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Biomedical subjects

R Lalloo

Publications and source records attributed to R Lalloo.

At least 19 recordsLinked to original sources
PubMed2006

Dental specialist training in South Africa--demographic characteristics 1985-2004.

This short communication complements a recently published dental undergraduate analysis, and analyses the demographic profile of dental specialists trained from 1985-2004, as well as that of the registrars in training (in 2005). A total of 309 dental specialists were trained from 1985-2004, of these 86% were males and 74% White. Of the registrars, two-thirds are males and a quarter Black. The dental faculties and the Health Professions Council of South Africa (HPCSA) face a significant challenge to find innovative ways to address these disparities, as well as the urban/rural and private/public sector maldistribution of dental specialists, and to develop a more rational basis for training dental specialists for the country. Dealing with these disparities should improve access to dental specialist care for the poor and rural populations.

Education, Dental↗
PubMed2005

A review of paediatric maxillofacial injuries--a hospital-based study.

This study describes the patient profile with maxillofacial injuries attending a trauma unit at a children's hospital. A retrospective record-based analysis was carried out of children (less than 13 years of age) presenting with maxillofacial injuries from January 1991 to December 2001. Of the almost 90,000 trauma records, 13% of children presented with maxillofacial injuries. 60% were boys, with a quarter less than 3 years of age. Most presented with superficial lacerations and abrasions. The face (other than the facial bones) and the mouth/oropharnyx were most often injured. Injuries were mainly caused by falls from a variety of heights and transport-related injuries. Almost 60% of traffic-related injuries involved children as pedestrians being struck by a motor vehicle and 20% were cycle-related. Almost 70% of injuries occurred in or around their own home. Maxillofacial injuries in children are a significant cause of morbidity and its prevention especially in the home and streets needs urgent attention.

Age Distribution↗
PubMed2005

Gender and race distribution of dental graduates (1985-2004) and first year dental students (2000-2005) in South Africa.

This paper, written at the close of a decade of democracy in South Africa, sets out to analyse the demographic profile of dental graduates from 1985-2004 at the five Faculties/Schools of Dentistry in South Africa. A comparison of the profiles for the pre-democracy (1985-1994) and post-apartheid (1995-2004) periods has been made. The demographic profile of first year dental students from 2000-2005 is also presented. From 1985-1994, most dental graduates were male (79%), but this changed substantially from 1995-2004, with females comprising 46% of those graduating. In the pre-democracy period, more than three-quarters of all graduates were White (78%), decreasing to 46% in the post-apartheid period under review. Black graduates increased from 6% to 24% across the two study periods. Amongst the first year dental student intake from 2000-2005, females comprised 57%. There was an almost equal distribution across the White, Black and Asian groups. Dental faculties/schools have made important strides in transforming the demographic profile of their students. The percentage of Black graduates, however, needs to be significantly increased if it is to reflect the national population. Faculties/schools must further ensure that able students from working class background are identified and considered for acceptance into the undergraduate dental programme, and should then be offered the necessary academic and mentoring support to enable success.

Asian People↗
PubMed2005

Scientific. Risk of intraoral cancer associated with tobacco and alcohol--a case-control study.

OBJECTIVES: The study examined the role of tobacco, alcohol consumption and their synergistic effect on the aetiology of intraoral cancer. DESIGN: A hospital-based, analytical case-control study. SUBJECTS: Information was collected from 67 intraoral cancer patients attending a cancer unit (cases) and 67 controls attending other clinics in the same hospital. Cases and controls were individually matched for age, gender and ethnicity. METHODS: A structured interview was used to collect the data on items related to smoking status and alcohol consumption. RESULTS: The odds of developing intraoral cancer were 41 times (OR = 4.63; 95% CI: 1.74-12.30) higher for current smokers compared to non-smokers. The odds of developing intraoral cancer were eight times higher for past drinkers (OR = 8.59; 95% CI: 2.96-24.92) and current drinkers (OR = 8.54; 95% CI: 3.55-20.50) compared to non-drinkers. Consumers of both tobacco and alcohol were ten times more likely to develop intraoral cancer compared to those who do neither. CONCLUSIONS: The risk of intraoral cancer arising from use of alcohol and tobacco, icant. The findings of the study strongly endorse the rationale behind efforts by the South African government to implement strict tobacco legislation and campaign for responsible drinking.

Adult↗
PubMed2004

African countries propose a regional oral health strategy: The Dakar Report from 1998.

