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Biomedical subjects

R R Frerichs

Publications and source records attributed to R R Frerichs.

84 records · Page 5Linked to original sources
PubMed1976

Serum lipoprotein profile in children from a biracial community: the Bogalusa Heart Study.

Serum lipoprotein profiles in 3182 children, ages 5-14 years, were studied in a biracial community as part of the Bogalusa Heart Study to describe the early natural history of atherosclerosis. White and black children showed similar mean levels of beta-lipoproteins. Pre-beta-lipoprotein levels, however, were significantly higher in white shildren, while significantly higher levels of alpha-lipoprotein were found in black children. Girls had generally higher levels of beta- and pre-beta-lipoprotein and lower levels of alpha-lipoprotein than boys, although the differences were not significant at each age group. With age there was little change in alpha-lipoprotein levels, a significant increase in pre-beta-lipoprotein levels and a slight but significant decrease between 11 and 14 years in beta-lipoprotein levels. The correlation of alpha-lipoprotein was negative with beta-lipoprotein and, to a greater extent, with pre-beta-lipoprotein. The above inverse relationships were significantly greater in white children than in black children, suggesting differences in lipoprotein profiles in the two groups. Lipoprotein values from a total community study are now available for comparison with the currently recommended upper normal limits for lipoproteins. Since only a very small percentage of children could be considered as hyperlipoproteinemic by those specific levels in this community, we suggest that distributions and percentiles be used to evaluate children for hyperlipoproteinemia.

Adolescent↗
PubMed1976

Studies of blood pressures in children, ages 5-14 years, in a total biracial community: the Bogalusa Heart Study.

Blood pressure, height, weight, maturation, triceps skinfold thickness, serum lipids, and hemoglobin were measured as risk factors for coronary artery disease in 3,524 children (93% of the eligible population) in Bogalusa, Louisiana. Nine blood pressures were taken on each child by trained observers with mercury sphygmomanometers (Baumanometer) and Physiometrics automatic recorders in a rigid randomized design in a relaxed atmosphere with other children present. The pressures observed were low compared to reported data. Black children had significantly higher blood pressures than white children. This difference, starting before age 10, was largest in the children in the upper five percent of the pressure ranks. Stepwise multiple regression analysis revealed that this racial differnce was significant when measured by an automatic recorder. Body size, expressed by height and by weight/height3 index, was a strong determinant of blood pressure level. Other positive determinants were blood hemoglobin and external maturation.

Adolescent↗
PubMed1975

Serum lipid and lipoprotein profile in school children from a rural community.

In 447 school children 5--16 years old, in one community, serum lipid and lipoprotein levels were estimated, including total cholesterol, triglycerides, beta- and pre-beta-lipoprotein cholesterol, alpha-lipoprotein cholesterol, and the serum concentrations of beta-, pre-beta-, and alpha-lipoproteins. Mean serum cholesterol of the entire group was 188 mg/100 ml, and alpha-lipoprotein cholesterol constituted 68 mg/100 ml of this total. The levels of serum triglycerides (48.9 mg/100 ml) and pre-beta-lipoprotein (39.8 mg/100 ml) are low in children in comparison to adults. Except for pre-beta-lipoprotein levels, there was very little correlation between age and all lipids and lipoproteins in this age span. Slight differences in values were noted at certain age intervals, but there were no significant differences in values between sexes. These observations emphasize the need for evaluating lipid abnormalities in individual children by quantitating specific serum lipoproteins.

Adolescent↗
PubMedDate not supplied

Comparison of saliva and serum for HIV surveillance in developing countries.

Saliva has been proposed as a non-invasive alternative to serum for HIV antibody testing. In a field study in Myanmar (formerly Burma), we evaluated such an alternative to identify the frequency of HIV infection in a surveillance programme of high-risk and low-risk sentinel groups. Duplicate vials of saliva and serum were collected from 479 high-risk and 1039 low-risk subjects. One vial of each pair was analysed blind in two laboratories, one in the USA and the other in Myanmar. The US laboratory followed WHO confirmatory strategy III with three different enzyme-linked immunosorbent assays (ELISAs), while the laboratory in Myanmar followed strategy I with one ELISA. Serum testing in the US was the gold standard. The Cambridge ELISA with saliva was a more effective surveillance tool (sensitivity 90.5%, specificity 99.5-100%) for describing the frequency of subjects with HIV antibodies than the serum ELISA supplied to Myanmar by WHO (95.9% and 98.3%, respectively). Saliva is recommended as a safe and effective alternative to serum for HIV antibody testing with ELISA in surveillance programmes in developing countries.

AIDS Serodiagnosis↗
PubMedDate not supplied

Computer-assisted rapid surveys in developing countries.

