n=2). The safety analysis showed persistent vomiting (n=1), fatigue (n=1), headache and dry mouth (n=2), epigastric pain (n=1) and slight changes in blood pressure under Eperisone which was generally well tolerated by the patients. CONCLUSION: Eperisone was found to be comparable to physiotherapy in its effects to improve spasticity in patients after stroke (p>0.05).

Adolescent↗

PubMed2005

Occurrence of shigellosis in the young and elderly in rural China: results of a 12-month population-based surveillance study.

In 2002, population- and treatment center-based surveillance was used to study the disease burden of shigellosis in rural Hebei Province in the People's Republic of China. A total of 10,105 children with diarrhea or dysentery were enrolled. Infants were treated most frequently for diarrhea (1,388/1,000/year) followed by children < or = 5 years old (618/1,000/year). Shigellosis was treated most often in children 3-4 years old (32/1,000/year) and people > 60 years of age (7/1,000/year). Fifty-six percent (184 of 331) Shigella isolates were detected in patients who had non-bloody diarrhea. Shigella flexneri was identified in 93% of 306 isolates. The most common S. flexneri serotypes were 1a (34%), X (33%), and 2a (28%). More than 90% of the Shigella isolates were resistant to cotrimoxazole and nalidixic acid, but remained susceptible to ciprofloxacin, norfloxacin, and gentamicin. Widespread resistance to antibiotics adds urgency to the development and use of vaccines to control shigellosis.

Adolescent↗

PubMed2005

The use of a computerized database to monitor vaccine safety in Viet Nam.

Health information systems to monitor vaccine safety are used in industrialized countries to detect adverse medical events related to vaccinations or to prove the safety of vaccines. There are no such information systems in the developing world, but they are urgently needed. A large linked database for the monitoring of vaccine-related adverse events has been established in Khanh Hoa province, Viet Nam. Data collected during the first 2 years of surveillance, a period which included a mass measles vaccination campaign, were used to evaluate the system. For this purpose the discharge diagnoses of individuals admitted to polyclinics and hospitals were coded according to the International Classification of Diseases (ICD)-10 guidelines and linked in a dynamic population database with vaccination histories. A case-series analysis was applied to the cohort of children vaccinated during the mass measles vaccination campaign. The study recorded 107,022 immunizations in a catchment area with a population of 357,458 and confirmed vaccine coverage of 87% or higher for completed routine childhood vaccinations. The measles vaccination campaign immunized at least 86% of the targeted children aged 9 months to 10 years. No medical event was detected significantly more frequently during the 14 days after measles vaccination than before it. The experience in Viet Nam confirmed the safety of a measles vaccination campaign and shows that it is feasible to establish health information systems such as a large linked database which can provide reliable data in a developing country for a modest increase in use of resources.

Adolescent↗

PubMed2004

Use of satellite imagery in constructing a household GIS database for health studies in Karachi, Pakistan.

BACKGROUND: Household-level geographic information systems (GIS) database are usually constructed using the geographic positioning system (GPS). In some research settings, GPS receivers may fail to capture accurate readings due to structural barriers such as tall buildings. We faced this problem when constructing a household GIS database for research sites in Karachi, Pakistan because the sites are comprised of congested groups of multi-storied building and narrow lanes. In order to overcome this problem, we used high resolution satellite imagery (IKONOS) to extract relevant geographic information. RESULTS: The use of IKONOS satellite imagery allowed us to construct an accurate household GIS database, which included the size and orientation of the houses. The GIS database was then merged with health data, and spatial analysis of health was possible. CONCLUSIONS: The methodological issues introduced in this paper provide solutions to the technical barriers in constructing household GIS database in a heavily populated urban setting.

Journal Article↗

PubMed2004

Correlation of cytokine and mobility in mice with arthritis and during therapy with Swertia chirayita.

