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P B Fourie

Publications and source records attributed to P B Fourie.

34 records · Page 2Linked to original sources
PubMed1995

Respiratory tuberculosis in childhood: the diagnostic value of clinical features and special investigations.

During a 16-month period children presenting to a pediatric outpatient facility from an area with a high tuberculosis incidence (> 400/100,000) and suspected of having respiratory tuberculosis (TB) were evaluated for close contact with adult pulmonary tuberculosis, weight loss, symptom duration, respiratory signs, lymphadenopathy and hepatosplenomegaly and by chest radiography and tuberculin testing (Mantoux or tine). Probable tuberculosis was diagnosed in 258 children and was confirmed in 109 (42%) patients with a mean age of 31 months by culture of Mycobacterium tuberculosis from gastric aspirate or another source. Eleven children with confirmed TB had a normal chest radiograph. After review of special investigations, clinical course and follow-up of the remaining 149 children, 86 children (58%) with a mean age of 32.4 months were considered to have probable TB and 63 (42%) with a mean age of 27 months not to have TB. Significantly fewer children in the "not TB" group than in the confirmed and probable TB groups had a close adult pulmonary tuberculosis contact (13 (21%) and 95 (49%), respectively; P < 0.01). There was no difference between the "not TB" group and the confirmed and probable TB groups in the proportion presenting with weight loss, cough or other respiratory symptoms, a symptom duration > 2 weeks, the presence of bronchial breathing, wheeze, hepatomegaly or splenomegaly or peripheral lymphadenopathy. Final diagnoses in the "not TB" group included bacterial or viral pneumonia or bronchopneumonia in 37, asthma often accompanied by segmental collapse in 9 and cavitating pneumonia in 3 children.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1992

Childhood tuberculosis and tuberculous meningitis: high incidence rates in the Western Cape of South Africa.

In recent years higher incidence rates of tuberculosis (TB) have been reported from the Western Cape than from other health regions of South Africa. In contrast to the various pulmonary forms of tuberculosis, tuberculous meningitis (TBM) always requires hospital admission, and can thus be used as an indicator of the extent of the infection in a community, as well as providing a measure of the effectiveness of primary and secondary preventive measures. In the present study an attempt was made to identify all cases of tuberculous meningitis aged 14 years and younger which occurred in the region, by checking notifications and the records of all hospitals, and verifying diagnosis against set criteria. Rates for the entire period were calculated according to updated census data. There was a total of 689 confirmed cases, of which only 55% had been notified. Of the 238 cases confirmed in the 3-years period, 1985-1987, 25.2% were under 1 year, 51.7% under 2 years, and 79.8% under 5 years of age. Age-specific incidence per 100,000 children were respectively 31.5 (0-1 years), 17.1 (1-4 years), 4.8 (5-9 years), and 0.7 (10-14 years). Rates in rural areas were far higher than in metropolitan regions. Utilizing tuberculin test data and total notifications, the following risks could be calculated for 'Coloured' children (of mixed race) aged 0-4 years: 2-3% annual risk of infection; 15.7% risk of TB in infected population; 0.5% risk of TBM in infected population; 0.9% risk of TB in children aged 5-14 years; 0.01% risk of TBM in children aged 5-14 years.

Adolescent↗
PubMed1990

Adjunctive therapy with bromocriptine in Parkinson's disease.

Patients with moderately severe Parkinson's disease complicated by the adverse effects of chronic levodopa use benefited from the addition of bromocriptine (Parlodel; Sandoz) in doses up to 26 mg daily, which allowed an approximate 30% reduction of levodopa dose. This resulted in a significant decrease in the amount of levodopa side-effects while maintaining or improving the original parkinsonian clinical stage. Increased effectiveness in these patients was not associated with increased dosage beyond 25-30 mg daily. When the doses of bromocriptine were increased slowly, the adverse reactions were minor and usually transient.

Adult↗
PubMed1987

Ethical issues in epidemiological research.

Ethical concerns pervade all aspects of epidemiological investigations. Ethical issues, including planning, carrying out, analysing and presenting the results of a study, are discussed. In southern Africa, where many community-based epidemiological surveys are undertaken, issues relating specifically to the conduct of such studies are especially relevant. These include informed consent, confidentiality and privacy.

Epidemiologic Methods↗
PubMed1987

BCG vaccination and the EPI.

BCG vaccination for newborns has been compulsory by law in the RSA since 1973. From limited published information, it appears that coverage has now reached more than 80%. However, the effectiveness of the vaccinations in terms of disease prevention in the young is unknown. Small studies indicate protection of approximately 60% against all forms of tuberculosis in infants, but this figure is not generalisable. It is pointed out that the contribution of BCG vaccination to an overall decline of tuberculosis rates is minimal and should not be considered as a measurement of success of the EPI. The prevalence and risk of infection in southern African children is such that a policy of reduction or withdrawal of BCG vaccination from some sections of the community is not feasible. The current strategy of compulsory BCG vaccination at birth, followed by repeat vaccination 3 months later in children without evidence of reactivity at the vaccination site, as well as revaccination at school entry and school leaving, is both adequate and necessary. A standardised immunisation data recording format and full exchange of information at all decision-making levels between the EPI and the tuberculosis control programme is called for.

Adolescent↗
PubMed1986

A population study on rheumatoid arthritis in Lesotho, southern Africa.