It is clear that the African region faces a number of serious oral diseases, either because of their high prevalence or because of the severe tissue damage or death that can occur. Previous approaches to oral health in Africa have failed to recognise the epidemiological priorities of the region or to identify reliable and appropriate strategies to assess them. Efforts have consisted of an unplanned, ad hoc and spasmodic evolution of curative oral health services. This document focuses on the most severe oral problems that people have to live with like noma, oral cancer and the oral consequences of HIV/AIDS infection. It proposes a strategy for assisting member states and partners to identify priorities and interventions at various levels of the health system, particularly at the district level. The strategy aims at strengthening the capacity of countries to improve community oral health by effectively using proven interventions to address specific oral health needs. The strategy identifies five main 'programmatic areas', including (i) the development of national oral health strategies and implementation plans, (ii) integration of oral health in other programmes, (iii) delivery of effective and safe oral health services, (iv) regional approach to education and training for oral health, and (v) development of effective oral health management information systems. Many of the programmatic areas share similar characteristics described as a 'strategic orientation'. These strategic orientations give effect to the concepts of advocacy, equity, quality, partnership, operational research, communication and capacity building. The WHO Regional Committee for Africa (RC) is invited to review the proposed oral health strategy for the African region for the period 1999-2008 and provide an orientation for the improvement of oral health in member states in the region.

Africa↗
PubMed2004

Profile of children with head injuries treated at the trauma unit of Red Cross War Memorial Children's Hospital, 1991 - 2001.

OBJECTIVE: To describe the profile of childhood head injury patients treated in a trauma unit. DESIGN: A retrospective record-based study. SETTING: The trauma unit of the Red Cross War Memorial Children's Hospital. SUBJECTS: Children (under 13 years of age) presenting with head injuries between January 1991 and December 2001. RESULTS: Of the almost 94 000 records, more than one-third were children presenting with head injuries. Fifty-nine per cent were boys, with more than half the sample under 5 years of age. The majority of children presented with superficial lacerations and abrasions, mostly affecting the scalp and skull. Injuries were mainly caused by falls from a variety of heights, and traffic-related injuries. Almost two-thirds of traffic-related injuries involved children as pedestrians being struck by a motor vehicle. More than 60% of injuries occurred in or around the child's own home. CONCLUSIONS: Head injuries in children are a significant cause of morbidity. Prevention, especially in the home and on the streets, needs urgent attention.

Accidental Falls↗
PubMed2004

Access to health care in South Africa--the influence of race and class.

OBJECTIVES: The first democratic government elected in South Africa in 1994 inherited huge inequities in health status and health provision across all sections of the population. This study set out to assess the impact of the new government's commitment to address these inequities and implement policies to improve population health in general and address inequalities in health care in particular. DESIGN: A 1998 household survey assessed many aspects of health delivery, including their own perceived and actual access to health care among different segments of South African society. RESULTS: Race was the main predictor of perceived changes in access to health care, with black, coloured-and Indian respondents significantly more likely to feel that access had improved since 1994, compared with white respondents. Socio-economic status (SES) was the main predictor of actual access to health care, with low and middle SES classes significantly less likely to access care when ill. CONCLUSIONS: One-third of respondents perceived health care access to have improved between 1994 and 1998, and this response was partially determined along racial lines. About one-quarter reported an inability to access health care when they required it, and this response was partially determined along socio-economic lines. This set of contrasting responses suggests that at a political level perceptions are largely influenced by race, but at the operational level actual access is influenced by SES.

Adult↗
PubMed2003

Oral diseases and socio-economic status (SES).

OBJECTIVE: To determine the association between social, economic and behavioural risk factors and national prevalences of: oral cancer, dental caries (12-year-olds) and destructive periodontal disease (35-44-year-olds). DATA SOURCES: Sources for the social and economic parameters were the UN Development Program; the behavioural risk factors' source was the World Health Organization, the UN Food and Agricultural Organization and the World Atlas of History. Oral diseases data came from UICC Globocan and the World Health Organization databases. DATA EXTRACTION: Data were extracted by hand from official publications. DATA SYNTHESIS: Data were synthesized and analyzed in sequence using SPSS, Pearson's correlation coefficient and multiple regression analyses. CONCLUSIONS: There is a discernable association between the three oral diseases and the variables selected, which varies in strength, being strongest for chronic destructive periodontitis and weakest for oral cancer. Dental caries lies in between. The degree to which variables account for differences in the three oral diseases between the countries studied is striking, being insignificant for oral cancer incidence, modest for oral cancer mortality, stronger for dental caries and strongest for destructive periodontal disease. Removing variables with strong co-linearity with the Human Development Index has little effect on the regression coefficients.