We attempt to derive a correlation between pro-inflammatory cytokines and mobility in arthritic mice and after treatment with Swertia chirayita plant extract. Tumor necrosis factor-á (TNF-á), interleukin-1alpha (IL-1alpha), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured by solid phase sandwich ELISA and the different parameters of mobility [distance traveled (DT), resting time (RT), ambulatory time (AT) and stereotypic time (ST)] was monitored and recorded by an Auto track system. Joint circumference of the right hind limb was monitored using a Vernier caliper. Our preliminary findings revealed that DT and RT correlated well with IL-1alpha, TNF-alpha and IL-10 levels in the joint homogenates of arthritic mice and after therapy with Swertia chirayita extracts. AT and ST showed poor correlation with the cytokines. Thus we demonstrate here the anti-inflammatory property of Swertia chirayita and its usage in the prevention of arthritis in the broader aspect in the management of associated cytokines.

Animals↗

PubMed2004

A community-based cluster survey on preferences for treatment of diarrhoea and dysentery in Zhengding county, Hebei province, China.

Passive surveillance on the burden of disease due to diarrhoea will underestimate the burden if families use healthcare providers outside the surveillance system. To study this issue, a community-based cluster survey was conducted during October 2001 in the catchment area for a passive surveillance study in Zhengding county, a rural area of northern China. Interviews were conducted at 7 randomly-selected households in each of 39 study villages. The respondents indicated where they sought initial care for cases of diarrhoea or dysentery among children or adults. In the absence of diarrhoea and dysentery cases in the household in the preceding four weeks, the respondents were asked about healthcare use for a hypothetical case. Overall, 80% (95% confidence interval [CI] 67-93%) would chose the village clinic, 11% village pharmacy (95% CI 1-22%), 4% township hospital (95% CI -1-10%), 4% self-treatment (95% CI 1-8%), and 1% county hospital (95% CI 0-2%). Approximately, 84% of patients would seek treatment for diarrhoea and dysentery at centres participating in passive surveillance, suggesting that passive surveillance will provide a relatively accurate assessment of burden of diarrhoea in Zhengding county.

Adult↗

PubMed2004

Preferences for treatment of diarrhoea and dysentery in Kaengkhoi district, Saraburi province, Thailand.

To estimate the proportion of cases missed in a passive surveillance study of diarrhoea and dysentery at health centres and hospitals in Kaengkhoi district, Saraburi province, Thailand, a community-based cluster survey of treatment-seeking behaviours was conducted during 21-23 June 2002. Interviews were conducted at 224 households among a study population of 78,744. The respondents reported where they sought care for diarrhoea and dysentery in children aged less than five years and adults aged over 15 years. Health centres or hospitals were the first treatment choice for 78% of children with dysentery (95% confidence interval [CI] 63-94%), 64% of children with diarrhoea (95% CI 54-74%), 61% of adults with dysentery (95% CI 40-82%), and 35% of adults with diarrhoea (95% CI 17-54%). A high degree of heterogeneity in responses resulted in a relatively large design effect (D=3.9) and poor intra-cluster correlation (rho=0.3). The community survey suggests that passive surveillance estimates of disease incidence will need to be interpreted with caution, since this method will miss nearly a quarter of dysentery cases in children and nearly two-thirds of diarrhoea cases in adults.

Adolescent↗

PubMed2004

Diarrhoea episodes and treatment-seeking behaviour in a slum area of North Jakarta, Indonesia.

Visits to household during a census in an impoverished area of north Jakarta were used for exploring the four-week prevalence of diarrhoea, factors associated with episodes of diarrhoea, and the patterns of healthcare use. For 160,261 urban slum-dwellers, information was collected on the socioeconomic status of the household and on diarrhoea episodes of individual household residents in the preceding four weeks. In households with a reported case of diarrhoea, the household head was asked which form of healthcare was used first. In total, 8,074 individuals (5%)--13% of children aged less than five years and 4% of adults--had a diarrhoea episode in the preceding four weeks. The two strongest factors associated with a history of diarrhoea were a diarrhoea episode in another household member in the four weeks preceding the interview (adjusted odds ratio [OR] 11.1; 95% confidence interval [CI] 10.4-11.8) and age less than five years (adjusted OR 3.4; 95% CI 3.2-3.5). Of the 8,074 diarrhoea cases, 1,969 (25%) treated themselves, 1,822 (23%) visited a public-health centre (PHC), 1,462 (18%) visited a private practitioner or a private clinic, 1,318 (16%) presented at a hospital, 753 (9%) bought drugs from a drug vendor, and 750 (9%) used other healthcare providers, such as belian (traditional healers). Children with diarrhoea were most often brought to a PHC, a private clinic, or a hospital for treatment. Compared to children, adults with diarrhoea were more likely to treat themselves. Individuals from households in the lowest-income group were significantly more likely to attend a PHC for treatment of diarrhoea compared to individuals from households in the middle- and higher-income groups.