Motivated by the results of a hospital study on rheumatoid arthritis (RA) in Lesotho (southern Africa) a survey of inflammatory polyarthritis (IP) and RA was undertaken in a sample of the rural population of that country. Contrary to expectations the prevalence of IP grades 2-4 (definite disease) was low (0.4%) and equal in both sexes, while probable and definite RA combined (American Rheumatism Association (ARA) criteria) occurred in 1.8% of both males and females. RA was slightly more severe than in other rural African Negro studies but less so when compared with the disease condition of the patients observed in the hospital study. Rheumatoid factor and particularly that directed against heterologous antigen occurred in 41% of the RA patients and in 16% of the controls. Two thirds of the definite cases and 29% of the combined probable and definite group showed radiological abnormalities.

Adult↗
PubMed1983

Patterns of tuberculin hypersensitivity in South Africa.

The frequency distribution patterns displayed by delayed hypersensitivity responses to 170 000 low-dose RT 23 Mantoux tests, measured as induration sizes, were determined for the South African population under 19 years of age. There were wide differences between the results obtained in different age groups and also between those obtained in different geographical regions. Nonspecific hypersensitivity to the tuberculin test, probably arising from nontuberculous mycobacterial infections and particularly BCG vaccinations, is generally high, hampering the calculation by commonly used methods of the sizes of reactor components. In South Africa a high degree of specificity of the tuberculin test may nevertheless be found in children aged 5-9 years who have no BCG scars.

Adolescent↗
PubMed1983

The prevalence and annual rate of tuberculous infection in South Africa.

The prevalence and incidence rates of tuberculous infection were calculated from 170 000 Mantoux test results gathered by the Tuberculosis Research Institute between 1974 and 1980 and also from tuberculin survey results from other sources covering the periods 1944-45 and 1953-54. Prevalence rates in 10-year-olds were generally low in the Asian and White groups, less than 5% at present, and fairly high in the Coloured and Black groups, whose rates ranged from 10% to 20%. Very little difference was found between the prevalence rates of the urban and rural populations in any of the age groups surveyed, but as a rule higher rates were found in lowland (mostly coastal) than in highland regions. An overall annual decrease over the past 25-30 years of 5% in the infection rates of Blacks and Coloureds was estimated, and of 7% and 8% in Asians and Whites. However, it is suggested that these downward trends have increased progressively in all ethnic groups in South Africa in recent years, but that annually they do not exceed 13%. Annual rates of infection in 7-year-olds were expected to reach 1-2 per 1000 Blacks by 1982. One tuberculous infection annually per 1000 population may be considered sufficiently low for the disease to be regarded as of minimal importance. In South African Whites this level has already been reached and it is expected to be in Asians within the next 5-10 years. In Coloureds and Blacks another 20 to 30 years will have to pass before this level is reached.

Adolescent↗
PubMed1983

Mycobacterium tuberculosis in a closed colony of baboons (Papio ursinus).

An outbreak of tuberculosis in a nonhuman primate colony involved 11 of 91 (12.1%) baboons (Papio ursinus). Tuberculin tests identified 80%, X-ray screening 10% and throat swab bacteriology 30% of diseased animals. Cough was a misleading indicator of tuberculosis. Stress resulting from experimental interference with animals was unrelated to disease development. Twice as many females as males were attacked. Screening and prophylactic, therapeutic and preventive measures are discussed.

Animals↗
PubMed1981

Tuberculosis prevalence survey in the Daveyton (Benoni) urban black community.

A sample of urban Blacks from Daveyton, Tvl, randomly selected to fully represent the parent community, was investigated for bacteriological prevalence of chest abnormalities associated with tuberculosis among adults, as well as for hypersensitivity to tuberculin in children. Radiological evidence of tuberculous lesions was demonstrated in 4.8% of subjects, half of whom were regarded as active cases. In the light of a bacteriological prevalence of 0.7% the radiological prevalence may be an overestimate, particularly since the 1978 incidence rate according to notification figures tends to support the prevalence survey estimates.

Adolescent↗
PubMed1980

Follow-up tuberculosis prevalence survey of Transkei.

After 5 years a follow-up prevalence survey was conducted in Transkei on a randomly selected sample of the rural population. The parameters investigated were bacteriological prevalence of tubercle bacilli in sputum, radiological prevalence of chest abnormalities associated with tuberculosis in adults, and hypersensitivity to tuberculin in children. Bacteriological positivity was 2.1% on smear microscopy and 4.3% on culture. Radiological evidence of tuberculosis was demonstrable in 12.5% of subjects, of whom 8.7% were considered active and 3.8% inactive. The mean prevalence of tuberculin positivity according to the Mantoux test was 30.1%. An annual risk of infection of 4% was calculated, showing a continuous decrease of 5% per year on the 7% risk of infection encountered in 1972. Compared with the first survey, a general reduction in prevalence of tuberculosis is evident.

Adolescent↗
PubMed1978

Tuberculosis in laboratory animals.

Tuberculosis can cause great losses in captive colonies of various animal species. In South Africa the culprit is the human type of tubercle bacillus. Interspecific transmission of tuberculosis infection amongst laboratory animals, notably primates, is known to occur, and often handlers and caretakers act as the source of infection. The need for preventive measures in laboratory colonies and procedures for case finding and treatment of tuberculous animals are discussed. Indiscriminate destruction of diseased animals is opposed. The South African situation as revealed by questionnaire survey is described.

Animals↗