Health surveys are an important source of population-based data in much of the developing world. Unfortunately, sample surveys often take more time to plan, process, and analyze than is practical, given the information needs of the local decision-makers. Rapid survey methodology (RSM) has been developed to permit health professionals to answer quickly questions about the health status and activities of people at the community level. These answers may be necessary for determining program priorities or for monitoring program activities. Rapid surveys are meant to supplement, rather than replace, information derived from existing sources of vital and health statistics data. RSM combines sample survey methods with contemporary software used in portable, battery-powered microcomputers. The ability to do rapid surveys in developing countries also requires knowledge of how to use appropriate computer hardware and software and how to apply cluster sampling theory in the local environment. RSM was used for the first time in Hlegu Township, Burma, to conduct a health survey of young children. The survey team started the field work on May 4, 1987. Four days later, while still in the field, the data were processed and rapidly analyzed by portable microcomputers for presentation to the local township medical officer and his staff. Within 10 days of starting the field work, we issued a detailed 50-page report of the study findings. This paper provides (a) a description of the components of rapid survey methodology, including the sample survey method, computer hardware, and computer software; (b) the general requirements for portable computer hardware in less developed regions of the world; (c) the procedures for doing a rapid survey; and (d) a summary of our experiences with RSM in Burma.

Developing Countries↗
PubMedDate not supplied

Simple analytic procedures for rapid microcomputer-assisted cluster surveys in developing countries.

Surveys are often deemed necessary in developing countries when routine sources of data are not considered adequate to answer important policy-related questions. Although field work often goes smoothly, many surveys become bogged down in the analysis stage. With the availability of microcomputers and contemporary software, investigators in developing countries can use rapid survey methodology (RSM) to process, analyze, and report survey findings more quickly than ever before. Presented in this paper are three simple analytic procedures for planning and doing two-stage, rapid cluster surveys. All were successfully used in three rapid surveys in rural regions of Burma and Thailand. By use of a spreadsheet and graphics software package, the three procedures (a) derive the first-stage selection of 30 cluster sites with probability proportionate to size, (b) calculate variance estimates and confidence limits for the parameters of interest and graphically present the findings as 90, 95, and 99 percent confidence intervals, and (c) estimate the necessary sample size for planning two-stage, rapid cluster surveys. The procedures can be used both in the field and in teaching workshops or courses on survey methods. Examples are given from three rapid surveys conducted in Hlegu Township, Burma, and Sisaket Province, Thailand. In both countries, local health professionals were first taught the methods in a 1-week workshop before they used the procedure for conducting the rapid computer-assisted surveys.

Analysis of Variance↗
PubMedDate not supplied

The effect of misclassification of diarrhoea on estimates of its occurrence, the identification of risk factors, and the assessment of prevention efforts.

Inaccurate assessment of true diarrhoea status introduces bias into estimates of its occurrence. A cross-sectional study of diarrhoea among 357 children in a rural Kenyan community found the sensitivity and specificity of the mother's report of diarrhoea to be 0.79 and 0.94 respectively, when compared to an independent observation of loose stool consistency. The observed diarrhoea prevalence of 9.5% overestimated the "true" prevalence estimated at 4.8%. With data on an exposure variable, lack of latrine ownership, an observed odds ratio of 2.0 (95% confidence interval (CI) 0.9-4.3) underestimated the "true" odds ratio of 5.4 (95% CI 2.0-14.5). Misclassification of diarrhoea can hinder the identification of communities of high incidence, the determination of risk factors for diarrhoea, and the evaluation of preventive intervention strategies. A precise definition and reliable means of measuring diarrhoea are critical for evaluating prevention or intervention efforts.

Child↗
PubMedDate not supplied

Training faculty in Bangladesh to use a microcomputer for public health: followup report.

In 1984 the Western Consortium for the Health Professions, Inc., under contract to the United Nations Fund for Population Activities (UNFPA), began a project to assist Bangladesh's National Institute for Preventive and Social Medicine (NIPSOM) in establishing a microcomputing capability. The project's goal was to enable NIPSOM to become self-sufficient in the analysis by microcomputer of health, population, and family planning data; program evaluation; and policy activities. Lack of a local microcomputer infrastructure demanded that a local team of experts be developed to run the system described in a previous report. Five NIPSOM faculty members--three of whom had taken the workshop held when the system was first installed--were assigned to a computer committee, which was responsible for the computer's well-being. Six months after the microcomputer system was installed, a second 2-week workshop was given. The consortium's consultant facilitated the development of a basic microcomputer course, which was taught by four members of the computer committee to an additional eight NIPSOM faculty members. Emphasis was placed on developing local self-reliance and the need to overcome obstacles imposed by the lack of local hardware and software support systems. A strategy is proposed for the successful introduction of microcomputers in developing countries.

Bangladesh↗
PubMedDate not supplied

Introduction of a microcomputer for health research in a developing country--the Bangladesh experience.

In November 1984, a powerful microcomputer was taken to Dhaka, Bangladesh, to aid health professionals at the National Institute for Preventive and Social Medicine (NIPSOM) in processing and analyzing locally derived health data. It was anticipated that this installation and an accompanying workshop on the analysis of health, population, and family planning data by microcomputer would enable the faculty at NIPSOM to share the results of their research with other public health and medical colleagues, provide administrators with timely analyses for policy or program implementation, and assist with internal management of information essential to the workings of the institute. This paper provides (a) a brief overview of NIPSOM and its recognized need for computing assistance, (b) a brief description of the 2-week workshop, (c) a description of the assembled software and hardware, and (d) a summary of the experience and the various problems encountered in bringing the computer to Dhaka and in teaching its use to educated health professionals with no prior computer contact.

Bangladesh↗