Adolescent↗

PubMed2004

The role of epidemiology in the introduction of vi polysaccharide typhoid fever vaccines in Asia.

Despite the availability of at least two licensed typhoid fever vaccines--injectable sub-unit Vi polysaccharide vaccine and live, oral Ty21a vaccine--for the last decade, these vaccines have not been widely introduced in public-health programmes in countries endemic for typhoid fever. The goal of the multidisciplinary DOMI (Diseases of the Most Impoverished) typhoid fever programme is to generate policy-relevant data to support public decision-making regarding the introduction of Vi polysaccharide typhoid fever immunization programmes in China, Viet Nam, Pakistan, India, Bangladesh, and Indonesia. Through epidemiological studies, the DOMI Programme is generating these data and is offering a model for the accelerated, rational introduction of new vaccines into health programmes in low-income countries. Practical and specific examples of the role of epidemiology are described in this paper. These examples cover: (a) selection of available typhoid fever vaccines to be introduced in the programme, (b) generation of policy-relevant data, (c) providing the 'backbone' for the implementation of other multidisciplinary projects, and (d) generation of unexpected but useful information relevant for the introduction of vaccines. Epidemiological studies contribute to all stages of development of vaccine evaluation and introduction.

Asia↗

PubMed2003

The vaccine data link in Nha Trang, Vietnam: a progress report on the implementation of a database to detect adverse events related to vaccinations.

Real, perceived and unknown adverse events secondary to vaccinations are a source of concern for care providers of children. In the USA large linked databases have provided helpful information regarding the safety of vaccines. Very little prospectively collected data on vaccine safety is available from resource poor countries, but safety concerns may be even more relevant in such settings. Vaccine manufacturers do not have to pass the same rigorous safety standards as vaccine manufacturers in rich countries. Vaccines, which protect against cholera, Japanese encephalitis, rabies or typhoid fever are predominantly used in resource poor, tropical countries and frequently do not undergo vigorous post marketing surveillance. New vaccines specifically suited for resource poor countries are sometimes marketed without the scrutiny of vigilant, independent regulatory authorities. We describe here the design and implementation of a large linked database for a semi-rural province in central Vietnam. The design overcomes several problems inherent in data bases of medical events and vaccinations in developing countries. Assigning a permanent identification (ID) number to each resident avoids the ambiguities of ID numbers based on the address. The distribution and use of medical identification cards with a permanent ID number assists in the unambiguous identification of vaccinees and patients. Medical records of all admissions are coded according to International Classification of Diseases (ICD-10) and transcribed into a computer system. Because these processes are novel the data collected by the study will be validated. Project staff will check records on vaccinations and hospital admissions through household visits at regular intervals. Data describing vaccinations and medical events are linked to the data collected by the project staff in a computer system. Based on the validation of the data we hope to optimize this model. Once we find the model working it is planned export this vaccine data safety link to other settings of similar economic status.

Database Management Systems↗

PubMed2003

Maxillary odontogenic keratocyst: a common and serious clinical misdiagnosis.

BACKGROUND: The authors conducted this study to determine the most common location of odontogenic keratocysts, or OKCs, in the maxilla and the implication of this for dental practice. METHODS: The authors reviewed all cases diagnosed as an OKC by the Oral and Maxillofacial Pathology Diagnostic Laboratory at University of Florida College of Dentistry from July 1, 1993, to June 30, 2001. They determined the location for each cyst and recorded relevant clinical information such as age and sex. In addition, the authors noted the practitioners' clinical diagnoses for the cases in the most common location in the maxilla and compared them with the final diagnosis. RESULTS: A total of 398 OKCs occurred in 393 patients. Of the 398 cysts, 266 (66.8 percent) were in the mandible, and 132 (33.2 percent) were in the maxilla. The most common location for OKCs was the third molar and ramus area of the mandible, with 137 cysts. The canine region of the maxilla, with 54 cysts, was the second most common location. Submitting clinicians mentioned OKC as a diagnostic possibility in only 31.5 percent of the maxillary canine region cases. CONCLUSION: The most common maxillary location for OKCs is the canine region where they commonly are mistaken for an apical inflammatory lesion or lateral periodontal cyst. Accurate diagnosis is essential for proper patient therapy and follow-up. CLINICAL IMPLICATION: A diagnosis based solely on clinical information can be problematic. In many cases, histologic examination of surgically removed tissue is necessary to establish a definitive diagnosis. That is particularly true for cases that do not resolve when treated by conservative endodontic therapy.