Adult↗
PubMed2003

Behavioural characteristics and accidents: findings from the Health Survey for England, 1997.

This study analysed the relationship between major and minor accidents, and major accidents involving a moving vehicle, and behavioural and emotional factors in children, aged 4-15 years, using the Strengths and Difficulties Questionnaire (SDQ), and adjusting for demographic, socio-economic and family type factors. Data from a large representative national sample of about 6000 children were analysed using simple and multiple logistic regression. The analysis shows that the prevalence of SDQ scales, such as hyperactivity and conduct disorder were significantly higher in boys, lower social classes and step- and single-parent families. After adjusting for the demographic, socio-economic and family type factors, children who scored borderline or high for hyperactivity were almost two times more likely to report having major accidents. Children who scored high for hyperactivity and emotional symptoms were one and a half times more likely to report having minor accidents. For major accidents involving moving vehicles, the relationships with the behavioural and emotional factors were generally stronger than for major accidents in general. Hyperactivity, in particular, was significantly associated with the occurrence of major and minor accidents, and major accidents involving moving vehicles. The behavioural risk factors were significantly more common in the lower social classes, families receiving benefits and step- and single-parent families.

Accidents↗
PubMed2000

A retrospective analysis of gunshot injuries to the maxillo-facial region.

This study analysed the prevalence, demography, soft- and hard-tissue injury patterns, management and complications of gunshot injuries to the maxillo-facial region in 301 patients treated at Groote Schuur Hospital, Cape Town. The number of patients presenting with maxillo-facial injuries caused by gunshot increased over the 15-year study period. The majority were caused by civilian type low-velocity hand-guns and were purposefully and intentionally inflicted by others. Males in their third decade of life and of low socioeconomic status were most often the victims. The wounding effects of these low-velocity injuries were characteristic--small rounded entrance wounds, causing fragmentation of teeth and comminution of the underlying bone, usually without any exit wounds. A comminuted displaced type of fracture pattern was most frequently observed. Special investigations included plain film radiographs with more sophisticated investigations being requested where indicated. Definitive surgical management was initiated by early soft-tissue debridement. Both the mandibular and maxillary fractures had more open than closed reductions. Bone continuity defects as a result of the initial injury were usually reconstructed secondarily using free autogenous bone grafts. All the patients received anti-tetanus toxoid on admission and the majority received antibiotic treatment. The most common complications were sepsis, ocular and neurological complications and limitation of mouth opening. The postoperative sepsis rate was high (19%). The wounding effects of these low-velocity missile injuries are devastating and pose a treatment challenge to the maxillo-facial surgeon.

Adolescent↗
PubMed1999

Dental caries, socio-economic development and national oral health policies.

A relationship between a population's level of socio-economic development and dental caries has often been assumed. Proxy measures such as sugar consumption have been used to reflect this. This study tests the hypothesis that there is a relationship between dental caries and the level of socio-economic development, using recent international data. It goes on to explore the implications of this relationship for the development of national oral health policies. Dental caries data was obtained from the WHO, Global Oral Epidemiology Data Bank for the period 1981-1996. Socio-economic data was obtained from the United Nations Development Programme (UNDP). Countries were ranked according to the Human Development Index (HDI) and their GNP. The study confirms the existence of a relationship between dental caries and development. Caries is a good proxy measure for socio-economic development. Countries in the throes of socio-economic transition have the highest DMFT scores.

Child↗
PubMed1999

A comparison of service profiles in alternative dental care delivery systems.

The financial crisis within the health care sector has resulted in the search by medical benefit funds of worker organisations for cost-effective alternatives to the private health care sector. This study compares the profile of services rendered to members of a union medical benefit fund by an 'in house' dental clinic and private dental practitioners. A total of 2,858 union clinic claims and 10,811 private practitioner accounts were selected. Each treatment code was categorised into either preventive, restorative, extraction or denture services. For the union clinic and private dental practitioners a total of 3,021 and 15,853 treatment codes respectively were included in the analysis. Significant differences were found in the profile of services rendered by the union clinic and private dental practitioners. The union clinic provided predominantly preventive and denture-related treatment compared with private practitioners who provided mainly preventive and extraction services. Members and their dependants are far more likely to have dentures made through the dental clinic (the odds of having dentures made at the clinic were 4.67 times the odds of having dentures made through private practitioners). On the other hand, members were more likely to receive all the other services (restorative, preventive and extractions) from private practitioners. However, the nature of the study design and the findings do not allow conclusions to be drawn regarding whether these differences were due to demand or supplier influences.

Dental Clinics↗