Adolescent↗

PubMed2003

Evaluation & management of clinically labeled carcinoma head of the pancreas--a prospective study of 60 patients.

Carcinoma head of the pancreas are assessed by clinical examination, imaging, Endoscopic Retrograde Cholangio Pancreatography (ERCP), Fine Needle Aspiration Cytology (FNAC) and finally by laparotomy. Nevertheless still there is a dilemma in labeling these patients as having inoperable cancer pancreas because operable lesions may be wrongly labeled as inoperable or benign lesion may be thought to be malignant. The aim of this study is to evaluate these patients who present with clinical features of inoperable carcinoma of pancreas and to assess their status of inoperability. Efforts were taken to explore the possibilities of curative resection. If found inoperable, then tissue or cytological sampling of the lesion and the alternative palliation therapy offered to them. Palliative surgery and respective analysis of data was done in 60 patients with clinically labeled carcinoma head of the pancreas. Laparotomy was done for--(i) Assessment of inoperability, (ii) tissue or cytological sampling and (iii) Bilioenteric and gastro enteric bypass. The tumor was considered to be inoperable by peroperative assessment & trial dissection when it invaded the surrounding vital structure. Histological confirmation was made by intraoperative core needle biopsy; shave biopsy, biopsy of hepatic and lymph node metastasis. Cytological sampling was done by transduodenal and intralesional FNAC. Hepaticojejunostomy or Cholecystojejunostomy, Gastrojejunostomy and enteroenterostomy were performed as palliative procedure in all patients. Chemical splanchinectomy was performed in 25 patients. Twenty patients were diagnosed to have carcinoma by Endoscopic biopsy. In remaining 40 patients, peroperative tissue biopsy and cytological sampling yielded pancreatic carcinoma in 16 (40.0%), chronic pancreatitis in 6 (15.0%), pancreatic tuberculosis in 5 (12.5%), pancreatic non Hodgkin's lymphoma in 3 (7.5%) and metastatic pancreatic cancer in 2 (5.0%). However, it failed to reveal any definitive diagnosis in 8 (20.0%) patients. These interesting findings changed the preoperative diagnosis and guided us to plan the surgical procedure for cancerous and non-cancerous patients accordingly.

Aged↗

PubMed2003

Use of a geographic information system for defining spatial risk for dengue transmission in Bangladesh: role for Aedes albopictus in an urban outbreak.

We used conventional and spatial analytical tools to characterize patterns of transmission during a community-wide outbreak of dengue fever and dengue hemorrhagic fever in Dhaka, Bangladesh in 2000. A comprehensive household-level mosquito vector survey and interview was conducted to obtain data on mosquito species and breeding as well as illness consistent with dengue. Clusters of dengue illnesses and high-density vector populations were observed in a distinct sector of the city. Dengue clusters are less identifiable in areas further away from major hospitals, suggesting that proximity to hospitals determines whether cases of dengue are diagnosed. Focusing on those areas relatively close to hospitals, we found a spatial association between dengue clusters and vector populations. Households reporting a recent dengue illness were more likely to have Aedes albopictus larvae present in the home when compared with households not reporting cases. Households reporting a recent dengue illness were also more likely to have a neighbor with Ae. albopictus present in the home. In contrast, the presence of Aedes aegypti within the premises as well as the homes of neighbors (within 50 meters) was not associated with dengue illness. Given that the breeding habitats for Ae. albopictus are somewhat distinct from those of Ae. aegypti, the findings of this study have implications for control of dengue transmission in this urban setting where much of the focus has been on indoor mosquito breeding and transmission. Public health officials may find the disease-environment map useful for planning targeted interventions because it displays areas where transmission is most intense.

Aedes↗